Learning-by-Doing: Learning through Performing the Role

The study identifies that there was no formal internship period for training newcomer pharmacists before starting the role. One respondent (P12) stated that they learned how to perform the role through “learning by doing”, which she referred to as learning how to perform the role by doing the role. The respondents summarised the processes through which pharmacists develop identity for their roles during the process of learning by doing as: 1) observing how their supervisors

and colleagues perform the role and imitating their role performance; 2) receiving feedback from supervisors and senior pharmacists; and 3) adjusting their role performances.

6.3.2.1 The Roles of Supervisor and Colleagues

Pharmacists’ mentors and senior colleagues are influencers of identity construction. The respondents revealed that their mentors and senior colleagues acted as role models who demonstrated appropriate behavioural traits that they chose to imitate. For example, one respondent explained the traits of her senior colleague which she perceived as appropriate for her role performance, and how she imitated such traits to perform her role:

At work, there is a senior pharmacist. She has expertise and experience. She is thorough and caring. I see how she works and I try to be like her

(P13).

It is evident that the respondents had also observed professional values in their supervisor and had internalised the values to develop their professional identity. This evidence is seen in both work contexts. For example, a respondent in a private drugstore mentioned that she did not sell drugs just to increase sales because she had learned to care about patient safety from her supervisor. She said:

Some customers requested antibiotics, and in most cases it was unnecessary for them to use antibiotics, especially in children. I won’t sell if I think the drug use is unnecessary, even though I could sell more

(P20).

She further explained that her supervisor influenced her thoughts about patient benefit. She said:

This kind of thing, I was taught by my senior. She told me to be concerned about safety first (P20).

With regard to pharmacists using mentors and senior colleagues as role models, the data show that the respondents did not always specify a particular person as a role model, but they selected useful traits and behaviours from many people and imitated those behaviours in performing their role.

I don’t have a particular role model. I observe how others solve problems or act and then I will choose what I think is good from many people (P11).

Another respondent also mentioned the role of her supervisor in her professional identity development, together with other people, especially her family. She said:

I learned from my previous supervisor. She acted like a lecturer. She nurtured professional value, gave me encouragement and gave me opportunities. So I have developed. But I also learned from many people. And I think part of it, I am the kind of person who would deal with a problem. I don’t like to ignore a problem. I think I am who I am because of my family (P01).

Mentors and senior colleagues also acted as social validators who provided feedback on the pharmacists’ practices. The respondents mentioned that they had received feedback from their mentor who trained them:

When I moved from the OPD to IPD, I was trained for the work of IPD. The head of the IPD department gave me training and she is the one who assessed my knowledge and skill and gave me feedback. If she found that I was not ready to work in terms of my knowledge for the IPD role, then I would have to train more for particular skills (P02).

Another respondent said:

My supervisor was good. She trained me at the beginning of my work. So it was useful because I got a chance to train in different service units of the pharmacy department and I also received feedback from her

(P08).

The respondents mentioned that they used feedback from their supervisor to adjust their role performance. For example:

I think it is OK to make a mistake. When I made a mistake, my supervisor corrected it. But what is important is that we learned from our mistakes because our mistakes might relate to the safety of patients. So I will not make the same mistake again (P01).

6.3.2.2 Role-Related Relationships

Pharmacists performing their roles always have role relationships with other roles. For example, in a hospital, pharmacists on the patient ward interact with doctors and nurses, as well as patients. They learn the meaning of the pharmacist role through interactions with the roles of others. Similarly, in a drugstore, pharmacists interact with patients/customers who seek health advice and products. Hence, through these interactions, pharmacists learn about the meanings of their role, as well as about others’ roles. For example, the interviews suggest that pharmacists learned about what other roles expected of their knowledge after they had been working for a period of time.

What doctors expect from us is they want to know whether we can make them an IV mixture for this individual patient. They don’t want us to judge them on their clinical decisions (P12).

From the above example, through working relationships with doctors on patient wards, the respondents gained an idea of what knowledge was required for their role.

Pharmacists also adjust their role performance by observing reactions from others. This was seen when pharmacists in public hospitals consulted doctors in a respectful way, resulting in gaining acceptance from doctors. For example:

We need good communication skills ... For me, I would rather have a face-to-face discussion than write a note because anybody can see a written note. It seems like I am pointing out their mistakes in public. And also, when you speak face to face, the other person knows the tone of your voice (P06).

This respondent had learned how to communicate effectively with doctors and it can be seen that her way of communicating was different from other pharmacists, as she chose to have face-to-face discussions.

On the other hand, pharmacists learned that their behaviour was not appropriate if they received negative responses from others. This study has found that

inappropriate behaviour leads to poor collaboration between pharmacists, as well as a loss of trust by doctors.

The problem is the doctors did not trust us [pharmacists]. Lately, they have called us due to many errors we made. Most of the mistakes were made by the newly graduated pharmacists (P01).

In summary, through role-related relationships between pharmacists and other roles, the pharmacists in this study learned the meaning of their role or came to know who they were as pharmacists by understanding what knowledge they were expected to be able to offer to doctors, and what approach they should use to contact doctors. Hence, the respondents developed professional identity through role-related relationships.