Responsibility and confidence

TLDR

Pharmacists report low confidence and responsibility in clinical decision‑making, a trend noted in observational studies but poorly understood. This exploratory study aimed to uncover reasons behind pharmacists’ lack of responsibility and confidence across practice settings. Semi‑structured interviews with 29 pharmacists (18 responded) covered seven questions on responsibility and confidence, and transcripts were thematically analyzed with supporting quotations. Six barriers—hierarchical medical structure, unclear role definitions, evolving responsibility, decision ownership, mentorship quality, and personality traits—were identified, highlighting practical implications for education and practice, though findings should be interpreted cautiously due to bias and small sample size. Can Pharm J 2013;146:155‑161.

Abstract

Despite the changing role of the pharmacist in patient-centred practice, pharmacists anecdotally reported little confidence in their clinical decision-making skills and do not feel responsible for their patients. Observational findings have suggested these trends within the profession, but there is a paucity of evidence to explain why. We conducted an exploratory study with an objective to identify reasons for the lack of responsibility and/or confidence in various pharmacy practice settings.Pharmacist interviews were conducted via written response, face-to-face or telephone. Seven questions were asked on the topic of responsibility and confidence as it applies to pharmacy practice and how pharmacists think these themes differ in medicine. Interview transcripts were analyzed and divided by common theme. Quotations to support these themes are presented.Twenty-nine pharmacists were asked to participate, and 18 responded (62% response rate). From these interviews, 6 themes were identified as barriers to confidence and responsibility: hierarchy of the medical system, role definitions, evolution of responsibility, ownership of decisions for confidence building, quality and consequences of mentorship and personality traits upon admission.We identified 6 potential barriers to the development of pharmacists' self-confidence and responsibility. These findings have practical applicability for educational research, future curriculum changes, experiential learning structure and pharmacy practice. Due to bias and the limitations of this form of exploratory research and small sample size, evidence should be interpreted cautiously.Pharmacists feel neither responsible nor confident for their clinical decisions due to social, educational, experiential and personal reasons. Can Pharm J 2013;146:155-161.