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Identifying stakeholder behaviors for competency-based pharmacy education: A stage 1 behavior change wheel analysis
Denise H Rhoney1, Aleda M H Chen2, Kimberly K Daugherty3
1UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB 7574, Chapel Hill, NC, 27599-7574, USA.
Research in Social & Administrative Pharmacy : RSAP
|June 19, 2026
Summary
Implementing Competency-Based Pharmacy Education (CBPE) requires understanding faculty and learner behaviors. This study used the Behavior Change Wheel (BCW) to identify key behaviors and barriers for successful CBPE transformation.
Area of Science:
- Pharmacy Education
- Behavioral Science
- Health Professions Education
Background:
- Competency-Based Pharmacy Education (CBPE) is crucial for preparing adaptable pharmacy graduates.
- Implementation challenges often stem from behavioral factors among stakeholders.
- Understanding these behaviors is key to successful CBPE adoption.
Purpose of the Study:
- To apply Stage 1 of the Behavior Change Wheel (BCW) framework.
- To identify specific stakeholder behaviors and their determinants for CBPE implementation.
- To map these behaviors to the five core CBPE components.
Main Methods:
- Utilized a multi-method approach integrating the BCW, COM-B model, and Theoretical Domains Framework (TDF).
- Conducted a targeted literature review and structured focus groups with experts and stakeholders.
- Employed an iterative consensus process to map behaviors to theoretical constructs.
Main Results:
- Over fifty stakeholder-specific behaviors were identified across the CBPE framework.
- Common barriers included limited instructional design knowledge, inadequate infrastructure assessment, and misaligned professional identity.
- Key determinants involved knowledge, environmental context, beliefs about capabilities, and professional roles.
Conclusions:
- This Stage 1 BCW analysis provides a behaviorally informed foundation for CBPE implementation.
- Identified stakeholder behaviors and enabling conditions guide future intervention development.
- Findings support creating readiness-to-change assessments for scalable CBPE transformation in pharmacy education.
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