Addressing Hidden Curricula That Subvert the Patient-Centeredness "Hub" of the Pharmacists' Patient Care Process "Wheel"

解决阻碍药剂师以患者为中心的患者护理流程“轮”中“中心”的隐性课程

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Abstract

Objective. This systematic review's purpose is to improve clarity for the meaning of patient-centered care in the JCPP Pharmacists' Patient Care Process and to provide an initial foothold for faculty to address "hidden curricula" that undermine the concept. Our corresponding objectives were to identify and describe the conceptualizations defining patient-centered care from the pharmacy literature; and compare the meaning of patient-centeredness in the pharmacy literature with the construct's seminal conceptualizations from other professional groups.Findings. The search protocol produced 61 unique sources from the pharmacy literature. More than two-thirds of these results lacked precise use of terminology consistent with the literature or operational depth or theoretical exploration of the term's meaning. The remaining sources yielded two separate conceptualizations of patient-centeredness with three commonalities but key differences between their grounding in the construct's seminal sources in the broader health care literature.Summary. The pharmacy literature clarifies the meaning of patient-centered care in the patient-pharmacist encounter, but additional understanding is needed at meso- (ie, health care) and macro-levels (ie, legislation, accreditation, payment, workforce dynamics) of care. This expansion of understanding may reduce dissonance between the formal and hidden curricula on patient-centeredness associated with health professional student disillusionment, contempt for faculty and institutions, and reductions in empathy and ethics. Increasing use of integrative case-based training, equitably blending patient-centeredness considerations with other curricular content, represents one strategy for reducing the presence and negative impact of hidden curricula.

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