Introduction

Pharmacists play a vital role in improving health outcomes by promoting the safe and efficient use of medications and contributing to building more efficient and sustainable health systems. They traditionally work in various settings, including the pharmaceutical industry sector, representing diverse scopes of practice opportunities [1,2,3].

Pharmacist can hold managerial positions in sales and marketing within pharmaceutical companies. Several factors can contribute to holding managerial positions, such as education, experience, leadership skills, industry knowledge, and networking. Other factors are not skill-related and include age and gender. Historically, managerial roles have been male-dominated, with women facing significant barriers to career advancement. In recent years, there has been a growing recognition of the value that diversity brings to organizational management, and efforts have been made to increase the representation of women in managerial positions. However, women remain underrepresented in management positions and continue to earn less than male managers [4]. Additionally, the age factor in managerial positions is complex and multifaceted. While age can contribute to effective leadership, it can become a barrier to equal opportunities for career advancement in some cultures [5]. Finally, the role of education in career attainment has long been debated, with diverging results regarding the importance of degrees in managerial success [6, 7].

Pharmacists in managerial positions are expected to have the necessary competencies to meet the job requirements. Competencies refer to the knowledge, skills, attitudes, and behaviors that affect an individual’s role or responsibilities related to job performance and are subject to improvement through training and development activities [8, 9]. Implementing a competency framework for pharmacy across different fields could lay the foundation for bridging the gap between traditional pharmacy education and the evolving needs of modern healthcare systems [10, 11].

In 2020, the International Pharmaceutical Federation (FIP) released a revised version of its Global Competency Framework [12], initially developed in 2012 [13], specifically intended to early-career pharmacists. This framework outlines competencies somewhat relevant to pharmacists with managerial positions in sales and marketing, particularly in the domains of Pharmaceutical Public Health Competencies, Organization and Management Competencies, and Professional/Personal Competencies (leadership and self-regulation). Nevertheless, these competencies are not sufficient since pharmacists working as sales and marketing managers are also required to demonstrate unique competencies specific to their roles in the industry, typically acquired with time and experience [14]. For example, in addition to the sales competencies (e.g., financial planning, business analytics, prospecting, upselling, time management, territory management, accountability and ownership, influencing skills, interpersonal skills, growth mindset, negotiation skills, digital engagement competencies and selling benefits), sales managers need to have four other critical competencies, i.e., coaching, mentorship, strategy, and advanced communication skills [15, 16]. As for marketing managers, they must have technical proficiency in marketing, including a deep understanding of common marketing models, strategies, and tools and the ability to analyze the market trends and market dynamics, the competitive landscape and behaviors and the marketplace factors. They should also demonstrate strong leadership, analytical skills, communication expertise, creativity [17], alongside strong business acumen. In 2020, the FIP released the Global Advanced Development Framework (GADF), which included competencies related to management. However, these competencies were not tailored for pharmacists in sales and marketing managerial positions [18].

While many educational programs are available, without a defined and recognized competency framework, it remains unclear whether these programs are relevant and beneficial. Furthermore, the World Health Organization (WHO) Global Strategy for the Healthcare Workforce 2030 highlights that health systems in any country can only function with a competent and accessible health workforce equipped with the necessary competencies to provide quality care [19]. Hence, pharmacists and stakeholders are encouraged to embrace and adopt competency-based education and training (CBET) in their professional development. CBET focuses on evaluating the performance of pharmacists in the workplace based on specific competencies and incorporating competency-based instructional approaches and assessments. It is also crucial to regularly revise and update these competencies to ensure their relevance and currency [10].

In view of all of the above, this study aimed to develop and validate the Specialized Competency Framework for Pharmacists in Managerial Positions in Sales and Marketing (SCF-PMSM) among a sample of Lebanese pharmacists and assess correlates related to the competency domains. The secondary objective was to compare education and gender.

Methods

Content validity: domains, competencies, and behaviors

After conducting a comprehensive literature review, a panel of seven experts, comprising two pharmaceutical company managers and five senior researchers involved in pharmacy education and academia, developed a specialized competency framework using the Delphi technique. Consensus was reached when an agreement of more than 90% was obtained. The framework agreed upon consisted of six domains. Domains 0 to 5 were adapted from several studies [20,21,22] and documented in a competency framework previously suggested by the Order of Pharmacists of Lebanon (OPL) [23] and inspired by the FIP Global Competency Framework [13]. Domain 0 included one set of competencies related to pharmaceutical knowledge. Domain 1 (Professional Communication) comprised four competencies, i.e., communication skills, negotiation skills, data processing and analysis skills, and information technology skills. Domain 2 (Organization & Management) covered two competencies, i.e., self-management and overall management. Domain 3 (Professional Practice) encompassed three competencies, i.e., standard practice, ethical practice, and legal practice. Domain 4 (Personal Practice) included two competencies: role modeling and teamwork. Domain 5 described upper management competencies in one set.

Furthermore, since the pandemic occurred after the previous framework was released by the OPL, a sixth domain related to Preparedness and Response to Emergency was added, inspired by several studies [11, 14, 24, 25]. It included four competencies: emergency preparedness and response, operation management (during emergencies), patient care and population health interventions, and evaluation, research, and dissemination for impact and outcomes.

Study design

A cross-sectional study was carried out from March to October 2022 using an online questionnaire created on Google Forms for ease of distribution on social platforms (Facebook, Instagram, LinkedIn, and WhatsApp groups). The snowball technique was applied to reach pharmacists working as sales and marketing managers across the five Lebanese governorates (Beirut, Beqaa, Mount Lebanon, South Lebanon, and North Lebanon). Explanations about the topic and the different aspects of the study were available in the introductory section of the questionnaire. Respondents gave written consent before proceeding to the survey. Anonymity and confidentiality were ensured across the entire data collection process. All pharmacists registered with the OPL, holding managerial positions in sales and marketing, and living in Lebanon were eligible to participate.

Ethical aspect

The Lebanese International University School of Pharmacy Research and Ethics committee approved the study protocol (2022RC-041-LIUSOP). This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.

Sample size calculation

The minimum sample size was calculated using the CDC Epi-info software [26]. The expected frequency was set at 90% since specialized competencies and domains were expected to be fulfilled by working pharmacists. Accordingly, a minimum sample of 58 participants was required to produce an acceptable error of 5%, with a 95% confidence interval, a 5% alpha error, and a power of 80%.

Questionnaire and variables

The questionnaire was in English, as this language is commonly spoken by healthcare professionals in Lebanon, and comprised two sections. The first section collected information related to sociodemographic features and professional status. In this part, participants were asked about their general sociodemographic data, including their age, gender, area of work, university of graduation, highest educational level, years of experience, the number of working hours per day, and the number of working days per week.

The second section consisted of the scale-based framework, which covered six domains, each comprising a set of competencies with their related behaviors (Additional file 1).

Statistical analysis

The data were analyzed using SPSS software version 25. A descriptive analysis was done using the counts and percentages for categorical variables and means and standard deviations for continuous measures.

The content validity of the items was ensured by using a competency framework previously suggested by the Order of Pharmacists of Lebanon [23], with an additional domain related to emergency preparedness [11, 14, 24, 25]. An exploratory factor analysis using the principal component analysis technique was conducted for behaviors based on competencies and domains. For every analysis, the Kaiser–Meyer–Olkin (KMO) coefficient, Bartlett’s test for sphericity and total percentage of variance explained were reported. Cronbach’s alpha values were calculated for every competency to assess internal consistency (reliability). For structural validity, Pearson correlation coefficients were calculated to assess the correlation of the domains within their respective competencies, and their association with the other domains was used for convergent validity assessment.

Regarding the correlates of competencies, a multivariate analysis of covariance (MANCOVA) was carried out to compare the competencies domain between the highest degree (high academic degree vs. low) adjusted for age, gender, year of experience, number of working hours per day, university where they graduated as a pharmacist and level of education. Moreover, related multiple regressions were conducted to show the correlates of every domain. Stratifications over education level, gender, and experience duration were also presented; in the latter operation, polynomial contrasts were assessed to check the association of competencies with quartiles of experience duration. A p-value less than 0.05 was considered significant.

Results

A total of 60 pharmacists with managerial positions in sales and marketing in Lebanon participated in the survey out of 101 initially approached (participation rate: 59.4%). Half of them were female (50%), the majority had a BS pharmacy degree (81.7%), used the English language in education (58.3%), worked in the Beirut area (65.0%), and did not have another field of work (76.7%). Also, 40% had a BS in pharmacy as the highest degree, and 36.7% and 28.3% graduated and earned their highest degree from the BAU, respectively. The average age of participants was 43.30 ± 9.58 years; the mean duration of work experience was 11.68 ± 8.86 years, the mean number of working days per week was 4.85 ± 1.23, and the mean number of working hours per day was 8.60 ± 3.74 (Table 1). On average, respondents reported having acquired these competencies mainly by experience (68%), followed by postgraduate studies (42%), continuing education sessions (34%), and undergraduate studies (30%) (Table 1).

Table 1 Sociodemographic and other characteristics of the pharmacists with managerial positions in sales and marketing (N = 60)
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Factor analysis of competency domains

All competencies loaded on one factor and loaded adequately each on its respective domain (loading varied between 0.42 and 0.95). The percentage of explanation varied from 43.76% (management skills domain) to 92.00% (role modeling subdomain).

Cronbach’s alpha values were good to excellent, ranging from a minimum of 0.75 for the standard practice domain to a maximum of 0.96 for the upper management skills domain.

Table 2 presents the distribution of competencies according to the factor analysis.

Table 2 Factor analysis of the competencies of Lebanese pharmacists with managerial positions in sales and marketing (Promax rotated component matrix)
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Structural and convergent validity

All competencies were correlated together, except for the Preparedness and Response in the Emergency Situations competency, which was correlated only with the professional communication competency. The correlation coefficients varied between weak (0.255) for Preparedness and Response in Emergency Situations and Professional Communication Skills and very strong (0.824) for Upper Management Skills and Organization and Management Skills.

Moreover, all behaviors correlated well with their respective competencies. The correlation values for the first competency varied from moderate (r = 0.42) to very strong (r = 0.90). In the second competency, the correlation values were strong (> 0.6). For Competency 3, the correlation values varied from moderate (r = 0.50) to strong (r = 0.87). In Competency 4, a weak correlation (r = 0.33) was found between Role Modeling and Team Working domains. In competency 6, the correlation varied from moderate (r = 0.45) to strong (r = 0.90) (Table 3).

Table 3 Correlation analysis between the domains and competencies
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Multivariable analysis

The MANCOVA analysis was performed taking the competency domains as the dependent variables and the highest academic degree (vs. the lowest) as the independent variable after adjusting for the covariates (age, gender, year of experience, number of working hours per day, and the university of pharmacy education) (Table 4).

Table 4 Multivariable analysis of covariance (MANCOVA)
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Considering the organization and management skills domain as the dependent variable, being a female (Beta = − 4.95) was significantly associated with lower competencies. Taking the professional practice as the dependent variable, the results showed that being a male (Beta = − 3.18), having a BS degree (Beta = 5.04), and working for longer hours per day (Beta = 0.49) were significantly associated with higher competencies. Considering the personal skills domain, the results showed that being a female (Beta = − 1.00) was significantly associated with lower competencies.

As for the Preparedness and Response in Emergency Situations domain, a higher number of working hours per day (Beta = 1.06) was significantly associated with higher competencies.

No significant association was found between the independent variables used and pharmaceutical knowledge, professional communication skills, and upper management skills (p > 0.05 for all). Only experience showed a borderline association with upper management skills (p = 0.07).

Stratification over education

Figure 1 shows the means of the competency domain scoring between the highest academic degree (vs. the lowest) after adjustment over age, gender, year of experience, number of working hours per day, and the university of pharmacy education. No significant difference was found for all the competencies comparing pharmacists with higher and lower academic degrees (p > 0.05 for all).

Fig. 1
figure 1

Mean values of the domain scoring by highest degree (high academic degree vs low) adjusted for age, gender, year of experience, number of working hours per day, and university of graduation as a pharmacist (p > 0.05 for all). Domain 0: Pharmaceutical knowledge; Domain 1: Professional communication; Domain 2: Organization and management; Domain 3: Professional Practice; Domain 4: Personal Practice; Domain 5: Upper management; Domain 6: Preparedness and Response to Emergency

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Stratification over gender

The means of the competencies’ domain scoring between males and females, after adjustment over age, year of experience, number of working hours per day, university of graduation as a pharmacist, and level of education are shown in Fig. 2. Males declared significantly higher confidence than females in domains 1 (Professional communication), 2 (Organization and management), 3 (Professional Practice), and 4 (Personal Practice; borderline significance). In other domains, the difference was also in favor of males, but did not reach statistical significance (Fig. 2).

Fig. 2
figure 2

Mean values of the domain by gender, adjusted for age, highest degree, year of experience, number of working hours per day, and university of graduation as a pharmacist. Domain 0: Pharmaceutical knowledge; Domain 1: Professional communication; Domain 2: Organization and management; Domain 3: Professional Practice; Domain 4: Personal Practice; Domain 5: Upper management; Domain 6: Preparedness and Response to Emergency. P-values were: Domain 0: 0.113; Domain 1: 0.007; Domain 2: 0.006; Domain 3: 0.009; Domain 4:0.066; Domain 5: 0.745; Domain 6: 0.131

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Stratification over experience

Work experience duration was associated with higher competency scores for all domains; it reached statistical significance for domains 1 (professional communication), 4 (personal practice), and 5 (upper management) (Fig. 3).

Fig. 3
figure 3

Mean values of the domain scoring by experience quartile, adjusted for age, gender, highest degree, number of working hours per day, and university of graduation as a pharmacist. Domain 0: Pharmaceutical knowledge; Domain 1: Professional communication; Domain 2: Organization & management; Domain 3: Professional Practice; Domain 4: Personal Practice; Domain 5: Upper management; Domain 6: Preparedness and Response to Emergency. P-values for polynomial contrasts were: Domain 0: 0.132; Domain 1: 0.013; Domain 2: 0.114; Domain 3: 0.282; Domain 4:0.009; Domain 5: 0.051; Domain 6: 0.775

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Discussion

To our knowledge, this study is the first to develop and validate the Specialized Competency Framework for Pharmacists in Managerial Positions in Sales and Marketing (SCF-PMSM) among a sample of Lebanese pharmacists; hence, it might be challenging to make comparisons with previous studies. This framework demonstrated good reliability, content, construct, and structural validity in all the domains, with the competencies being well correlated with their respective domains and behaviors having excellent loadings on related competencies, except for emergency preparedness and response. Expectedly, this domain had a low correlation with others (significance was only shown with the professional communication domain) since the concept is not taught at any level of the pharmacy curricula. Further, no studies were found about emergency preparedness among pharmacists with managerial positions in sales and marketing. However, this lack of preparedness was reported in various health sectors during the COVID-19 pandemic [27]. Despite the statement of policy released by the FIP in 2017 and published frameworks related to emergency preparedness, no countries seem to have included a part related to this aspect in their frameworks [11, 14]. Furthermore, comparisons were made with findings from other sectors due to the lack of data and specificity in the literature on the competencies of pharmacists with managerial positions in sales and marketing. Mapping our framework with the management and leadership areas of the FIP-GADF would help optimize the suggested framework [18].

As for the correlates of the competency domains, gender and years of experience were the main factors associated with self-declared confidence in different behaviors. Consistent with previous literature findings, males were more confident than females in the following domains: Professional Communication, Organization & Management, Professional Practice, and Personal Practice. The gender gap in confidence has long been described as the rule rather than the exception in different sectors (medicine, business, and finance) and age groups (schoolchildren, young adults, and adults) and seems to be cross-cultural [28,29,30,31]. In a sample of about one million people from 48 countries [32], self-esteem among men was significantly higher in each culture.

Furthermore, participants with longer experience (or heavier workload) declared having higher levels of competency, particularly for the subdomains of upper management skills, communication skills, and professional practice. Studies have shown that education level does not necessarily correlate with declared competency in the workforce, as people with the same degree can have different levels of competency. Further, competency acquisition is a lifelong process that continues after graduation. The on-the-job experience was the most significant predictor of competency, rather than formal education [33,34,35].

Also, education level was not significantly correlated with declared competency; this result was confirmed by the fact that experience was the most cited source of competence, followed by postgraduate degrees and continuing education sessions, while undergraduate education was the least reported. A study exploring self-reported competency of graduating nursing students and their perception of the quality of the undergraduate program revealed that some competency domain scores were significantly associated with previous professional experience, but none were associated with degree grades [33].

These results suggest a mismatch between what is taught at undergraduate and postgraduate levels and the needs in actual practice, confirming previous findings among pharmacists from different professional sectors in Lebanon [23, 36]. This discrepancy described in the literature triggered a reflection on studies and strategies to counter this issue and reduce the gap between formal education and job market needs [37, 38].

In light of all these facts, relevant stakeholders should place more emphasis on work experience and continuing professional development rather than solely relying on formal education as an indicator of competency.

Limitations and strengths

This study has several limitations. It was conducted online, and a selection bias may have occurred due to the lengthy questionnaire. Additionally, the study relied on self-reported data, and participants may have overestimated or underestimated their competencies, and recall bias is also possible due to the economic crisis affecting the healthcare sector. The study may also have residual confounding bias and a low power due to the small sample size. Therefore, further research on a larger scale is recommended to address these limitations.

Despite these limitations, developing and implementing a framework to assess competencies among pharmacists with managerial positions in sales and marketing is crucial for improving pharmacy practice in Lebanon. This framework can align with international pharmacy standards, adapt to local needs, and guide universities and pharmaceutical companies in identifying gaps and developing expertise in the sales and marketing field.

Conclusion

This study could develop and validate the Specialized Competency Framework for Pharmacists in Managerial Positions in Sales and Marketing (SCF-PMSM) among a sample of Lebanese pharmacists. This framework demonstrated good reliability, content, construct, and structural validity in all the domains, with the competencies being well correlated with their respective domains and behaviors having excellent loadings on related competencies, except for emergency preparedness and response. It also revealed a mismatch between what is taught at undergraduate and postgraduate levels and the needs in practice, confirming previous findings among pharmacists from different professional sectors in Lebanon. Hence, relevant stakeholders should place more emphasis on work experience and continuing professional development rather than solely relying on formal education as an indicator of competency to reduce the gap between formal education and job market needs.