Exploring how interprofessional forces shape population-health competencies for clinical pharmacy trainees

Background: Interprofessional clinical training is increasingly recognized as essential for preparing pharmacy graduates to address both individual patient needs and broader population-health priorities. Yet how Doctor of Pharmacy (PharmD) students actually develop population-health competencies within clinical environments remains poorly understood. Methods: This qualitative research explored the learning frame with driving and restraining forces that shape population-health competence among final-year PharmD students during their clinical pharmacy training. Using semi-structured interviews were conducted with a clinical pharmacist, a medical doctor, a nurse, and three PharmD students at Thumbay University Hospital. ATLAS.ti software version 25 was used for data analysis. Results: Data was collected from three professionals and seven pharmacy students. Thematic analysis following Braun and Clarke's six-phase approach generated 257 coded quotations and 17 themes. These themes were organized into three categories: learning frame themes, driving forces, and restraining forces. Findings show that students learn through iterative movement between population-to-patient and patient-to-population reasoning, supported by processes such as listening, observing, complementing team activities, validating clinical decisions, and implementing changes. Their development is shaped by driving forces including knowledge, compatibility, collaboration, integration, and trustworthiness, and restrained by limited knowledge, limited involvement, conflicting views, missing information, and unreliable performance. Together, these dynamics illustrate how interprofessional clinical environments can both foster and hinder the development of population-health competencies. Conclusion: This study highlights how population-health competence among PharmD trainees emerges through dynamic, interprofessional interactions that shape both their reasoning and clinical engagement. The interplay of driving and restraining forces within clinical environments reveals that supportive team processes can accelerate learning, while structural and relational barriers can impede it. Strengthening interprofessional integration and addressing these barriers may enhance the development of population-health competencies in future pharmacy training models.