Why pharmacists choose to seek or not seek board certification in pharmacy practice: A comparison of motivation and motivating factors.

摘要

The stated mission of the Board of Pharmaceutical Specialties (BPS) with regard to specialization is, via board certification, to recognize specialty areas, define skill standards for those specialty areas, and evaluate the knowledge and skills of individual Pharmacy specialists. The perceived or real benefits to the pharmacist of pursuing board certification are unknown. These benefits can be evaluated by separating into values (valences) and instrumentalities, the latter of which is the perceived or known probability that a performance will lead to an outcome. The primary purpose of this study was to determine the differences in values and instrumentalities perceived by the pharmacist, and differing calculated forces of motivation, using an Expectancy Valence equation, between board certified pharmacists and those who were not.A survey instrument, the Advanced Certification Index for Pharmacists (ACI-P), was designed to test instrumentalities, values, and calculated force of motivation. The ACI-P was deployed via electronic mail and the internet in cooperation with four major Pharmacy organizations and the Board of Pharmaceutical Specialties. Four direct comparisons between the two groups were completed. These were instrumentality, valence, valence-minus-instrumentality and valence-times-instrumentality. Additionally, the components of the valence and instrumentality products (the VI Scores) were multiplied by expectancy (anticipated chance of success of an effort leading to successful performance) resulting in a force of motivation calculation for each pharmacist's score.The ACI-P was deployed in the summer of 2007. Of the 2,274 pharmacists who began the survey, 2,129 completed all of the survey question sets for a completion percentage of 93.7%. A total of 2,057 of 2,129 completed surveys were retained for the research data representing a clean data rate of 96.6% of those completing all questions and 90.5% of those initiating the survey. This data set was comprised of 496 (24.1%) non-board certified pharmacists and 1,561 (75.9%) board certified pharmacists.Validation and reliability of the ACI-P was confirmed via parallel axis analysis and Cronbach's alpha reliability coefficient. There were two factors or domains found in the data and these were Professional, Career and Personal (PCP) and Financial Support (FS). Cronbach's alpha for the PCP factor or domain was 0.94 and the FS domain had an alpha of 0.81. The constructs were validated and the items addressed within the constructs of PCP and FS were reliable. The overall Cronbach's alpha reliability coefficient for the ACI-P was 0.94.In the four major comparisons, there were significant differences between non-board certified and board certified pharmacists.The primary value used for the motivational force calculation was based on valence-times-instrumentality-times-expectancy. The valence-times-instrumentality value was the VI score or VIS. The summed VI scores for the non-board certified pharmacists were in general lower (303.54 SD 101) than those for the board certified pharmacists (343.82 SD 83), and these were statistically different (t= -8.03, p.0001).The overall expectancy mean for non-board certified pharmacists was 4.05 and 4.4 for board certified pharmacists (5-point Likert scale), and these were significantly different (t = -9.16, p.0001).The overall motivational force calculated using the ACI-P scoring methodology yielded a force of motivation to seek board certification of 1249 (95% CI 1201-1296) for non-board certified pharmacists and 1521 (95% CI 1499-1544) for board certified pharmacists. The differences were statistically significant. (t=10.15, p=0.001). A tipping point in the range of 1500-1520 was identified that would indicate a 95% probability that a pharmacist scoring in this range would be a board certified pharmacist.The results of this study show that there were significant differences in motivational factors between non-board certified pharmacists and those that were board certified with the latter scoring higher on nearly every measure. The ACI-P survey instrument was shown to be a valid and reliable tool for evaluation of the force of motivation for pharmacists to seek board certification.