Cultivating Inclusive Learning Environments in Pharmacy Education: A Threefold Approach

Suzanne C. Harris, PharmD, clinical pharmacist practitioner in psychiatry, associate professor and Director of Well-being and Resiliency, Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Pharmacy education plays a pivotal role in shaping the future of health care professionals. As pharmacy educators, it is our responsibility to create an inclusive and supportive learning environment for all learners, regardless of their background or experience. Inclusive learning refers to teaching practices that are equitable and accessible for all learners.¹ Inclusive teaching practices ensure that every learner has the opportunity to participate, pose ideas, construct knowledge, see personal connections to the topic, and feel welcomed into intellectual discussions.

The basis of inclusive learning is respecting and accommodating the diversity of learners. Research has shown that embracing diversity and inclusion in the health care environment also has the potential to improve patient outcomes and equitable access to care.² Although diversity, equity, and inclusion (DEI) has been identified as critical in higher and health professions education, there is still a need for training educators on how to build an inclusive learning environment. ^3,4 In this article, we will explore three essential themes related to inclusivity in pharmacy education: 1) how to create and set the stage for inclusivity, 2) staying informed on the topic to impact teaching, and 3) managing topics of inclusion in different learning environments and diverse learners.

Creating and Setting the Stage for Inclusivity

Inclusivity in pharmacy education goes beyond mere acceptance of diversity; it involves actively creating an environment where every learner feels valued and respected. ^5,6 To achieve this, consider the following strategies:

1. Cultivate a Respectful Learning Environment: Begin by fostering a culture of respect within the classroom or rotation. Encourage open dialogue and active listening, ensuring that all voices are heard. Establish ground rules that emphasize the importance of respectful communication and the acknowledgment of diverse perspectives.
2. Diversify Content: Integrate a variety of perspectives and examples into your teaching and precepting to reflect the diversity of the pharmacy profession and patient populations. Utilize case studies, diverse instructors or team members, and real-world scenarios that encompass different cultural, social, and economic backgrounds. Create opportunities in content or topics to address health care disparities, stigma, cultural perceptions, or ethnic-related factors that may impact medications (ie, polymorphisms).
3. Implement Inclusive Teaching Practices: Ensure course or rotation expectations are clear and evaluate the performance of learners with equivalent criteria. Triangulate knowledge by utilizing inclusive teaching methods that cater to various learning styles. Incorporate interactive activities, group work, and technology to engage learners with diverse preferences and abilities. Recognize and accommodate different learning needs to ensure that all learners can thrive.
4. Provide Resources for Support: Recognize that learners may come from various backgrounds and may require different types of support. Consider including resources in your syllabus or rotation description such as mental health or well-being services, mentorship programs, and academic assistance for students, to address the unique needs of each learner.

Keeping Up on the Topic to Impact Teaching

Staying informed on inclusivity in pharmacy education is crucial for effective teaching and continuous improvement. National organizations have begun to encourage the incorporation of DEI concepts addressing social determinants of health, unconscious bias, health disparities, and cultural competence into health care professional curricula, as well as in continuing professional education requirements.^7,8 As educators, it is essential to remain up-to-date on the latest research, best practices, and evolving perspectives on inclusivity. Here are some strategies to achieve this:

1. Engage in Continuous Professional Development: Attend workshops, conferences, and seminars that focus on diversity, equity, and inclusion in education. Participate in relevant webinars and training sessions to enhance your knowledge and skills in creating inclusive learning environments.
2. Join Professional Organizations: Engage in professional organizations that prioritize inclusivity in pharmacy education. These organizations often provide resources, networking opportunities, and forums for discussing best practices in creating inclusive curricula.
3. Collaborate with Colleagues: Foster a culture of collaboration among pharmacy faculty and preceptors. Share experiences, resources, and strategies for promoting inclusivity in the learning environment. Collaborative efforts can lead to innovative approaches that benefit the entire learning community.
4. Stay Informed on Legislative Changes: Be aware of any changes in legislation or accreditation standards related to diversity and inclusion in pharmacy education and practice. Create awareness and ensure alignment with your teaching practices, when appropriate.

Managing Diversity in the Learning Environment

Teaching a diverse group of learners is both a challenge and an opportunity. Understanding and meeting diverse needs stems from being culturally competent—a set of congruent behaviors, attitudes, and policies that come together in a system or among professionals and enable them to work effectively in cross-cultural situations.⁹ Effectively managing diversity requires a proactive and thoughtful approach, with potential strategies outlined below.^5,6,10-13

1. Understand and Respect Differences: Recognize that learners may come from various cultural, socioeconomic, and educational backgrounds. Take the time to understand and respect these differences, creating an environment where people feel acknowledged and valued. Know yourself (i.e., practice self-awareness), and get to know your learners and colleagues holistically.
2. Adapt Teaching Styles: Be flexible in your teaching approach and offer experiences to accommodate the level of learner, diverse learning styles, and preferences of your learners. Use a variety of instructional methods and provide options for activities and assessments to ensure that all learners can succeed. For residents, encourage discussions surrounding their observations of how preceptors model inclusive teaching and how that impacts how they want to teach, mentor, or precept younger learners.
3. Encourage Inclusive Communication: Foster open communication by encouraging learners to share their perspectives and experiences. Create a learning environment where people feel comfortable expressing their thoughts without fear of judgment. Encouraging vulnerability among educators and learners doesn’t mean no boundaries or oversharing; the goal is to be more approachable and relatable with learners. Ask learners to share what they have observed on their previous rotations or when working in a pharmacy as it relates to diverse patient care experiences.
4. Be Aware of Non-Inclusive Communication: Use inclusive language that reflects the diversity of the learners and patients they may interact with. Are the terms you are using marginalizing versus centralizing, and are they using person-centered language? Recognize that terminology is ever evolving and consider asking the learners how they identify when it comes to race, pronouns, etc. Make efforts to pronounce learner names as they prefer. Acknowledge when you misstep in your journey for inclusive communication---you won’t get it right all of the time. Do not stop believing in your personal transformation.
5. Handle Difficult Interactions and Address Microaggressions Promptly: Microaggressions can undermine inclusivity in the learning environment. Address any inappropriate comments or behaviors by peers, teams, or patients promptly. See examples of microaggressions in the classroom.¹³ In a teaching setting, remind them of the ground rules and emphasize the importance of creating a respectful and inclusive learning environment. Microaggressions can also occur in patient care settings. For both, respond to the conflict in a manner that helps learners or patients become aware of the “learning moment” and the impact of microaggressions, to promote awareness and understanding. Debrief with the learner promptly.

• Use a AAA framework¹⁴ for difficult conversations with learners – 1) Acknowledge: Clearly communicate awareness of the issue, 2) Ask: Gather information and pay attention to verbal and non-verbal responses, and 3) Adapt: Agree to a plan moving forward and commit to ongoing dialogue.

As pharmacy educators in both the didactic and experiential settings, our commitment to inclusivity in education is integral to shaping a future generation of health care professionals who are culturally competent and compassionate towards their teams and the patients they serve. By actively creating and sustaining an inclusive learning environment, staying informed on best practices, and effectively managing diversity in our educational settings, we can contribute to the development of a pharmacy workforce that embraces the rich tapestry of our global community.

References

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