Giving "Best Advice": Proposing a Framework of Community Pharmacist Professional Judgement Formation
Community pharmacy is often portrayed as a marriage of professional and business roles in a commercial domain, thereby creating a need for, and value in, pursuing the development of professional competencies for use in the community pharmacy business. In context, professional judgement is the application of knowledge, skills and attitudes (competencies) which, when applied to situations where there is no one or obvious right or wrong way to proceed, gives a patient a better likelihood of a
... ikelihood of a favourable outcome than if a lay-person had made the decision. The challenge for community pharmacists is that professional judgement formation is influenced by professional, commercial and personal criteria with inherent interconnected challenges. In community pharmacy practice in the Republic of Ireland (ROI), this challenge is compounded by the fact that advice is normally provided in an environment where the pharmacist provides professional advice "for free" and then may offer to sell the patient a product or service based on that advice, an activity which amounts to a commercial transaction. While there is currently no evidence to confirm whether or not these professional judgement influences are resolved successfully, their very existence poses a risk that their resolution "in the wrong way" could compromise patient outcomes or professional standing following the delivery of pharmacy services. It is therefore apparent that a community pharmacist requires skills in identifying and analysing professional/commercial/personal influences in order to appreciate the criteria which may affect both parties' (patient and pharmacist) decision making. By contemplating the interaction between the pharmacist's professional competencies and the individual influences OPEN ACCESS Pharmacy 2014, 2 75 on that pharmacist, we can consider the enhancement of professional competencies that underpin the "best" advice being offered to the patient, regardless of whether that advice is offered in the course of dispensing prescriptions or delivering vaccination or other services, culminating in a framework of professional judgement formation.