Understanding the ethical implications of AI adoption in future pharmacy education and practice is evolving to inform discussions and policy about the persistent “digital native” concept surrounding technological proficiency and generational differences, particularly in the context of ethical considerations related to AI integration [14]. This study's results shed light on pharmacy students' perspectives regarding AI integration into their education and practice, mainly focusing on ethical considerations.
Several studies have explored the ethical integration of AI, particularly ChatGPT, in pharmacy education. They emphasized the importance of ethical education in curricula, the reliance on AI support among students, and the need for ethical guidelines. The development and validation of the KAP-C tool provide crucial insights into pharmacy students’ perspectives on AI [15]. However, there's a noted paradox between AI benefits and concerns over privacy and human rights, emphasizing ongoing refinement for ethical AI integration. Findings underscore the need for ethical guidance and pedagogical strategies to ensure responsible AI use in pharmacy education [16]. Moreover, there’s a call for integrating ethical education into pharmacy curricula and establishing robust ethical guidelines to govern AI integration, highlighting the importance of ongoing discourse and refinement to align the AI in Education (AIED) systems with societal values [17]. To navigate ethical complexities, these systems propose frameworks highlighting seven core principles, including governance, transparency, sustainability, privacy, security, inclusiveness, and human-centered design.
Participants expressed various concerns and barriers related to AI integration in pharmacy. Notably, concerns regarding patient data privacy, susceptibility to hacking, potential replacement by AI systems, and cost limitations hindering accessibility were prominent. These concerns are consistent with previous research highlighting the importance of data privacy, cybersecurity, and equitable access to AI technologies in healthcare settings [18, 19]. Additionally, participants emphasized the need for comprehensive legal regulations governing the use of AI in pharmacy practice, proper training to utilize AI effectively, and addressing physicians’ reluctance and patient apprehension toward AI technologies. These findings underscore the importance of regulatory frameworks, education, and stakeholder engagement in fostering responsible AI integration in healthcare [20].
Research in various countries, including the UAE, Pakistan, Jordan, and Palestine, indicates positive attitudes of pharmacy and medical students towards AI in healthcare and education [21–25]. However, concerns remain about over-reliance, ethical implications, lack of awareness, and training persist. While students acknowledge the potential benefits of AI, they emphasize the importance of addressing ethical considerations, integrating AI education into curricula, and promoting responsible AI usage in academia and practice. This aligns with our findings on pharmacy students’ concerns about AI, suggesting a shared sentiment across healthcare disciplines regarding the potential benefits and challenges of integrating AI into education and practice.
Our study revealed a generally negative attitude among participants toward AI integration in pharmacy practice. Factors such as country of residence, monthly household income, university type, academic year, cumulative GPA achievement, work status, technology literacy, and basic AI understanding significantly influenced participants’ attitudes. These findings contradict a prior study suggesting that individuals with higher technology literacy may exhibit more positive attitudes toward AI [25]. This indicates a need for targeted interventions to address concerns and promote positive attitudes among pharmacy students, particularly those with higher academic achievement and technological proficiency.
These identified factors also reveal several noteworthy associations that provide insights into the dynamics of these concerns among pharmacy students. The discrepancy between countries might be influenced by diverse cultural, educational, or contextual factors in these regions. Interestingly, gender did not emerge as a significant predictor, suggesting that concerns about AI ethics are relatively uniform across male and female students. This did not align with our previous research, which indicated a different level of awareness and interest in AI-related topics among students [25]. The lack of a gender effect suggests a shared perception of the ethical implications of AI in pharmacy practice.
Monthly household net income was associated with students’ concerns, with those in the lower and middle-income brackets demonstrating a higher likelihood of expressing concerns. Economic factors can influence individuals’ perceptions of emerging technologies. Addressing these concerns is essential to ensure inclusivity and equal opportunities for students from diverse socioeconomic backgrounds. Academic factors, including university, academic year, and GPA, also shaped AI ethics concerns. These findings underline the need for targeted educational interventions, tailoring AI ethics discussions to students' specific academic context and progression. Another notable aspect is the influence of technology literacy and AI understanding on concerns. Students who reported agreement with being tech-savvy expressed concerns, indicating a potential relationship between technological familiarity and reduced ethical apprehensions.
In considering the integration of AI into pharmacy education and practice, it's crucial to identify the competencies that pharmacy graduates need to navigate and excel in an AI-driven world [26]. Pharmacy graduates must possess a blend of traditional pharmaceutical knowledge alongside technical competencies in data analytics and visualization, computational thinking, and ethical decision-making within AI applications in healthcare [27, 28]. Additionally, pharmacy graduates should be capable of collaborating effectively with multidisciplinary teams and be skilled communicators capable of effectively conveying complex AI-driven insights to patients and caregivers clearly and understandably [29, 30].
To ensure that these competencies are adequately addressed in pharmacy curricula, it is essential to integrate AI and digital health education throughout the pharmacy curriculum rather than treating them as standalone modules [31, 32]. Precisely, the integration can align with the Patient Care Process (PCPP) Framework, a foundational model that outlines the steps involved in providing pharmaceutical care [33]. AI can be incorporated into each stage of the PPCP Framework, from patient assessment and medication selection to monitoring and follow-up, to optimize clinical decision-making and improve patient outcomes.
Faculty and staff can leverage AI in pharmacy education to streamline administrative tasks, facilitate personalized learning experiences, and enhance teaching effectiveness [34]. Despite the potential benefits of AI in education, faculty and educational institutions must prioritize ethical AI practices and ongoing monitoring of AI systems' impact on student learning outcomes [35]. Additionally, students should be educated about the ethical implications of AI use and encouraged to evaluate AI-driven recommendations in the context of patient care critically.
Implications for Pharmacy Education and Practice:
There is a need to incorporate education on AI, digital health and biomedical ethics into pharmacy curricula, preparing future pharmacists with the skills and knowledge to navigate the ethical complexities of AI integration. Augmented reality, which combines virtual reality with AI, is pivotal in hybrid education and enhanced learning experiences, offering automation for teachers, personalized learning, and adaptive assessments [4]. This synergy creates personalized and immersive learning experiences, addressing individual students’ needs. Moreover, collaborative efforts involving stakeholders from various disciplines are essential to develop robust regulatory frameworks and promote responsible AI utilization in healthcare. Finally, regulatory bodies and policymakers should work to develop comprehensive legal frameworks and guidelines for the use of AI in pharmacy practice, addressing issues such as data privacy, accountability, and equity.
Limitations of the Study and Future Research
The sample size may not represent the entire pharmacy student’s community, limiting the generalizability of the findings. Additionally, the survey relied on self-reported concerns, which could be subject to response bias. Future studies could benefit from more diverse and larger samples. Future research could conduct in-depth interviews to gain a more comprehensive understanding of the ethical concerns and perspectives of pharmacy professionals and stakeholders. Longitudinal studies could track changes in attitudes and concerns over time as AI becomes more integrated into pharmacy practice. Comparative studies across different countries could highlight variations in concerns and the readiness of varying healthcare systems for AI integration. They are investigating the effectiveness of specific interventions, such as education programs, in mitigating ethical concerns and improving the responsible implementation of AI in pharmacy practice.
Finally, this study provides valuable insights into pharmacy students' ethical considerations and attitudes regarding AI integration in pharmacy practice. By addressing the identified concerns and promoting ethical AI practices, pharmacy education and practice can harness AI's potential to enhance patient care, improve outcomes, and advance the profession.