Pharmacy Students’ Perspectives on Racial and Religious Inclusivity Within the Pharmacy Course at a London University: A Mixed-Methods Study

Abstract

Race and religion are social constructs that shape students’ experiences within higher education, particularly in healthcare disciplines where cultural competence is essential. In pharmacy education, students from racially minoritised or religiously observant backgrounds may face microaggressions, bias or discrimination, and underrepresentation, which can negatively impact their engagement, attainment, and sense of belonging. This study investigated pharmacy students’ experiences and perceptions of racial and religious inclusivity within a single-institution UK university's MPharm programme. A cross-sectional mixed-methods design was used, combining survey responses (n = 105) and semi-structured interviews (n = 5). Quantitative data were analysed using descriptive statistics and chi-square tests, while qualitative data underwent thematic analysis. Findings revealed that while overt discrimination was relatively uncommon, microaggressions were frequently reported, particularly during clinical placements. A significant correlation was found between ethnicity and experiences of racial bias. Students demonstrated limited understanding of key concepts and low awareness of institutional support systems. Although the curriculum was generally perceived as inclusive, gaps in religious representation were noted. The study highlights the need for targeted interventions in curriculum design, staff training, and student support to develop inclusive learning environments, sense of belonging and prepare culturally competent pharmacy trainees.

Keywords

race religion inclusion discrimination higher education belonging

Introduction

Race and religion are socially constructed yet deeply influential aspects of identity that shape individuals’ experiences within educational and professional settings (Smedley, 1998; Ysseldyk et al., 2010). In the context of healthcare education, these identities intersect with institutional structures and cultural norms, which may result in differential treatment, implicit bias, and exclusionary practices (Mosley et al., 2025). Pharmacy students from racially minoritised or religiously observant backgrounds may encounter microaggressions, stereotyping, or a lack of cultural representation in teaching materials, which can affect their engagement, attainment, and sense of belonging (Connelly and Burns, 2023; Frings et al., 2020; Morrison et al., 2023). As future healthcare professionals, pharmacy students must be equipped not only with clinical knowledge but also with the cultural competence necessary to provide equitable, person-centred care to diverse populations.

One of the issues linked to inclusivity in higher education is the differential attainment gap (Doll, 2024; Morrison et al., 2023). The causes of differential attainment are multifaceted. They include structural inequalities, implicit bias within teaching and assessment, lack of representation among academic staff, and limited cultural relevance in course content (Doll, 2024; Rana et al., 2022). Students who do not see themselves reflected in the curriculum or who experience subtle forms of exclusion may disengage from learning, feel isolated, or underperform academically (Mawdsley et al., 2024). These experiences can have long-term consequences, affect not only degree outcomes but also access to postgraduate training, employment opportunities, and career progression (Mawdsley et al., 2024).

The persistence of racial and religious bias in healthcare education is well-documented. Broad et al. (2018) found that discrimination and harassment were prevalent in UK medical schools, yet underreporting was common due to fears of retaliation and perceptions of ineffectiveness. Similarly, Ahmed et al. (2024) highlighted the experiences of racial minority stress among pharmacy students and professionals, noting that such stressors can lead to burnout, disengagement, and reduced academic and professional attainment.

Microaggressions are subtle, often unintentional expressions of bias. They may manifest as assumptions about a student's language proficiency, exclusion from group activities, or inappropriate comments about religious practices (Kiles and Chisholm-Burns, 2022; Wittkower et al. (2022)). These experiences, though individually minor, can accumulate over time to create a hostile or unwelcoming learning environment. A scoping review by Wittkower et al. (2022) identified a range of training interventions aimed at helping healthcare educators and students respond to microaggressions yet noted a lack of consistent implementation and evaluation.

A recurring theme in the literature is the underreporting of bias and discrimination. Reasons for non-reporting included fear of retaliation, uncertainty about what constitutes discrimination, and lack of awareness of reporting mechanisms, which suggest that students often feel unsupported or disempowered to challenge discriminatory behaviour (Broad et al., 2018).

Discrimination within healthcare education is not limited to the classroom. Clinical placements are an essential component of pharmacy training and can also be sites of exclusion and bias. The National Health Service (NHS), as the primary employer of UK pharmacy graduates, has acknowledged ongoing issues of racial and religious discrimination within its workforce. According to the 2024 Workforce Race Equality Standard (WRES), the overall percentage of ethnic minority staff across the NHS workforce in the UK was 28.6% and in London was 53.9% (NHSProviders, 2024). Staff from ethnic minority backgrounds were more likely to face harassment, bullying, or abuse from patients, their families, and the public (28.6%) than their White counterparts (23.5%). Ethnic minority staff were also significantly more likely to report experiences of discrimination from colleagues (24.9%), compared to their White counterparts (20.8%) (NHSProviders, 2024).

These workplace inequalities can have a profound impact on career progression, job satisfaction, and retention. The TIDES (Tackling Inequalities and Discrimination in Healthcare Services) study, which surveyed over 900 healthcare professionals in London, found that discrimination was associated with poorer mental health, increased sickness absence, and lower job satisfaction (Rhead et al., 2020). For pharmacy students or newly qualified pharmacists entering such environments can hinder their professional development and reinforce existing disparities.

A student's sense of belonging (the feeling of being accepted, valued, and included within their academic community) is a critical factor in educational success (Gilani and Thomas, 2025). For students from racially or religiously minoritised backgrounds, this sense of belonging can be undermined by experiences of exclusion, underrepresentation, or discrimination (Lewis et al., 2019; Rana et al., 2022; Sen, 2025). Conversely, inclusive practices that affirm students’ identities and develop supportive relationships can enhance belonging, motivation, and academic resilience (Sen, 2025; Ude, 2025).

A key strategy for addressing these issues is the development of an inclusive curriculum. In addition to adding diverse content, it requires a fundamental rethinking of pedagogical approaches, assessment methods, and institutional values (Stentiford and Koutsouris, 2022). An inclusive curriculum reflects the diversity of the student body, challenges dominant narratives, and equips students with the cultural competence needed to serve diverse communities (Hunt and Alexander, 2024).

McDuff et al. (2018) found that institutional changes aimed at promoting inclusivity, such as diversifying reading lists, embedding equality, diversity and inclusivity (EDI) training, and improving staff-student relationships, were associated with reductions in the attainment gap. Moreover, students who feel represented and respected within their learning environment are more likely to engage, persist, and succeed (Pedler et al., 2021).

In pharmacy education, encouraging a strong sense of belonging is particularly important given the profession's emphasis on person-centred care, ethical practice, and interprofessional collaboration. Students who feel confident in their identity and supported by their institution are more likely to develop the professional behaviours and cultural competence required for effective practice in diverse healthcare settings (Hunt and Alexander, 2024). The current literature focuses mainly on medical and nursing students

This study aims to explore pharmacy students’ perspectives on racial and religious inclusivity within the pharmacy course at a London university.

Aims and Objectives

To investigate the prevalence and nature of bias, discrimination, and microaggressions within various settings of the pharmacy course.

To evaluate the inclusivity of the curriculum and learning environment in relation to race and religion.

To examine students’ awareness and use of support systems.

This research contributes to the growing body of evidence on inclusivity in healthcare education and offers practical recommendations for curriculum development, staff training, and institutional policy.

Methods

Study Design

This cross-sectional mixed-methods study was conducted among year one to four Master of Pharmacy (MPharm) students at a university in London, UK over a two-month period.

Survey and Interview Design

A draft survey and interview schedule was developed by authors DK and MA based on published literature and designed to address the study objectives (Ahmed et al., 2024; Broad et al., 2018; Kiles and Chisholm-Burns, 2022; Mawdsley et al., 2024; McDuff et al., 2018).

The survey and interview schedule were internally reviewed for validity by an expert in inclusive pharmacy practice. To assess the relevance and clarity of the survey, a small pilot study was undertaken with five MPharm students. Minor changes (such as inclusion of definition of microaggressions) were made and responses were excluded from the main study dataset.

The questionnaire consisted of 21 questions divided into five sections. Section one consisted of three multiple-choice questions, aiming to gather information about the participants’ knowledge of terminology associated with racial and religious inclusivity. The questions were closed, with pre-formulated answer choices. Section two consisted of eleven questions focused on capturing participants’ experiences associated with racial or religious bias in the university, if any. While bias (an attitude or belief that can influence behaviour) and discrimination (unjust or prejudicial action taken based on bias) are conceptually distinct, for the purposes of this study they were grouped together as a single category for ease of participants with microaggressions as a separate category, similar to other studies (Mateo and Williams, 2020; Treffers et al., 2024). Section 3 comprised two questions focused on gauging student perceptions on racial and religious inclusivity within the pharmacy curriculum and environment with a closed question and a 5-point Likert scale question ranging from strongly disagree to strongly agree. Section 4 examined students’ knowledge of available support within the university with regards to discrimination with two multiple-choice questions. Section five captured demographic data (no identifiable information requested).

The semi-structured interview schedule consisted of 15 questions in five sections focusing on knowledge of terminology, perspectives on racial and religious inclusivity within the pharmacy department and university, perspectives on racial and religious inclusivity within the pharmacy curriculum and environment, knowledge of existing available support, and an additional open-ended question asking participants for any additional information they wanted to share on the topic. The interview questions allowed for in-depth exploration of participants’ knowledge, perspectives, and experiences.

Data Collection

The study population was MPharm students at the university. The inclusion criterion for the study was any MPharm student from years 1, 2, 3 or 4 of any race or religion. As per university records, there were 639 pharmacy students across the four-year course. Using the Raosoft online calculator with a 95% confidence level and a 5% margin of error, the required sample size for statistically significant results was calculated to be 241. However, all eligible students were invited to participate in this study.

The anonymous survey was created using Microsoft Forms which generated a QR code and link that was shared with all pharmacy students at the university via email. At the end of the survey, participants were asked to leave their contact details via separate link if they wished to participate in a follow up interview.

Eligible participants were provided with a participant information sheet outlining the study objectives. Completion of the survey was accepted as informed consent.

Participants were invited to take part in optional semi-structured interviews, conducted either in person or remotely. Interviews were audio-recorded and transcribed verbatim, with written consent from the participant. Overall quantitative and qualitative data were collected concurrently and then integrated to provide a more complete picture of the findings.

Data Analysis

All survey responses were inputted into Microsoft Excel. Descriptive statistics, including percentages and frequencies were used. The data was reviewed by two researchers MA and DK for quality assurance. The chi-square test was used to identify any associations between responses. Sub-analyses were performed by respondents’ gender, age and ethnicity. An a priori level of <0.05 (P < 0.05) was set as significant.

Qualitative data were analysed using thematic analysis (Braun and Clarke, 2006, 2019). Initial codes were identified from the data then grouped into broader themes. These themes were reviewed by MA and DK. Illustrative quotes are reported verbatim to support the discussion.

Ethical Considerations

The delegated ethical approval team at the university operating under the faculty ethics committee granted ethical approval for the study in February 2024 (1213/045). To reduce the risk of participants experiencing discomfort due to the nature of the topic, all participants were signposted to support in place at the university in addition to external sources.

Results

105 MPharm students completed the survey, representing a response rate of 44%.

The demographic characteristics of the survey participants are summarised in Table 1 . The majority of participants were female (74%), while 23% were male and 2% were transgender. Only 6% of students classified as mature students. The largest ethnic backgrounds were Asian (38%) and Arab (24%) and majority faith was Muslim (69%).

Table 1.

Demographics of Survey Participants (N = 105).

Characteristic	n	Percentage (%)
Gender
Female	78	74
Male	24	23
Transgender	2	2
Prefer not to say	1	1
Age (years)
18–24	99	94
25–34	6	6
Ethnicity
Black	17	16
Asian	40	38
Arab	25	24
White	7	7
Mixed ethnicity	7	7
Other	9	9
Religion
Atheist	3	3
Christian	13	12
Hindu	4	4
Muslim	72	69
Sikh	5	5
Jewish	1	1
Prefer not to say	7	7

Knowledge of Participants

42% (n = 44) students were able to correctly identify the meaning of differential attainment, 41% (n = 43) students were unsure of the meaning, and 17% (n = 18) selected incorrect definitions of differential attainment.

Majority of students were able to correctly select scenarios which constituted racial or religious discrimination such as exclusion based on race (86%, n = 90), racial slur (84%, n = 88), racial profiling (73%, n = 77) and unequal treatment based on religion (83%, n = 87). 11% (n = 12) selected non-aligning views on religion and 15% (n = 16) selected not liking an individual's personality, which do not constitute racial or religious discrimination. Student opinions on what constitutes microaggressions varied with 33% (n = 35) and 55% (n = 58) indicating that validating a person speaks English well and racist banter respectively were microaggressions. 70% (n = 74) indicated being followed and 71% (n = 75) indicated nobody sitting next to an individual on public transport due to race or religion constituted microaggressions.

Experiences of Bias, Discrimination and Microaggressions

14% (n = 15) self-reported experiences of racial bias or discrimination and 16% (n = 17) of religious bias or discrimination within various settings of the pharmacy course. 24% (n = 25) self-reported experiences of microaggressions, mostly during placements (n = 10) then within the department (n = 9). A higher proportion of students have witnessed microaggressions and religious or racial bias and discrimination, seen in Table 2 . There was a correlation between ethnicity and experience of bias/discrimination based on race (χ²(13, N = 105) = 32.03, p = .002).

Table 2.

Student Experiences of Microaggressions, Bias and Discrimination (N = 105) Counts Represent Number of Students Selecting Each Option; Students Could Select Multiple Categories.

Setting	Microaggression	Bias/discrimination (religious Belief)	Bias/discrimination (race/ethnicity)
Experienced within department	9	3	7
Witnessed within department	12	7	7
Experienced during placement	10	9	5
Witnessed during placement	6	7	9
Experienced within university (non-pharmacy)	6	5	3
Witnessed within university (non-pharmacy)	9	6	7
Not experienced this	80	88	90
Not witnessed this	78	85	82

All pharmacy students who self-reported experiences of any discrimination/bias during their course were asked how frequent their encounters were and by whom ( Table 3 ).

Table 3.

Frequency of Bias/Discrimination Encounters (N = 38).

Source	Daily	Weekly	Monthly	Yearly	One Time
Pharmacy students	3	1	3	1	7
Other university students	1	1	2	3	7
Pharmacy staff	1	1	0	6	7
Other university staff	1	1	0	3	6
Patients during placement	1	0	2	4	6
Placement staff	2	1	0	3	10

Most students reported their encounter was with placement staff one time overall (n = 10). Daily encounters with discrimination/bias occurred mostly with other pharmacy students (n = 3) followed by placement staff (n = 2).

The three most frequent manifestations of discrimination/bias were ridicule due to cultural differences (n = 15), verbal abuse (n = 11) and racist comments (n = 11) and least frequently, physical intimidation (n = 3), damage to personal property (n = 3) and cyber bullying (n = 4).

From 38 students self-reporting discrimination/bias, only 4 students in total discussed or reported their experience. The three main frequent reasons cited by students for not reporting their experience ( Table 4 ) were lack of awareness of who to report to (n = 15), followed by doubt their claim would be taken seriously (n = 13) and fear of further discrimination (n = 12).

Table 4.

Reasons for not Reporting Experiences of Bias or Discrimination (N = 38).

Reason	n
Did not know who to report to	15
Did not think it would be taken seriously	13
Fear of further discrimination	12
Wanted to avoid conflict	11
Did not think reporting would achieve an outcome	11
Unsure if it was discrimination/bias	9
Cultural norm not to report	8
Too time consuming to report	7
Embarrassed to report	6
Feared retaliation	5
Other	4

Table 5.

Student Perspectives on Curriculum Inclusivity (N = 105).

Statement	Strongly Disagree	Disagree	Neither Agree Nor Disagree	Agree	Strongly Agree
Curriculum is representative of race	7% (n = 7)	14% (n = 15)	23% (n = 24)	40% (n = 42)	16% (n = 17)
Curriculum is representative of religion	12% (n = 13)	16% (n = 17)	31% (n = 33)	27% (n = 28)	13% (n = 14)
Staff use inclusive language in their teaching and communication	4% (n = 4)	7% (n = 7)	20% (n = 21)	48% (n = 50)	22% (n = 23)
Reading lists reflect cohort diversity	9% (n = 9)	8% (n = 8)	38% (n = 40)	31% (n = 33)	14% (n = 15)
Awareness of racial inequality in healthcare	5% (n = 5)	8% (n = 8)	22% (n = 23)	43% (n = 45)	23% (n = 24)
Case studies reflect student diversity	3% (n = 3)	4% (n = 4)	27% (n = 28)	42% (n = 44)	25% (n = 26)

Table 6.

Desired Changes to Improve Racial and Religious Inclusivity (N = 105).

Proposed Changes	n	Percentage (%)
Raised awareness of reporting tools	42	40
More serious outcomes from reporting	39	37
Stronger implementation of a zero tolerance policy	35	33
Student training on discrimination	35	33
Staff training on discrimination	30	29
No changes required	30	29
Unconscious bias training for staff	23	22
Unconscious bias training for students	21	20
More inclusive curriculum	18	17
Increase in staff diversity	13	12
Other	4	4

Perspectives of Curriculum and Support Services

Approximately, two thirds of students agreed the case studies in the curriculum reflected the diverse student cohort (67%, n = 70), that the curriculum raised awareness of racial inequality in healthcare (66%, n = 69) and inclusive language was used within teaching (70%, n = 73), seen in Table 5 . Over half believed the curriculum is representative of race (56%, n = 59) but less so of religion (40%, n = 42).

80% (n = 84) students were unaware of the university reporting tool for harassment, discrimination or misconduct. Around half were unaware faith-based student societies (57%, n = 60) and culture-based student societies (50%, n = 52) were available as support systems. Over half (57%, n = 60) were unaware of university schemes to support ethnic minority students such as mentoring and career focused schemes.

Majority of students want ( Table 6 ) raised awareness of reporting tools (40%, n = 42), more serious outcomes from reporting (37%, n = 39) and student training on discrimination (33%, n = 35).

Qualitative – interview findings

Five students participated in semi-structured interviews. Notably of the five interview participants, four were female and one was male, and all participants were of Muslim faith with varying cultural backgrounds.

Four main themes were derived from thematic analysis: understanding of key concepts, experiences of bias/discrimination, perceptions of diversity and representation, and awareness and use of support systems.

Understanding of key Concepts

All students were able to define discrimination and bias but only two participants could correctly define microaggressions. All students understood the term differential attainment to some extent though not all were able to fully define the term.

“Discrimination is treating someone unfairly like being rude or just excluding them.” (Participant 2)

“Microaggression… small belittling comments or gestures targeted at you unintentionally.” (Participant 4)

“Attainment gap is the gap in achievements between different backgrounds based on certain characteristics such as race.” (Participant 1)

Experiences of Bias/Discrimination

There was a mixture of experiences within the interview cohort. One student experienced and two students witnessed discrimination/bias in the pharmacy course.

“Witnessed other students ridicule specific cultures like speaking behind someone's back about their culture in a rude way. It was a group of us in the library… he brought it up how people from a certain culture smell.” (Participant 2)

“I went to a placement with other students who were not wearing a headscarf. I felt that I was treated differently… they weren’t as helpful to me as they were to other students, and I felt sort of awkward or embarrassed.” (Participant 4)

“I saw a student get treated differently during placement… I was treated absolutely fine, but I was from the same background as the pharmacist.” (Participant 5)

Perceptions of Diversity and Representation

All five students believed that race and religion were well represented within the curriculum and found the university diverse.

“I think Kingston is one of the most diverse with their staff and students.” (Participant 2)

“The curriculum is inclusive with its workshops, case studies and even exams.” (Participant 3)

Awareness and use of Support Systems

All students demonstrated limited awareness of support systems and reporting tools and only one participant had used a support system.

“I know of the personal tutor scheme.” (Participant 2)

“I haven’t used any.” (Multiple participants)

“I guess student union would count as one and the reporting tool.” (Participant 1)

“It's just the one instance on placement and no I didn’t report it because I felt embarrassed or silly to report it.” (Participant 4)

Students had recommendations of what tools or programmes could be implemented to improve inclusivity.

“We could have a training day each year.” (Participant 1)

“A special app to report issues.” (Participant 3)

“A specific number you could text anonymously and would get help from.” (Participant 5)

Discussion

This study explored pharmacy students’ experiences and perceptions of racial and religious inclusivity within a UK university's MPharm programme. The integrated quantitative and qualitative findings show that while overt experiences of bias and discrimination were not widespread, microaggressions were more frequently reported, particularly during clinical placements, indicating that subtle exclusionary behaviours remain a persistent concern.

Students demonstrated varied understanding of key concepts such as differential attainment and microaggressions, and many expressed limited awareness of institutional support systems and reporting tools. Although the curriculum was generally perceived as inclusive, students felt gaps remained in religious representation. The mixed-methods findings create a more complex picture of belonging and inclusion than either dataset would reveal independently.

The achieved survey sample size of 105 is notably smaller than the calculated minimum sample size. As reduced power may increase uncertainty, the observed associations and statistical analyses should be considered as exploratory and interpreted with caution. Additionally, all interview participants were from a single religious background, limiting the qualitative exploration of religious inclusivity across faith groups. The researcher shared the same religious background as all interview participants, which facilitated rapport and may have enabled participants to speak openly about sensitive aspects of belonging and inclusion. However, it may also have shaped the interview dynamics and data interpretation. This positionality, combined with a single-faith sample, means that the qualitative findings reflect the perspectives of one religious community and do not capture how belonging and inclusion is experienced across other faith groups.

Knowledge of Participants

Students demonstrated basic understanding of discrimination and bias but limited grasp of microaggressions and differential attainment. This aligns with MacIntosh et al. (2022), who found that healthcare professionals often lack clarity on microaggressions, leading to under-recognition and under-reporting. Embedding these definitions into teaching materials and workshops could strengthen students’ ability to identify and challenge subtle forms of bias as outlined by previous research (MacIntosh et al., 2022).

Experiences of Bias, Discrimination and Microaggressions

While only a minority of students reported direct experiences of racial or religious bias, nearly a quarter reported microaggressions in the survey data. However, the qualitative data revealed hesitancy to report incidents and uncertainty about reporting pathways, suggesting the possibility that underreporting may be more substantial than the quantitative figures alone indicate. Students reported experiencing various forms of bias and discrimination, with ridicule due to cultural differences, verbal abuse, and racist comments being the most common, similar to discrimination and harassment experienced by ethnic minority undergraduate medical students in the UK (Montasem et al., 2023). More severe incidents such as physical intimidation and property damage were rare but still present. The correlation between ethnicity and experience of racial bias (p = 0.002) underscores the structural nature of these issues. Placement staff were most frequently cited as sources of bias or discrimination, both within quantitative and qualitative findings, echoing experiences of nursing students on placement (Caffrey et al., 2023), with some pharmacy students experiencing daily encounters mainly with other pharmacy students in the course.

Interview participants mirrored these findings with their lived experience that they were treated differently or witnessed racial or religious microaggressions, illustrating how these behaviours were experienced by students within an otherwise diverse environment. Ahmed et al. (2024) highlighted similar experiences of racial minority stress among pharmacy students, noting that such stressors contribute to burnout and disengagement. Despite these experiences, the vast majority chose not to report them. Key barriers included uncertainty about reporting procedures, lack of confidence in institutional responses, and fear of further discrimination. These findings reflect a broader pattern of underreporting in healthcare education and highlight the urgent need for clearer reporting mechanisms, visible accountability, and a culture that empowers students to speak up (Broad et al., 2018).

Perspectives on Curriculum and Support Services

Survey and interview findings indicated that students generally viewed the curriculum as inclusive, with over two thirds agreeing that inclusive language was used and affirming that case studies reflected cohort diversity. However, students felt religion was less sufficiently represented, suggesting religious inclusivity requires further attention.

The mixed-methods design also revealed consistent gaps in awareness of institutional support. Awareness of support systems and reporting tools was limited which was one of the reasons cited for lack of reporting discrimination or bias (Broad et al., 2018). Eighty percent of survey respondents were unaware of the university's reporting tool, and over half were unaware of faith-based societies or mentoring schemes and qualitatively, participants could name very few support systems and described limited engagement with them although students were aware of the personal tutor scheme as an option for support. Raising awareness of reporting tools and support systems is necessary, particularly given the low levels of awareness identified in this study, with actions including highlighting reporting tools at annual inductions, one-to-ones for tutors and students to discuss placements, and implementation of staff-student anti-racism training, aligning with previous recommendations (Kiles and Chisholm-Burns, 2022).

Strengths and Limitations

Limitations include small sample size as the response rate was lower than the calculated minimum sample size due to time constraints for data collection. Perception bias may contribute to variability in the findings as the study design relied upon participants discussing their subjective experiences. Due to the sensitivity of the topic, people may not have felt comfortable discussing their experiences. The mixed-methods design strengthens the study by allowing the quantitative patterns to be interpreted alongside students’ lived experiences, providing a more comprehensive understanding than either method could offer alone.

Although there was a diverse representation of the student cohort within the survey, all interview participants were from the same religious demographic giving a narrower view of racial and religious inclusivity within the course. The shared religious background between researcher and interview participants, combined with the single-faith sample, may have shaped interview dynamics and limits the transferability of findings to other faith groups. There is limited generalisability to the wider pharmacy student population, but this study focuses on the experiences of students within one institution.

Conclusion

This mixed-methods study highlights the nuanced experiences of pharmacy students regarding racial and religious inclusivity. While overt discrimination is relatively less common, microaggressions persist, particularly in clinical settings. Limited understanding of key concepts and low awareness of support systems hinder students’ ability to navigate and challenge exclusionary practices. The integration of qualitative insights underscores the emotional and practical impact of these issues. Enhancing curriculum representation, increasing visibility of support services, and implementing targeted training for staff and students are essential steps toward encouraging an inclusive educational environment. A more inclusive curriculum and learning environment can strengthen students’ sense of belonging and engagement. Inclusivity also develops cultural competence, preparing future pharmacists to deliver equitable, person-centred care in diverse healthcare settings. Future research should explore longitudinal impacts of these interventions and expand sample sizes to ensure broader representation.

Footnotes

Acknowledgements

The authors wish to thank all participants in this study.

ORCID iD

Dipa Kamdar

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the delegated ethical approval team operating under the faculty ethics committee of Kingston University (protocol code 1213/045; February 2024).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Author C ontribution Statement

Conceptualization, D.K. and M.A.; Methodology, D.K. and M.A.; Validation, M.A.; Formal Analysis, M.A.; Investigation, M.A.; Resources, M.A.; Data Curation, D.K. and M.A.; Writing – Original Draft Preparation, D.K.; Writing – Review & Editing, D.K.; Visualization, D.K.; Supervision, D.K.; Project Administration, D.K. and M.A.

Author Contribution(s)

Dipa Kamdar: Conceptualization; Data curation; Methodology; Project administration; Supervision; Visualization; Writing – original draft; Writing – review & editing.

Maryam Abotabekh: Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Project administration; Resources; Validation.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Access Statement

All authors had full access to the study data in Microsoft Excel.

Data Availability Statement

The data underlying this article will be shared on reasonable request to the corresponding author.

Supplemental Material

Supplemental material for this article is available online.

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