Curricular Inclusion of Health Disparities/Cultural Competence and Health Literacy in U.S. and Canadian Pharmacy Programs

Abstract

Objective. To determine how U.S. and Canadian pharmacy schools include content related to health disparities and cultural competence (HDCC) and health literacy (HL) in curriculum and assessment practices.

Methods. A cross-sectional survey was distributed to 143 accredited and candidate status pharmacy programs in the U.S. and 10 in Canada in three phases using Qualtrics. Statistical analysis was performed to assess inter-institutional variability and relationships between institutional characteristics and survey results.

Results. No significant differences were found among the responding institutions, 72 (50%) in the U.S. and 8 (80%) in Canada, after stratification by institutional characteristics. A core group of faculty typically taught HDCC/HL. HDCC was primarily taught in multiple courses across multiple years in the pre-APPE curriculum. While HL was primarily taught in multiple courses in one year in the pre-APPE curriculum in Canada (75.0%), delivery of HL was more varied in the U.S., including in a single course (20.0%), multiple courses in one year (17.1%), or multiple courses in multiple years (48.6%). HDCC/HL was mostly taught at the introduction or reinforcement level. Active learning approaches were mostly utilized in the U.S., whereas in Canada active learning was more frequently utilized in teaching HL (62.5%) than HDCC (37.5%). Few institutions reported providing professional preceptor development.

Conclusion. U.S. and Canada pharmacy schools have wide inclusion of HDCC/HL content; however, less is required and implemented within experiential programs and co-curricula. Opportunities remain to expand and apply information on HDCC/HL content, particularly outside the didactic curriculum, as well as identify barriers for integration.