INTRODUCTION:

The profession of Pharmacy has taken new dimensions globally to match the technological advancements and patient’s ever-growing expectations. The traditional role of the pharmacist that involves the production and dispensing medications has become inadequate for the profession to thrive¹. Patient is the centre of medical universe; this mandates that the healthcare professionals must be competent in ensuring exemplary patient focused health care². As pharmaceutical healthcare changes its direction towards clinical roles, the real challenge is that of advancing competency and adaptability¹. To match the dynamic demands of pharmaceutical industry such as direct patient counselling¹, medicine optimisation services, Continuous Professional Development (CPD) and advanced competencies, Australian Chamber of commerce and industry and business council of Australia³ has identified eight skills for employability including communication, teamwork, problem -solving and various entrepreneurship skills³.

The regulatory bodies of the Pharmacy education have been responding to these challenges through curriculum reforms to prepare the future pharmacists. The American Association of Colleges of Pharmacy has been instrumental in the formation of outcome-based guidelines for pharmacy education since the early 1990s⁴. The Royal Pharmaceutical Society of Great Britain (RPSGB) and Pharmacy in a New Age (PIANA) and publication of white paper on Pharmacy in England: building on strengths, delivering the future, in April 2008, is a step in the right direction for modernising the Pharmacy Profession. (British Pharmaceutical Conference in September 1995). This initiative elevated the profession’s profile and assisted the regulatory bodies and layperson an insight on the underutilised profession⁵.

In the Indian perspective, the era of patient-centred care started in 1984, when Dr.BD Miglani, considered to be the father of Indian Hospital pharmacy, introduced the Postgraduate programme in Hospital Pharmacy with specialization in clinical and community pharmacy and subsequently, many universities have started to apply in their settings⁶.

Pharmacy profession transformed globally in the year 2020 in terms of education, science, and practice with the initiative formulated by The International Pharmaceutical Federation (FIP) (FIP2021)⁷. FIP has been instrumental in the provision of a strategic framework through the implementation of 21 development goals which serve as a worldwide reference. Competency development, goal No.5, plays a pivotal role in this transformation⁷.

In India, while the importance of pharmacy profession has been felt in the branches of education, business, marketing, and research, still, patient-oriented services are insufficient⁸. There is a vision to apply competency-based pharmacology curriculum in this country, yet the approach is still traditional rather than practice and science based². Therefore, there is a need to develop a framework, within the Indian context to stimulate Competency-based education (CBE)⁷. CBE has been a focus of interest as the health education models has shifted their emphasis⁷ to address “glaring gaps and inequities in health persisting both within and between countries”⁹.

Major reformation in the Indian pharmacy structure is anticipated with the launch of The Draft National Pharmacy Commission Bill 2023, which is going to alter the existing Pharmacy Act of 1948¹⁰. To achieve a more inclusive legislative process, Government of India has encouraged stakeholders and the public to give their inputs.

The aim of our study is to investigate the stakeholder’s perspectives on the competency-based education (CBE) in Southern India with the following objectives.-To understand the notions of the key stakeholders ranging from Senior academia, research, regulatory department, industry, community, hospital pharmacy and the fresh graduates development on CBE in line with the FIP developmental goal no.5⁷ and to understand the barriers and to create a framework for the pharmacy education in India, specifically for CBE.

MATERIALS AND METHODS:

We conducted an exploratory Cross-sectional survey amongst the pharmacy professionals in various sectors to analyse the stakeholder’s views on CBE in Southern India. A web linked open ended online questionnaire was distributed via email among the participants who were recruited by the combination of purposeful and snowball sampling. Online qualitative surveys which prioritise qualitative questions and interpretivist values has gained popularity among the researchers, particularly in relatively unexplored areas of public health^11,12. This allows rapid collection of data given with a wide-angle lens from a diverse group of individuals, maintaining their anonymity if they wish to do so^11.

The questionnaire was based on the literature review particularly, in line with the FIP Goal no 5, competency development⁷. Further, the questionnaire incorporated demographic details related to the participants. To validate, this questionnaire was initially piloted to 5 pharmacists to check the reliability, comprehensibility, functionality, time taken to complete, and was revised accordingly. We continued the data collection until the point of data saturation and redundancy, as required by qualitative studies¹³. Thematic analysis is a widespread method used for qualitative analysis utilizing a specific coding system to help organize the data in a reasonable way so that meaningful conclusions can be drawn^12,14. While the main themes were already known from FIP Goal no 5, competency development⁷ (Deductive thematic analysis), the sub themes emerged from inductive reasoning after the detailed analysis of the data^15,16.

We obtained the ethical approval for the study from St. Stephen’s college, Kerala and the stakeholders gave prior consent.

RESULTS:

The demographic details of the participants are depicted in Table 1.

Table 1; Demographics of the participants

	Effect (n)	Percentage %
Gender distribution Male	16	57.1
Female	12	42.9
Educational level
B.Pharm	2	7.1
M.Pharm	10	35.7
Ph.D	7	25.0
Final Year B.Pharm/Pharm.D	2	7.1
Not specified	7	25.0
Age distribution
20-25	5	17.9
25-30	2	7.1
30-35	3	10.7
35-40	6	21.4
40 and Above	11	39.3
Not specified	1	3.6
Area of work
Teaching	12	42.9
Hospital	2	7.1
Community Pharmacy	3	10.7
Pharma Industry and Marketing	5	17.9
Research	2	7.1
Regulatory Department	2	7.1
Final Year/Fresh Graduate	2	7.1
Experience and training:
<5 years	4	14.3
5-9 years	4	14.3
10-14 years	4	14.3
15-19 years	3	10.7
20-24 years	1	3.6
25-29 years	2	7.1
>29 years	6	21.4
Not specified	4	14.3

Table 2 represents the data presented in 3 main themes as shown in FIP,2021⁷ and the emerging sub‐themes as below.

Theme 1: FIP Development Goal of competency development 5: Workforce (Subthemes: Present admission process attracting enough talent, Policies to protect motivation, well-being, and resilience)

Theme 2: FIP Development Goal of competency development 5: Practice (Subthemes: Current foundational knowledge and competency-based education, Efficiency of current assessment tools, Balance between theoretical knowledge and clinical applications)

Theme 3: FIP Development Goal of competency development 5: Science (Subthemes: Pharmacy curriculum contributing to the development of pharmacists, Tools to evaluate the outcomes of CBE, Current pharmaceutical competency achieving the needs of the Indian market, Pharmacy education facilitating theory into real-life practice, Tools for collaborative learning and communication skills, Exposure to modern information and communication technology, Technical and administrative support for self-professional development including leadership

Table 2: Stakeholder’s opinions based on themes

Theme 1: FIP Development Goal of competency development 5: Workforce

Subthemes

Subcategories

Exemplar quotations

Present admission process attracting enough talent

-It is inadequate

-Yes

-Yes, but can be more stringent

“A centralised test for pharmacy admissions is required to attract best talent.”

“Still stringent screening procedure is essential to get admission in pharmacy courses.”

“The process is wonderful”

Policies to protect motivation, well-being, and resilience

-It’s on a basic level

-It depends on the institution.

-Some of the institutions not all

-None

-Yes, they are adequate

-Partial

“Generally, institutions strive to have policies supporting motivation, well-being, and resilience. Assessing adequacy would require reviewing specific policies and gathering feedback from students and faculty. Improvements could involve regular assessments, mental health resources, and responsive feedback mechanisms.”

“Formal policies are there just to fulfil the requirements of All India technical education and pharmacy Council of India. Not implemented”

“Some of the students are not aware of the importance of the Course. They can be engaged with experimental works to increase their interest.”

“Education is business in India. Educational institutions are becoming money minded.”

“Consider adding a Pharmacist Resilience and Wellness Program to your existing competency program. This initiative can include stress management workshops, mental health resources, and strategies to enhance well-being.

Theme 2: FIP Development Goal of competency development 5: Practice

Current foundational knowledge and competency-based education

-Yes. Updating new technologies, discoveries, workshop on using modern equipment is a must.

-The current syllabus is good but students need much more time period to learn everything.

-Strict examination and results control

-Current knowledge is insufficient

Foundational knowledge is very important to have a basic understanding

“Semester system of B Pharmacy is degrading the quality of education as this system is not sufficient enough to learn the core subjects”

“Yes, Foundational knowledge is crucial for a competent pharmacist, but incorporating real-world simulations, interprofessional collaboration experiences, and emphasis on evolving technologies could enhance competency-based education”

“I think, the various scopes of the pharmacy field should be educated among the students by conducting various workshops, research programs, etc for bringing the pharmacy field worldwide popular”

“Still candid techs are to be sculptured in blessing the progression of pharmacy education which leads best professional output.”

“Privatization of the universities has diluted the knowledge”

“Foundational knowledge is the core and invariably those with excellent knowledge of basic sciences are in a better place to garner a command of the advanced pharmacy courses and progression in research.”

“No. Talented pools are required to teach the students and also faculties to be recruited from pharmaceutical industry.”

“Specialization should be introduced at the undergraduate level”

“B. Pharm students need exposure to clinical pharmacy”

Suggested additional tools for the existing CBE:

- Artificial intelligence (AI) - Virtual reality - Pharmacogenomics - Marketing skills- Latest ICT tools to help align. - Wellness program

Efficiency of current assessment tools

-Assessment method is right. But tools have yet to be developed.

-More competitive assessment/exams

-No. Online evaluation is making the students and the examiner more lethargic

“The efficiency of current assessment tools varies. Some tools may accurately gauge student understanding, while others might have limitations. Continuous evaluation and updates are crucial for improving accuracy in student appraisal.

“Definitely needs to improve to produce skilled pharmacists who will excel in the market and meet the challenges of the health care needs.”

“Assessing students involves a variety of tools, and their efficiency can vary based on context and goals. Continuous evaluation, diverse assessment methods, and personalized approaches contribute to a more comprehensive understanding of students' abilities. However, ongoing research and adaptability in educational practices are essential for enhancing the effectiveness of assessment tools.”

Balance between theoretical knowledge and clinical applications

-Currently, the balance is very poor.

-No opportunities for practical exposure in India, especially, compared to abroad,

-One must be able to correlate and apply the theoretical knowledge practically

-Structured and clinical scenario modules are required to simulate real life skills.

“Pharmacy education should be focused on training students in curriculum as well different practice scenarios. Of course, graduates hone their skills further on job.” “It's still to knock door properly.”

“Theoretical knowledge are considered as a strong foundation to build multistorey building. Your hardworking, characters and efficiency will decide the number of floors.”

“The ideal balance between theoretical knowledge and clinical applications varies, but a strong foundation in theory enhances effective practical application, fostering a well-rounded understanding.”

“The balance between theoretical knowledge and clinical applications varies depending on the field, but generally, a strong foundation in theory enhances effective clinical practice. Practical experience helps apply and refine theoretical understanding, creating a symbiotic relationship for a well-rounded professional.”

“The ideal balance would be to apply the theoretical knowledge to help the patients and families with the disease prevention, medication management, and effectively participate in the health promotion programme of the state and provide cost effective and affordable treatment for the needy.”

“Somewhat imbalanced even after decades of introduction of Pharmacy Programme in the country, legislation and laws needs to be updated to bring respect and accountability of the Pharmacy workforce.”

“Studying drugs with clinical application. Theory complemented with exposure to different practical scenarios in real environments is essential.”

Theme 3: FIP Development Goal of competency development 5: Science

Present Pharmacy curriculum

contributing to the

development of pharmacists

-Budding pharmacist should be aware of drug dose response, drug interaction, along with other diseases.

-Training programme from time to time regarding to current updates.

-Yes, by gaining an understanding of the clinical and basic sciences modules.

“The present pharmacy curriculum focuses on providing comprehensive knowledge in pharmacology, therapeutics, and patient care. It includes clinical rotations, enabling pharmacists to develop skills in medication management, patient counseling, and interdisciplinary collaboration, fostering their role as medical experts in ensuring safe and effective drug therapy.”

“Curriculum is good. Students should attend college regularly and learn as much as possible”

“Advancing the Pharmacy practice and therapeutic module is required to gain advanced knowledge which will help to develop the future Pharmacist as medication management and use expert.”

“The subjects like pharmaceutical chemistry and Pharmacology and therapeutics are essential basics for excelling in Medication Management and use experts for the future Pharmacists, the drug information specialists in the tertiary care hospitals can perform in an effective way if they have adequate knowledge of Pharmacology and therapeutics, Pharmacoeconomics is another major field in which the professionals can contribute as an effective care givers specially in developing countries and it gained more important with the medical insurance.”

Tools to evaluate the outcomes of CBE

-No. Can improve the certification skills by using SWAYAM portal, OPEN WHO ,Programmed courses from Udemy, IT GUVI academy, Biotechnika

-No. AI and other tools should be incorporated

-Yes to certain extent.

“The effectiveness of tools for evaluating competency-based education outcomes varies. Continuous refinement and development of assessment tools, incorporating diverse measures like project-based assessments and real-world applications, could enhance their accuracy”

“To conduct exit exam for students.”

“Strict evaluation of answer papers and two mid-term exams average to be considered for each semester”

“Open book test, giving report on case studies”

“The assessment tools must be structured in line with international standards, need to have more training and infrastructure.”

“Time students rotating doesn’t look long enough for them to be ready with confidence and may be looked into”

“It could be improved by employing hands on modules and compulsory training in community and hospital.”

Current pharmaceutical competency achieving the needs of the Indian market

-Not enough. Still spurious Market products are compelling to circulate in the Market without any ethical values.

-Focused curriculum on clinical pharmacy

-The field of pharmacy has so many opportunities yet to be worked on

-Suitable for Industry, but not for community pharmacy.

“The pharmaceutical competency in India has evolved to meet diverse healthcare needs through a combination of generic drug manufacturing, research and development, and collaborations with global pharmaceutical companies. This approach allows for affordability and accessibility of medicines, addressing the diverse healthcare requirements of the Indian market.”

“By manufacturing new formulations, by discovering new drugs, by maintaining quality standards”

“Drug profile practice is required”

“The current pharmaceutical competency in India addresses market needs by developing and providing affordable medications, focusing on local health challenges, and complying with regulatory standards to ensure product quality and safety”

“The market is constantly expanding and rapidly growing, the future generations pharmacy professionals have to equip with latest technologies and soft skills.”

“There is an ever-growing demand for the skilled and competent pharmacists in Indian Market with the emerging healthcare demands and newer diseases and preventive healthcare solutions in the form of vaccination. Clinical trials is another niche market for the Pharmacy professionals to explore. "

Pharmacy education facilitating theory into real-life practice

-Makes us service oriented

-Adding new innovative ideas

-There's a big gap in theory and practice, a through curriculum Reforms in Pharmacy Education will help to bridge the gap.

-Students learn in classrooms, and obtain work experience at the same time, combining theoretical learning, quizzes, homework and applying it at work under supervision again.

“It is like an illusion/hallucination. Not satisfied”

“Most of the current pharmacy education are outdated but can apply the basics in real life practice”

“The integration of theory into real-life practice in current pharmacy education varies. Some programs excel at bridging the gap, emphasizing practical skills and clinical experience, while others may need to enhance their approach for a more seamless transition.

“The theoretical knowledge and understanding is important, but translation to the real life practice is a different ball game, for that the graduates are required to develop an excellent attitude and soft skills with good inter personal skills to effectively communicate with the different stakeholders.”

“Partial, still need improvement in the advanced pharmacy course and continuing study to keep pace with the current technologies.”

“Pharmacy education often provides a solid theoretical foundation, but the effectiveness of translating theory into real-life practice depends on the curriculum's practical components and experiential learning opportunities. Hands-on experiences, internships, and exposure to diverse healthcare settings can enhance the application of theoretical knowledge in real-world scenarios. Continuous efforts to bridge this gap contribute to producing well-rounded and competent pharmacy professionals.”

Tools for collaborative learning and communication skills

-Students should go to industry to learn

-Need 5 years curriculum like medical and dental courses

Regular updates based on user feedback would contribute to their ongoing improvement

“Various tools facilitate collaborative learning and communication for students, such as Google Workspace, Microsoft Teams, and Slack. While these tools are effective, continuous improvement is essential. Enhancements could include better integration of real-time collaboration features, enhanced user interfaces, and increased accessibility options to cater to diverse learning needs. Additionally, addressing privacy and security concerns is crucial for the ongoing development of these tools.”

“Institutes should have minimum set of equipment and materials to conduct experiments”

“Students should undergo training to be included as a part of curriculum. Final year should have 3 months quality control lab , 3 months in community pharmacy, 3 months in pharmaceutical industries and last 3 months in multispecialty hospital”

“Appoint qualified staffs. Arrange practical training. Pharmaceutical institutions must collaborate with relative commercial sector to have good exposure.”

“The area of communication, soft skills, humanities and ethics are to be given importance in the curriculum to produce an efficient and effective workforce”

“There's a big chance for improvement in collaboration between different disciplines of the medical sectors, the duplication of work and better coordination is required.”

“Can be improved by conducting various webinar, seminar and development program”

Exposure to modern information and communication technology

-Yes

-No, new technologies can be included in the syllabus

-Yes, but to keep pace with latest ICT tools, certification and self learning resource should be useful.

Implementing AI in pharmacy education

“Sufficient exposure to modern information and communication technology varies, but integrating more hands-on tech activities, updating curricula, and providing teacher training could enhance the learning experience.”

“It is a matter of infrastructure availability and trained dedicated staff is required to teach students”

“Ensuring sufficient exposure to modern information and communication technology (ICT) in education is crucial. Continuous integration of relevant tech tools, hands-on activities, and collaborative projects can enhance learning experiences. Regular updates to curricula to reflect technological advancements are also essential for keeping students well-prepared for the digital age.”

“The current generation is well versed with the use of modern technology in information and communication, and it helps to establish a strong and successful treatment options, with safety and effective health care services at affordable rates. Also, the research needs can be achieved with the use of modern technology in information and communication and artificial intelligence.”

Support for self-professional development

-Yes, but still not completely adequate.

-Not much

“Provided All of them are getting opportunities, most of them were not using the chances”

Curriculum Reforms required to gain respect for the Pharmacy profession

· The whole field needs to be revamped as students graduating further go on to become educators themselves or look for opportunities outside the country.

· Outdated drugs to be eliminated from syllabus. New updated software used in modern equipment can be updated, Simple extraction techniques and manufacturing siddha medicines in small scale, combination of allopathy and Siddha system of medicine can be updated, newer formulations and their evaluation etc.

· Syllabus should be uniform across India for all institutions and to be followed strictly. Public awareness and revolution in politics are required.

· To enhance Indian pharmacy education, consider incorporating:

1. Practical Application: Emphasize hands-on training and practical skills, ensuring students are well-equipped for real-world scenarios. 2. Industry Exposure: Foster collaborations with pharmaceutical companies for internships, workshops, and guest lectures to provide industry insights. 3. Interdisciplinary Learning: Integrate subjects like business management, ethics, and communication skills to prepare graduates for diverse roles in the pharmaceutical sector. 4. Research Emphasis: Strengthen research components, encouraging students to engage in meaningful projects. 5. Technology Integration: Include modules on emerging technologies like AI, data analytics, and digital health to align education with industry trends. 6. Patient-Centric Approach: Introduce courses on patient counseling, healthcare communication, and understanding patient needs to enhance the pharmacist's role in healthcare. 7. Global Perspectives: Include international perspectives in pharmaceutical regulations, practices, and innovations to broaden students' understanding of the global pharmaceutical landscape. 8. Continuous Learning: Encourage a culture of lifelong learning by incorporating continuous education modules, enabling professionals to adapt to evolving industry requirements. 9. Entrepreneurship Training: Provide resources and guidance for students interested in entrepreneurial ventures within the pharmaceutical domain. 10. Ethical and Regulatory Awareness: Strengthen the understanding of ethical practices and regulatory frameworks governing the pharmaceutical industry to ensure compliance and responsible conduct. 11. Collaborative Research Initiatives: Foster collaboration between academia and research institutions to promote cutting-edge research and development in pharmaceutical sciences. 12. Soft Skills Development: Integrate soft skills training, including teamwork, communication, and problem-solving, to enhance overall professional competence.

· Pharmacy law and legislation need to be updated with the prevailing scenario, subjects like pharmaceutical marketing, pharmaco-economics, and communication skills will help the students.

· Dedicated pharmacy university in major cities and in each state capital in line with the Indian institute of technology IIT, it can be Indian institute of Pharmacy IIP and recruit the best talented faculty, and Foster industry collaboration in order to be viable these institutions can collaborate with leading pharmaceutical companies of national and international reputation for commercial ventures, at the same time the students can be trained in different areas of pharmacy.

· Quality assurance is another important area for improvement in Indian Pharmacy scenario both in the educational and industrial sectors.

· So many unwanted chapters like maths, engineering, be deleted and add more clinical knowledge and interpretation of the labs, Pharmacoeconomics, genomic and vaccination, independent prescribing.

· Community pharmacy or hospital pharmacy seems to be still in its infancy in India. Pharmacy graduates are highly underutilized, and the profession deserves more awareness and respect.

DISCUSSION:

Stakeholder engagement significantly influences pharmacy education, its clinical relevance and practice development¹⁷. Recent study has shown that involving practitioners in curriculum design ensures programs reflect current practice needs^18.

Our study uniquely incorporates diverse stakeholder perspectives, including academia, industry experts, and recent graduates. The Indian pharmaceutical industry’s exponential growth—from $0.32 billion in 1980 to $21.3 billion in 2009-10—underscores the urgent need for a workforce equipped with practical skills and global competencies¹⁹. Recommendations include updating the curriculum, fostering collaborations with the industry, and aligning education with international benchmarks.

Several key points were elucidated from this exploratory study as discussed below:

1. “CBE and Societal Role of Pharmacists”

CBE aims to prepare pharmacists to address societal needs effectively, including improving patient safety and healthcare outcomes²⁰. As highlighted in our study, the transition to such a system in India faces challenges, including insufficient practical training and outdated curriculum designs. A Review by Sharma et al. emphasizes the crucial role of pharmacists in ensuring patient safety, noting their pivotal position in minimizing medication errors and optimizing drug use processes²¹. Developing practical skills through structured training, as seen in global examples like the UK's clinical rotations, can address these challenges²².

The COVID-19 pandemic has particularly highlighted the necessity for competency-based education, as pharmacists assumed expanded roles in public health, medication management, and patient education²³.

The successful implementation of CBE requires educational institutions to align their curricula with practice-based competencies, incorporating experiential learning opportunities to facilitate application of knowledge gained by the students in real-world settings²⁴. This alignment is particularly crucial in India, where studies have shown gaps between educational outcomes and industry requirements²⁵. These concerns were addressed by stakeholders in our study (Table 2). Furthermore, ongoing professional development has become essential for maintaining competency in an evolving healthcare landscape²⁶.

2.. “The Evolving Role of Pharmacists - Primary Care Provider”

Globally, pharmacists have transitioned from being primarily product-focused to patient-centred healthcare providers²⁷. This shift requires a curriculum that emphasizes interpersonal skills, ethics, and advanced pharmaceutical techniques. As noted by several stakeholders, integrating these elements into Indian pharmacy education can elevate the profession’s status and better serve societal healthcare needs (Table 2)

Mor et al. stress the increasing role of pharmacies in managing chronic and acute conditions²⁸, a trend that aligns with the opinions in our study. Expanding patient-centric services in Indian pharmacy education will better prepare graduates for these evolving roles²⁸. Additionally, Layqah et al. highlight that effective patient counselling, currently underdeveloped in many Indian pharmacy programs, plays a key role in patient satisfaction and treatment outcomes²⁹. Addressing communication gaps and incorporating counselling training can enhance pharmacist’s contributions to primary care²⁹.

To realize this expanded role, policy changes supporting formal integration of pharmacists into primary care teams are essential³⁰. This is particularly relevant in India, where mapping studies of private pharmacies indicate significant potential for expanding patient-centric services³¹. This will ultimately be improving healthcare outcomes and providing opportunities for global recognition of Indian graduates.

3. “Advancing Clinical Pharmacy Education”

As Porselvi discusses, the adoption of advanced clinical pharmacy education for chronic disease management is well-established in Western countries but remains underdeveloped in India³². Including advanced clinical training for conditions such as diabetes can align Indian pharmacy education with international standards is important³².

The COVID-19 pandemic has accelerated the need for telehealth integration in pharmacy curricula. Bingham et al. emphasize that pharmacy programs must incorporate this training to prepare graduates for remote healthcare delivery³³. This aligns with India's digital health initiatives and the technology-enabled pharmaceutical care³⁴.

As noted by our stakeholders, interprofessional education such as integration of nutrition education into pharmacy curricula has gained strong student demand for comprehensive patient care training^35,36.

4.“Technology and Innovation in Pharmacy Practice”

The integration of artificial intelligence (AI) into pharmacy education, as discussed by Bora et al., has the potential to revolutionize drug discovery, market access, and pharmaceutical pricing strategies³⁷. Our study findings emphasize the importance of exposing students to modern technologies, which could include AI tools for predictive analysis and drug interaction monitoring. This will prepare graduates for a technology-driven healthcare landscape.

Implementation challenges remain, however, as noted by our stakeholders (Table 2). Ameri et al. and other studies identify regulatory frameworks and training requirements as key barriers^38,39. The successful integration of these technologies requires addressing these challenges while ensuring pharmacists are equipped with necessary digital competencies.

5. “Transition from Academia to Practice”

The transition from academic learning to professional practice significantly influences the creation of professional identity among pharmacy students⁴⁰. In India, this transition is often hindered by limited practical opportunities and industry exposure as noted by number of Stakeholders in our study (Table 2). “Bridging the gap between theoretical knowledge and practical application through internships and hands-on training”, as suggested in our study, is crucial to developing confident and competent professionals.

Burrows et al. emphasize the growing importance of patient-centred care skills during this transition, noting that graduates must develop strong communication and collaborative abilities⁴¹. Rajiah et al. and similar others suggest student-centred active learning approaches could better prepare graduates for practice^42,43. These findings underscore the need for curriculum reform that bridges theoretical knowledge and practical application.

6. “Regulatory Framework and Curriculum Reform in India”

Pharmacy education in India has a strong regulatory foundation with the Pharmacy Act of 1948 and subsequent updates by the PCI and AICTE⁴⁴. However, these reforms have not kept pace with the rapid advancements in global pharmaceutical practices. As Surwade et al. highlight, the National Board of Accreditation’s (NBA) accreditation criteria offer a structured approach to evaluating educational outcomes, which could guide curriculum redesign to meet both national and international standards⁴⁵. Integration of pharmacovigilance and patient safety into core curricula remains crucial for preparing graduates for modern pharmacy practice. Pol et al. advocate for continuous curriculum evaluation and adaptation to meet contemporary healthcare demands⁴⁶. Excellent suggestions and recommendations have been made by our stakeholders, in transforming the journey of the Indian Pharmacy profession, beginning with attracting the best talent, taking care of their wellness through incorporation of Pharmacist Resilience and Wellness Program in the contemporary programs to revamp the existing pharmacy structure which will contribute to a robust pharmacy programme in India matching international standards (Table 2). However, several barriers to this implementation have been identified such as time consumption, lack of sufficient trained staff, lack of public awareness, need for revolution in politics and regulatory policies, and cost. Challenges remain in the efficient collaboration of intra- and interdepartmental structure within the profession. The pharmaceutical personnel, along with other important healthcare professions, needs to be armoured to cope with an increasingly high demand of patient care needs, and contemporary methods for professional education and training are a critical component of this solution^1,7.

CONCLUSION:

The findings of our study reflect broader global trends and highlight critical areas for reform in pharmacy education in India. The discussion incorporates insights from recent literature to contextualize these findings and propose actionable recommendations. Incorporating global best practices, leveraging technology, and fostering a student-centred approach are essential for transforming pharmacy education in India. By addressing gaps in curriculum, practical training, and professional development, educational institutions can prepare pharmacists for an increasingly complex healthcare landscape. This alignment will ensure that pharmacy graduates are not only competitive in the global market but also capable of addressing India’s unique healthcare challenges effectively.

STRENGTHS, LIMITATIONS AND FUTURE DIRECTIONS:

Our study findings should be interpreted in line with the study's limitations in mind. The first is related to nonresponse bias, which could lead to erroneous results as the nonrespondents might have differing views than the respondents. This was, however, circumvented as all the participants to whom the survey was sent, answered the questionnaire and data saturation and redundancy was used in the analysis. Secondly, the restriction of the sample to limited population from Southern India. Therefore, we cannot generalize the findings from this study beyond this region. Finally, investigating limited set of variables obtained from a single source would restrict the research conclusions. It is suggested that further larger research to build upon the current findings and follow up that could examine curriculum reforms in Indian Pharmacy education.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this study.

REFERENCES:

1. FIP-International Pharmaceutical Federation. ‘Statement of policy on good pharmacy education practice.’ The Hague: FIP; 2000. https://www.fip.org/file/1518. on...April2024

2. Shah N, et al. Competency-based medical education: An overview and application in pharmacology. Indian J Pharmacol. 2016;48:S5-9

3. NCVER: Employability, skills for the future. VOCED Plus International tertiary education research database 2002; Department of Education, Science and Training, Canberra. Available from: http://hdl.voced.edu.au/10707/62282. pp1-74.

4. Medina, M.S. et al. Center for the Advancement of Pharmacy Education2013 Educational Outcomes. Am. J. Pharm. Educ. 2013; 77: 162. [CrossRef] [PubMed]

5. David Guile and Farah Ahamed. Modernising the Pharmacy Curriculum. LLAKES Research Paper 26 Centre for Learning and Life Chances in Knowledge Economies and Societies. www.llakes.org.uk

6. Growth of pharmacy education in India from 1932 to 2007 [Internet]. [cited 2022 Apr 14]. Available from: http://test.pharmabiz.com/special features/growth-of-pharmacy-education-in-india-from-1932-to-2007-44185

7. The FIP Development Goals Report 2021: Setting goals for the decade ahead. (https://developmentgoals.fip.org/global-report-2021/ )) Accessed on 21st Feb 2024.

8. Sharon Susan Raj, et al. Modern pharmaceutical education and its root in India. International Journal of Research and Review. 2023; 10(2): 705-713. DOI: https://doi.org/10.52403/ijrr.20230286

9. Frenk, J., et al., Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 2010;376:1923-1958.

10. Draft: National Pharmacy commission Bill. Nov, 2023,

11. https://main.mohfw.gov.in/sites/default/files/Public%20notice%20Draft%20National%20Pharmacy%20Commission%20Bill.pdf Accessed on 28th October 2024.

12. Thomas SL, et al. Methodological and practical guidance for designing and conducting online qualitative surveys in public health. Health Promot Int. 2024; 39(3): daae061. doi:10.1093/heapro/daae061

13. Braun V, et al. The online survey as a qualitative research tool. International Journal of Social Research Methodology. 2021; 24(6): 641-54.

14. Rahimi S, Khatooni M. Saturation in qualitative research: An evolutionary concept analysis. Int J Nurs Stud Adv. 2024;6:100174. Published 2024 Jan 5. doi:10.1016/j.ijnsa.2024.100174.

15. Suter, W. N. 2012. “Chapter 12: Qualitative Data, Analysis, and Design.” In Introduction to Educational Research: A Critical Thinking Approach, 2nd ed., 342–86. Thousand Oaks, CA: SAGE Publications, Inc. https://doi.org/10.4135/9781483384443.n12.

16. Kiger ME, Varpio L. Thematic analysis of qualitative data: AMEE Guide No. 131. Med Teach. 2020; 42(8): 846–854. https://doi.org/10.1080/0142159X.2020.1755030.

17. Delve, Ho, L., and Limpaecher, A. (2024, March 01). Inductive Thematic Analysis and Deductive Thematic Analysis in Qualitative Research https://delvetool.com/blog/inductive-deductive-thematic-analysis

18. Bajis, D., et al.. Stakeholders' perspectives on quality assurance of pharmacy education in the eastern Mediterranean region. American Journal of Pharmaceutical Education. 2018; 82(10), 6482.

19. Bertilsson, E. Stakeholder role in setting curriculum priorities for expanding pharmacy scope of practice. Pharmacy Education. 203; 23(1): 640-647.

20. Patil, P. (2010). Recent Trends in Pharmacy Education and Practice. Conference Address.

21. Atkinson J., et al. The Second Round of the PHAR-QA Survey of Competences for Pharmacy Practice. Pharmacy (Basel). 2016; 4(3): 27. Published 2016 Sep 21. doi:10.3390/pharmacy4030027.

22. Palak Sharma et al, .A Review on Pharmacist Impact on patient safety. Asian Journal of Pharmacy and Technology. Tech. 2024; 14(1): 87-4 doi: 10.52711/2231-5713.2024.00016.

23. Winch, C., and Clarke, L. Front-loaded Vocational Education versus Lifelong Learning. Oxford Review of Education, 2004; 29(2): 239-252.

24. Durand C.et al. Contributions and challenges of community pharmacists during the COVID-19 pandemic: a qualitative study. J Pharm Policy Pract. 2022; 16; 15(1): 43. doi: 10.1186/s40545-022-00438-8. PMID: 35710392; PMCID: PMC9202330.

25. Önen Bayram FE, Köksal M. A Quantitative Curriculum Mapping of the Faculty of Pharmacy of Yeditepe University, Turkey: A Process to Assess the Consistency of a Curriculum with the Mission and Vision of an Institution and National Requirements. Pharmacy (Basel). 2019; 1; 7(3): 78. doi: 10.3390/pharmacy7030078. PMID: 31266147; PMCID: PMC6789817.

26. Balakrishnan, A., et al. Training needs assessment for employability in pharmaceutical industries. Open Access Macedonian Journal of Medical Sciences. 2020; 8: 239-244.

27. Martin, L., et al. Health informatics competencies for pharmacists in training. American Journal of Pharmaceutical Education. 2019; 83(2): 6512.

28. Shah, N. V., et al. Advances in Hospital Pharmacy. Research J. Pharm. and Tech., 2017; 10(2): 618-624. doi: 10.5958/0974-360X.2017.00120.2

29. Mor N. et al. The pharmacy as a primary care provider. Front Public Health. 2023;11:1221439. Published 2023; 24. doi:10.3389/fpubh.2023.1221439

30. Laila Ali Layqah, Yousif S. Alakeel, Jinan Z. Shamou. The Practice of Counseling in Pharmacy: Patients’ Perspectives. Asian J. Res. Pharm. Sci. 2018; 8(3):170-176.

31. Mossialos, E., et al. From "retailers" to health care providers: transforming the role of community pharmacists in chronic disease management. Health Policy. 2015; 119(5): 628-639.

32. Sabde YD.et al. Mapping private pharmacies and their characteristics in Ujjain district, Central India. BMC Health Serv Res. 2011; 11: 351. 2011; 28. doi:10.1186/1472-6963-11-351,

33. Porselvi, A. A Review on the Need of Advanced Clinical Pharmacy Education Services for Diabetes Prevention and Management in India. Research J. Pharm. and Tech., 2021; 14(1): 493-500.

34. Bingham JM, Axon DR. Telehealth Integration into Pharmacy Practice Curricula: An Exploratory Survey of Faculty Perception. Pharmacy (Basel). 2023; 11(4): 110. 2023; 30. doi:10.3390/pharmacy11040110

35. Deshmukh, P., Paliwal, S. Pharmacy education 2.0 with special reference to digital India. Multidisciplinary Reviews. 2024; 7(4): 2024065. https://doi.org/10.31893/multirev.20240655713.2023.00041.

36. Syed-Abdul MM. et al. Role of Nutrition Education in Pharmacy Curriculum-Students' Perspectives and Attitudes. Pharmacy (Basel). 2021; 9(1): 26. 2021: 23. doi:10.3390/pharmacy9010026

37. Ameena Samreen et al., An Overview of Various Subjects Included as Syllabus for B. Pharmacy Students by JNTUH for its Definitions, Significance, Objectives and Outcomes. Asian J. Res. Pharm. Sci. 2017; 7(1): 38-48.

38. Bora, S.J., et al. The Use of Artificial Intelligence in Pharmacy. Asian Journal of Pharmacy and Technology. 2023; 13(3): 229-4.

39. Ameri A, et al. Investigating Pharmacists' Views on Telepharmacy: Prioritizing Key Relationships, Barriers, and Benefits. J Pharm Technol. 2020; 36(5): 171-178. doi:10.1177/8755122520931442.

40. Jessy Jauza, Muhammad Thesa Ghozali. Professional competence and Perception on the Practical Implementation of Telepharmacy among Pharmacists – A Review. Research Journal of Pharmacy and Technology. 2024; 17(6): 2915-4.

41. Noble, C., et al. Making the Transition from Pharmacy Student to Pharmacist. Int J Pharm Pract. 2015; 23(4): 292-304.

42. Burrows. J., et al. (). We are all patient-centred now, aren't we? Lessons from new pharmacy graduates. Currents in Pharmacy Teaching and Learning. 2020; 12(5): 508-516.

43. Rajiah, K., et al. Students as partners: how the student-centred active learning concept may help Indian pharmacy education. Indian Journal of Pharmaceutical Education and Research. 2022; 56(4): 620-626.

44. Rajesh Kumar Sharma, Mark H. Gulela. Problem Based Learning in Nursing: A New Approach of Active Learning. Int. J. Nur. Edu. and Research. 2014; 2(1): 16-18.

45. Shivhare, S. C., et al. Indian Pharmaceutical Education and its Regulatory Authorities. Research J. Pharma. Dosage Forms and Tech., 2012; 4(1): 14-18.

46. Surwade, K. S., et al. A Review of NBA’s Accreditation Criteria for Programmes in Pharmacy. Res. J. Pharma. Dosage Forms and Tech., 2019; 11(1): 35-38. doi: 10.5958/0975-4377.2019.00005.3.

47. Pol, R., et al. Current pharmacy curriculum in India and need for an update. International Journal of Life-Sciences Scientific Research. 2017; 3(6): 1459-1461.