Introduction

Current trends in the expanding role of pharmacy professionals, the greater use of digital technologies in healthcare, and the development of cooperation within interprofessional groups dictate increased demands on the training of professionals with higher pharmaceutical education (pharmacists) [1-5]. Graduates must be equipped with the necessary knowledge, skills, and abilities to provide competent pharmaceutical care in an unstable, changing environment. The preparation of a competitive graduate in the specialty "Pharmacy" (specialist) in Russia is based on the formation of professional competencies [6]. These include preparation for solving tasks of professional activity of the following types: pharmaceutical, expert-analytical, organizational-managerial, control and resolution, and production and research. Professional competencies are developed based on professional standards [7-10], as well as concerning the requirements for graduates in the labor market, generalization of Russian and international experience, consultations with leading employers [6, 11-16]. In 2019 in Russia, professional competencies were presented in the Sample Basic Educational Program (SBEP) of the Federal Educational and Methodological Association in the system of higher education in the specialty "Pharmacy" (specialist) [17]. The SBEP includes 27 professional competencies, including 6 mandatory competencies (MPC) and 21 recommended competencies (RPC).

Currently, the SBEP is used in the system of higher pharmaceutical education as a tool to guide the development of basic educational programs of each higher educational institution and assess the formation of professional competencies in the specialty "Pharmacy" (specialist). Considering that the SBEP is a relatively new tool, obtaining data from pharmacy students on their perceptions of professional competencies can provide useful information regarding the clarity of key concepts and suggestions, as well as identifying gaps in their understanding of the roles and responsibilities of pharmacy students. While many stakeholders have contributed to the development of the SBEP and experienced practicing educators have supported the presented professional competencies, it is unknown whether the students-pharmacists consider the MPC and RPC relevant for their future work and are sufficiently prepared to perform them.

The objective of the work is to establish the opinion of students-pharmacists of different courses on the perception and degree of readiness to perform professional competencies (mandatory and recommended) presented in the SBEP for the specialty "Pharmacy" (specialist).

Materials and Methods

The study involved a survey in which students majoring in the specialty "Pharmacy" (specialist) were to participate. Respondents were searched on the portals: Surveys for pharmaceutical and medical universities, Surveys for doctors and pharmacists, VseOprosy, All-Russian portal for pharmacists and pharmacists, MedMnenie; on forums: Pharm-Community, Pharmedicine; in groups: Pharmstudent, Pharma Community, Pharma RF, Conversations about medicine and pharmacy on Facebook; on the platform for surveying students; on the site Katrenstil. The inclusion criteria for the survey were students currently enrolled in the 1^st-5^th year of the specialty "Pharmacy" (specialist), over 18 years of age, willing to participate in the survey. Participation was anonymous and voluntary. Respondents were fully aware of the purpose, nature, and potential benefits and risks of the survey. The survey was conducted following the principles stipulated in the Declaration of Helsinki and the ICC/ESOMAR international code on market, public opinion, social research, and data analysis [18].

The survey involved a total of 359 participants from 37 higher education institutions in Russia. The sample size was determined by time and resource constraints. The sample was drawn using a probability (random) stratified method. This was due to the aim of reducing the participation of respondents from large educational institutions or a particular year of study. For example, older students may be more likely to answer the questions posed; as a result, their response rate would be higher in the overall analysis. All survey participants were divided into five target cohorts (C1-C5), depending on their course of study.

The survey instrument, a structured questionnaire, consisted of three parts and contained 12 questions. The first part of the questionnaire focused on the characteristics of the respondents, the name of the higher education institution, the course of study, and the reasons why they chose the profession (6 questions). The second part of the questionnaire included 3 questions, 2 of which consisted of 27 items. The questions dealt with students' perception of professional competencies and their opinion on the formation of each MPC and RPC. The third part of the questionnaire summarized the satisfaction with the formed professional competencies, further plans for their application, and professional development (3 questions). The questionnaire was accompanied by a cover letter with information for the survey participants, including indicators of professional competence achievement in the specialty "Pharmacy" (specialist) from the SBEP [17]. The Likert scale was used in the answers to some questions of the questionnaire, and a "free text" field was applied for a deeper understanding of the respondents' opinions.

The questionnaire was preliminarily tested on 15 undergraduate students of the specialty "Pharmacy" (specialist) at the Sechenov First Moscow State Medical University. The purpose of the pilot study was to determine the time needed to conduct the survey, the technical feasibility of using the questionnaire and additional information in the web survey, and the clarity of the questions on the questionnaire and the cover letter. The final version of the questionnaire was used for the mass survey from April to June 2020. Codes were assigned to all questionnaires for tracking purposes and stored securely.

Data were statistically processed using SPSS.Statistics.v17.Multilingual-EQUiNOX (SPSS Inc). Study results were expressed either in absolute and relative values or in metric units such as median (Me), lower (25%), and upper (75%) quartiles (IQR), or mean ± standard deviation (M ± SD). Cross tabulations, Mann-Whitney tests, and Kruskal-Wallis tests were used to assess differences between target cohorts (C1-C5). The critical level of significance for statistical hypothesis testing in the study was 0.05.

Results and Discussion

Characteristics of survey participants

The number of respondents in each target cohort corresponded to the following: С1 – 70 1^st-year students, С2 – 72 2^nd-year students, С3 – 72 3^rd-year students, С4 – 71 4^th-year students, and С5 -74 5^th-year students. Women predominated among the respondents in each of the five cohorts: C1 – 72.2%, C2 – 77.1%, C3 – 73.6%, C4 – 78.9%, and C5 – 85.1%. The mean age of respondents in group C1 was 18.2 ± 0.8 years (Me 18, IQR: 17-19), in group C2 was 19.1 ± 0. 9 years (Me 19, IQR: 18-20), in group C3 – 20.2 ± 1.2 years (Me 20, IQR: 19-21), in group C4 – 21.4 ± 1.2 years (Me 21, IQR: 20-23), and in group C5 – 22.6 ± 1.4 years (Me 22, IQR: 21-24). The participants of the survey represented 11 large higher education institutions of Russia (with the number of students in the specialty "Pharmacy" in one course 100 or more) and 26 smaller educational institutions (with the number of students in one course less than 100). The proportion of respondents who had previously received secondary vocational education in the specialty "Pharmacy" corresponded in the C1 cohort – 24.3%, C2 – 29.2%, C3 – 22.2%, C4 – 28.2%, and C5 – 27.0%.

The choice of profession is one of the decisive factors in a student's professional development. It was relevant to identify the reasons that prompted the survey participants to choose the profession of a pharmacist. The results showed that the main factors in choosing a profession in all target cohorts were: dreaming of becoming a pharmacy specialist (about 60% of respondents with the possibility of choosing one or more answers), enrollment due to the advice of relatives and friends (about 40%), desire to help sick people and take care of the health of loved ones (about 30%), a sufficient score to enter the profession (about 30%). Therefore, the choice of future work activity for the majority of respondents had a rather clear orientation to the future profession.

Respondents' perceptions of professional competencies

The study of the perception of MPC and RPC by the survey participants included an assessment of the clarity of the interpretations, their topicality, relevance, necessity, and the degree of agreement with them. The evaluation was carried out on a 5-point scale.

There was a high level of agreement that the competencies were clear, relevant, and necessary (Me 5, IQR: 4-5) among the respondents on the overall MPC. The lowest level of perception in all target cohorts was for the competency "able to perform clinical laboratory investigations of the third category of complexity, including through the introduction of new research methods and techniques" (Me 4, IQR: 3-5). Differences in perceptual levels of MPC between student cohorts were not significant (p˃0.05).

The level of respondents' perception of RPC was in the range of 2-5 points (Table 1). The lowest scores were observed among the participants of the survey of the target cohorts C1 and C2 for the following professional competencies: RPC-9 (Me 2, IQR: 1-2 and Me 2, IQR: 1-3 respectively), RPC-12 (Me 2, IQR: 1-2 and Me 2, IQR: 1-3 respectively), RPC-16 (Me 2, IQR: 1-3 in cohorts C1 and C2) and RPC-20 (Me 2, IQR: 2-3 in cohort C1). The low level of perception of professional competencies among students of all courses was observed in RPC-1 and RPC-16 (Me 2-3). The most comprehensible, relevant, and topical professional competencies among the respondents of all target cohorts were RPC-2, RPC-5, RPC-6, RPC-7, and RPC-8 (Me 5). Significant differences in the levels of their perception of RPC-9 and RPC-12 were found among first- and fifth-year students (p<0.05).

The total sufficient number of MPC and RPC for professional activity in the specialty "Pharmacy" (specialist), according to the respondents, ranged from 10 (3.3%) to 27 (62.3%). The number of senior students (target cohorts C4 and C5) who perceived all 27 professional competencies to be in their future profession was equal in target cohort C4 – 66.2% and in target cohort C5 – 78.4%.

Respondents' perception of vocational competence development

To establish the formation of MPC and RPC, the participants of the survey were offered to use the indicators of achievement of professional competencies presented in the SBEP and the cover letter. The assessment of the competencies was carried out according to the Likert scale.

The results of the survey showed that the ability of respondents to independently perform each MPC, as would be expected, increases as their course of study increases (Table 2). Thus, the highest proportion of responses among students in the target cohorts C1 and C2 corresponded to "completely capable" (68-87%). Participants in the C3 cohort responded to questions about their readiness to perform the MPC as follows: "completely capable" 3-65%, "rather capable" 3-57%, "difficult to answer" 11-33%, "rather capable" 8-28%, and "completely capable" 0-64%. The results of MPC formation among senior students (target cohorts C4 and C5) are quite high. Thus, the proportion of respondents in cohort C5 who answered "completely capable" for professional competencies MPC-1, MPC-2, MPC-3, MPC-4, and MPC-6 corresponded to 81-87%. The absence of the answers "completely capable" and "rather capable" among the participants of the C5 target cohort is noteworthy. Significant differences in the level of competence formation between target cohorts C1 and C4, C2 and C4, C1 and C5, C2 and C5 were established for all MPC for the statements "completely capable" and "completely incapable" (p<0.05).

The students' RPC proficiency increased during their higher pharmacy education. The overall trend of respondents' readiness to perform RPC was similar to that of MPC. Figure 1 shows the transition of students' self-assessment regarding RPC formation from "completely incapable" in the target cohorts C1 and C2 (78.6±18.9 and 73.6±18.2 respectively) to "completely capable" in cohorts C4 and C5 (53.5±15.4 and 68.9±19.7, respectively).