Abstract
Background
The rapid integration of digital health technologies into pharmacy practice necessitates the development of corresponding competencies within pharmacy education. This study describes the development and evaluation of a novel elective course on digital health designed for professional pharmacy students.
Methods
The 15-hour elective course was offered to second- and third-professional year pharmacy students and emphasized foundational knowledge, clinical application, ethical reasoning, and digital tool proficiency, with learning objectives mapped to the educational outcomes of the Accreditation Council for Pharmacy Education (ACPE) Standards 2025. Course delivery incorporated active learning methods such as hands-on demonstrations, debates, and case-based assignments. Student learning was assessed through exams, assignments, and implementation activities. Anonymous course evaluation and perception survey was administered at the end of semester, and descriptive statistics were used to summarize quantitative outcomes.
Results
Thirty students enrolled and completed the course. Course evaluation survey responses (97% response rate) indicated high satisfaction with course organization and instructional methods. Perception findings showed strong endorsement of the course’s relevance to modern pharmacy practice and its role in enhancing digital health competencies. Learning objective achievement was assessed by mapping exam questions, assignments, and graded activities to objectives and calculating combined scores. Students with scores > 70% were considered to have met the objective. At least 83% of students met this threshold for all objectives, with 100% achieving it for seven of ten objectives.
Conclusion
The elective course effectively supported student learning and preparedness in digital health, aligning with ACPE educational standards and addressing emerging practice needs.
Supplementary Information
The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-10008-0.
Keywords: Digital health, Pharmacy education, Pharmacy practice
Background
Digital health, encompassing technologies such as telemedicine, mobile health applications, electronic health records, and artificial intelligence (AI)-driven clinical decision support systems, have emerged as a foundational component of modern practice. In pharmacy practice, these technologies can support remote access to care, medication adherence and chronic disease monitoring, medication safety through electronic prescribing and clinical decision support, and more efficient medication-use processes [1–4];. Pharmacists are increasingly required to leverage these tools to optimize therapeutic outcomes, enhance medication safety, and manage chronic diseases through interventions like remote patient monitoring and adherence platforms [5–12].
Consequently, the development of a digitally literate pharmacy workforce has become a professional necessity. This need is explicitly recognized by international bodies such as the International Pharmaceutical Federation (FIP) through its Development Goal 20, as well as accrediting bodies, including the Accreditation Council for Pharmacy Education (ACPE) which require education on digital health and its associated technologies [8, 13]. Failing to prepare future practitioners for this technological shift risks leaving pharmacists unable to practice at the top of their license and creates potential gaps in coordinated patient care [14, 15].
Despite the growing relevance of digital health in pharmacy practice, global studies and comprehensive reviews have consistently indicated a significant gap, revealing that a large proportion of pharmacy schools lack formal, dedicated digital health education components [16–20]. Students and interns reported feeling unprepared, indicating a substantial deficiency in their digital health literacy and practical skills [21–23]. This is compounded by a global lack of standardized curriculum, where a large proportion of schools offer minimal dedicated digital health training [18]. The result is a cohort of graduates who may possess strong clinical knowledge but whose digital health literacy level and competence to effectively utilize digital tools are varied, potentially limiting their ability to practice in a modern setting [21, 22, 24].
Therefore, the objectives of this manuscript are twofold: first, to describe the development and implementation of a new course in digital health for Doctor of Pharmacy students, and second, to gauge students’ perception about the learning experience, content relevance, and impact on their preparedness for future practice.
Methods
Educational setting
The Lebanese American University (LAU) School of Pharmacy program consists of two pre-pharmacy years and four professional pharmacy years that is accredited by the Accreditation Council for Pharmacy Education (ACPE).
Digital health course description
The digital health 1-credit elective course is designed for second- and third-professional year pharmacy students. The course content falls under the social/administrative/behavioral sciences category of ACPE’s Appendix 1 required elements of the didactic PharmD curriculum. The course learning objectives were formulated using an outcomes-based approach informed by intended digital health competencies, ACPE Standards 2025 educational outcomes, and Bloom’s taxonomy to ensure measurable objectives across progressive cognitive levels [13, 25]. These objectives are detailed in (Additional file 1), where they are mapped to the ACPE Standards 2025 educational outcomes and aligned with corresponding course activities and assignments.
The course was intentionally designed using the evidence-based practice (EBP) 5-step framework (Ask, Acquire, Appraise, Apply, Assess) to structure student learning (Additional file 2) [26]. A blended instructional approach was adopted, integrating didactic teaching with active learning strategies across multiple levels of Bloom’s taxonomy (knowledge, comprehension, application, synthesis, and evaluation).
The course begins with foundational concepts, introducing students to the scope, components, and impact of digital health in pharmacy practice. Students then progress through focused topics such as digital diagnostics and biomarkers, digital therapeutics, remote monitoring tools, AI chatbots, and automation in the medication management process. The AI chatbot session also addressed ethical considerations, including the accuracy and limitations of automated health advice, misinformation, transparency, patient dependency, and the need for pharmacist verification and human oversight. The content builds toward more complex systems like closed-loop medication management, telehealth environments within pharmacy practice, human factors engineering, and ethical considerations in digital health and artificial intelligence. Course development and selected instructional materials were informed by relevant international guidelines and policy statements, regulatory standards, and digital health industry resources to support evidence-based learning. Examples included telehealth guidance from the Centers for Medicare & Medicaid Services; FDA guidance on digital health technologies for remote data acquisition; the ASHP/ASHP Foundation Pharmacy Forecast 2025; and ASHP guidelines and statements on telehealth pharmacy practice, automated dispensing cabinets, artificial intelligence in pharmacy, and bar-code-enabled medication administration technology [27–34].
The course delivery emphasizes active student engagement through case discussions, hands-on demonstrations, student presentations, debates, and clinical application assignments. Practical engagement is emphasized through live demonstration of a Continuous Glucose Monitoring (CGM) device, and structured discussions with a guest speaker in telehealth practice. Structured learning activities included application-based videos demonstrating real-world medication-use technologies, engaging assignments including small-group presentations evaluating digital therapeutics and a human factors engineering assignment, and a graded team-based debate on digital health controversies. In the digital therapeutics’ assignment, student groups selected a unique digital therapeutic tool and delivered a brief presentation evaluating its functionality, clinical evidence, patient outcomes, accessibility, and relevance to pharmacy practice, followed by a question-and-answer discussion. In the human factors engineering assignment, students selected a digital health or medication-use technology, described its functionality, identified a related human factors challenge, examined its impact on pharmacists, patients, or care processes, and proposed improvement strategies using evidence-informed rationale. Debate topics addressed real-world controversies such as the role of AI-powered decision support in clinical decision-making, accountability for AI-related medication errors, ethical concerns surrounding patient data use, the role of telepharmacy versus in-person consultation, and the clinical value and responsibilities associated with wearable health technologies.
Student learning is evaluated through a combination of assignments, examinations, and active participation, designed to foster real-world thinking, professional judgement and practical communication skills. All assessments were aligned with the EBP framework to evaluate both knowledge acquisition and higher-order competencies, including critical appraisal, application, and reflective evaluation.
Data collection and analysis
Student satisfaction with course delivery, organization, and perceptions of digital health was assessed through an anonymously administered online survey at the end of the semester. The survey measured satisfaction with course structure, clarity of objectives, instructional methods, learning experience, workload, and overall quality using a 4-point Likert scale strongly agree, agree, disagree, and strongly disagree. It also included 13 items evaluating the value and impact of the course, focusing on its relevance to contemporary pharmacy practice, the applicability of digital health tools, and the extent to which it enhanced students’ digital health competencies, rated on a 4-point Likert scale strongly satisfied, satisfied, dissatisfied, and strongly dissatisfied).
Exam questions and assignments were mapped to the corresponding course learning objectives. For each objective, students were considered to have met the objective if they scored at least 70% on the associated assessment components. Direct assessment data were extracted from course records and analyzed retrospectively to calculate the average score and the percentage of students meeting each learning objective.
Data were analyzed in Microsoft Excel® with descriptive statistics used to calculate mean scores (± SD) and percentages of responses indicating agreement or satisfaction. This study was approved by the university’s Institutional Review Board (IRB) (LAU.SOP.ER2.27/Oct/2025). Informed consent was obtained from students at the beginning of the survey. Access to identifiable information was limited to the investigators. All participant identifiers were replaced with coded labels to ensure anonymity during data analysis.
Results
Thirty students enrolled in the course and successfully completed all requirements. With a response rate of 97% (29 out of 30 students), the student course evaluations indicated a high level of satisfaction with the course structure, instructional methods, and overall learning experience (Table 1). All students agreed the course was well organized, relevant, and effectively delivered, with strong encouragement of participation and timely instruction. Most students (97%) also agreed that course materials supported learning and that the overall experience was beneficial.
Table 1.
Course Evaluation Ratings (N = 29)
| Percent of students (SA + A) |
|
|---|---|
| The course was effectively organized and well structured. | 100% |
| Assigned texts and other resource materials facilitated my learning experience in this course | 97% |
| Graded assignments (exams, papers, projects, presentations, performances, reports, etc.) were relevant to the material covered in the course. | 100% |
| The learning experience in this course was beneficial | 97% |
| The course learning outcomes were effectively covered by the faculty member. | 100% |
| Student participation (discussion, debate, independent critical thinking, creativity, innovative thinking, etc…) was encouraged. | 100% |
| The faculty member ensured a timely delivery of workload in the course. | 100% |
| The teaching practices used were effective in delivering the course learning outcomes. | 100% |
Percentages represent the proportion of students who selected “Strongly Agree” or “Agree” (SA + A) for each evaluation item
Student feedback on the digital health elective indicated strong overall endorsement of the course’s relevance, content, and educational value. As shown in Table 2, students overwhelmingly recognized the importance of digital health in contemporary and future pharmacy practice, expressing that the course enhanced their understanding and preparedness to engage with emerging technologies. The course was perceived as intellectually engaging and closely aligned with real-world healthcare challenges. Nearly all students would recommend the course to peers and supported its continued inclusion in the pharmacy curriculum.
Table 2.
Students’ Perceptions of the Digital Health Elective (N = 29)
| Percent of students (SS + S) |
|
|---|---|
| The Digital Health course is relevant to my future role as a pharmacist. | 100% |
| The course helped me understand how digital technologies are used in pharmacy practice. | 100% |
| I believe digital health will play a significant role in the future of healthcare. | 100% |
| The topics covered (e.g., telehealth, digital therapeutics, AI) are essential for pharmacy students. | 100% |
| The course content was aligned with real-world healthcare challenges. | 100% |
| The Digital Health course is relevant to my future role as a pharmacist. | 97% |
| The course helped me understand how digital technologies are used in pharmacy practice. | 100% |
| I believe digital health will play a significant role in the future of healthcare. | 100% |
| I found the course intellectually engaging. | 97% |
| The course introduced new concepts I was not previously aware of. | 97% |
| I feel more prepared to engage with digital health tools in my future practice. | 100% |
| I would recommend this course to other pharmacy students. | 97% |
| The course should remain a part of the pharmacy curriculum. | 100% |
Percentages represent the proportion of students who selected “Strongly Satisfied” or " Satisfied " (SS + S) for each evaluation item
Assessment of learning objectives showed strong student performance across all exams and assignments (Table 3). Each objective contributed 4 to 16% of the final grade, and at least 83% of students scored above 70% for every objective, with seven objectives reaching 100%. Average scores on a 5-point scale ranged from 4.14 ± 0.47 to 5. The lowest-scoring objective involved explaining the role of telehealth, while objectives on defining digital health, using AI chatbots, and examining digital health tools achieved the highest scores and full student attainment.
Table 3.
Students’ Achievement of Course Learning Objectives (N=30)
| Learning objectives |
Weight in final grade
(%) |
Average score ± SD (out of 5) |
Students
scoring > 70% (%) |
|---|---|---|---|
| Define digital health and describe its significance in contemporary pharmacy practice. | 4% | 5 ± 0 | 100% |
| Identify the different applications of digital diagnostics and digital therapeutics. | 9% | 4.79 ± 0.38 | 100% |
| Identify ethical dilemmas that may arise in digital health scenarios. | 14% | 4.35 ± 0.14 | 100% |
| Explain the role of telehealth and its application in pharmacy practice environment. | 15% | 4.14 ± 0.47 | 83% |
| Differentiate and describe various automation technologies for different steps of the medication management process. | 7% | 4.61 ± 0.57 | 97% |
| Demonstrate adequate use of AI Chatbot to answer drug related queries. | 5% | 4.88 ± 0.38 | 100% |
| Examine the functionality and benefits of remote monitoring tools, wearable health devices and mobile health applications. | 6% | 4.9 ± 0.31 | 100% |
| Explain the functionalities of digital health tools used in community and hospital settings. | 15% | 4.56 ± 0.37 | 100% |
| Develop strategies for integrating digital health tools into pharmacy practice to enhance patient care. | 16% | 4.4 ± 0.42 | 100% |
| Assess the potential risks associated with digital health technologies, including data breaches and misuse of patient information. | 8% | 4.36 ± 0.6 | 97% |
Weight in final grade indicates the proportion of the total course grade allocated to each learning objective. The average score (± SD) is normalized to a 5-point scale. Percent of students scoring >70% refers to those who achieved more than 70% of the allocated points for the respective learning objective assessments
Discussion
This study described the development, implementation, and evaluation of a digital health elective designed to provide pharmacy students with foundational knowledge and practical exposure to digital health concepts relevant to contemporary pharmacy practice. Overall, the course was well received, with students achieving all learning objectives and reporting high levels of satisfaction with the course design, relevance of content, and instructional strategies. Student performance across assessments suggests that a structured, competency-oriented course can effectively enhance knowledge, skills, and confidence related to digital health tools. These findings align with prior literature demonstrating that targeted educational interventions can address existing gaps in digital health preparedness among pharmacy students [18, 23, 35].
Pedagogical approaches to digital health
Embedding digital health concepts across therapeutics, skills laboratories, and experiential education may enhance progressive skill development. However, such integration is often constrained by the lack of standardized competency frameworks, variable faculty expertise, limited curricular time, and logistical-related barriers. Addressing these challenges will require coordinated faculty development and resource planning [7, 11, 14, 19, 36–38]. In this context, frameworks such as Health Education England’s Digital Capabilities framework have been proposed to ensure coherence between teaching, learning outcomes, and assessment and may support more consistent implementation aligned with evolving practice needs [39]. In response to these challenges, pharmacy programs have adopted different educational approaches to digital health education, including blended learning models and practical courses using simulations and real-world tools [19, 35, 40]. The course described in this study aligns with these approaches by offering structured content, hands-on learning activities, and applied assessments that address both knowledge and skills. To support a structured progression from awareness of digital health concepts to critical appraisal and applied use of digital tools, the Ask, Acquire, Appraise, Apply, Assess framework provided an organizing structure for sequencing learning activities and scaffolding competency development (Additional file 2) [26]. It enabled a progressive learning pathway, beginning with formulation of clinical questions and evidence acquisition, advancing through critical appraisal of digital health technologies, and culminating in application and structured assessment through both simulated and real-world contexts. This structured approach supported integration of cognitive, analytical, and applied learning domains within a single cohesive framework.
Assessment of learning
Assessment of digital health competencies in pharmacy education remains heterogeneous. Reported methods include quizzes and written examinations on health informatics concepts, critical appraisal of digital health tools and mobile applications, patient care plan presentations incorporating digital health technologies, and live evaluations of telehealth consultations [19, 23]. The assessment strategy employed in this course integrates knowledge-based, skills-based, and reflective components, thereby supporting comprehensive evaluation of student learning. Furthermore, differences in grade weight across the learning objectives reflect the varying levels of cognitive complexity of the skills being covered. Objectives related to applying digital health tools in the patient care process and recognizing ethical dilemmas were assigned higher weight because they require critical thinking and decision-making skills that are increasingly essential as pharmacists engage in technology-enabled care [28, 34, 41, 42]. In contrast, objectives such as defining digital health and identifying tool categories represent foundational knowledge and were therefore assigned lower weight.
Students’ perceptions of digital health
Students have consistently identified a need for more comprehensive and hands-on digital health training, particularly in areas such as telehealth, wearable technologies, mobile health applications, electronic health records, and artificial intelligence [23, 35, 43]. Consistent with prior research, students in this study demonstrated positive perceptions of digital health and its relevance to future pharmacy practice. Globally, pharmacy students report strong agreement that digital health technologies can improve patient care quality, enhance counseling, and support medication adherence [21, 23, 44, 45]. There is also widespread willingness to adopt emerging technologies, including artificial intelligence, and to engage in further digital health training. Higher literacy and confidence have been associated with greater exposure to digital health technologies, advanced year of study, and personal use of mobile health applications [24, 46, 47]. Despite these positive attitudes, gaps remain between perceived importance and self-reported competence. These findings underscore the importance of structured educational interventions, such as the elective course described here, that move beyond awareness to skill development.
Alignment with ACPE educational outcomes
The course demonstrates intentional alignment with the ACPE Standards 2025 Educational Outcomes through structured mapping of learning objectives and assessments [13]. Domain 1 (Knowledge; Learner) is addressed by establishing foundational understanding of digital health concepts and their relevance to pharmacy practice. Domain 2 (Skills) is supported through applied activities that engage students as Providers, Communicators, Problem Solvers, Stewards, Advocates, Promoters, and Leaders, including evaluation of digital therapeutics, telehealth case application, automation exposure, and use of artificial intelligence tools. Ethical reasoning and professionalism are emphasized through Domain 3 (Attitude), as students examine data privacy, safety, and ethical challenges associated with digital health technologies. Overall, this outcomes-driven alignment provides an accreditable approach to advancing digital health literacy and practice readiness within the PharmD curriculum.
Study limitations
This study has several limitations. First, it was conducted on one cohort at a single pharmacy school with a relatively small sample size, which may limit the generalizability of findings to other institutions or educational settings. Second, because of the elective format of the course, students who enrolled may have had a pre-existing interest in digital health, introducing potential selection bias. Third, the findings do not capture long-term retention or application of learned competencies in practice. Finally, qualitative feedback from course evaluations was limited, with only three students providing comments, all of which focused on perceived course workload. Although these comments highlight opportunities to optimize workload balance in future course iterations, the limited number of responses restricts interpretation of qualitative feedback.
Conclusion
The findings of this study suggest that a structured digital health elective can provide pharmacy students with foundational knowledge, applied exposure, and opportunities to critically engage with digital health tools relevant to contemporary pharmacy practice. Students achieved the course learning objectives and reported positive perceptions of the course’s relevance and educational value. Further longitudinal, comparative, and competency-based research is needed to determine whether such curricular interventions reduce broader gaps in digital health education and literacy in pharmacy education. Clear educational frameworks remain essential to prepare graduates to use, evaluate, and contribute to the implementation of digital health innovations in pharmacy practice.
Supplementary Information
Acknowledgements
None.
Abbreviations
- ACPE
Accreditation Council for Pharmacy Education
- EBP
Evidence-based Practice
Authors’ contributions
E.R. and M.Z. contributed equally as co-first authors. E.R. and M.Z. were responsible for conceptualization, methodology, investigation, visualization, project administration, supervision, and writing the original draft, as well as reviewing and editing the manuscript. ReK. performed data curation, formal analysis, visualization, and manuscript review and editing. R.K. contributed to conceptualization, methodology, data curation, formal analysis, validation, investigation, visualization, and writing the original draft, as well as reviewing and editing the manuscript. All authors read and approved the final manuscript.
Funding
None.
Data availability
All data generated or analyzed during this study are included in this published article. Additional material is available from the corresponding author on reasonable request.
Declarations
Ethics approval and consent to participate
This study was approved by the Lebanese American University Institutional Review Board and granted exempt status under the code number LAU.SOP.ER2.27/Oct/2025). Informed consent was obtained from students at the beginning of the survey. All methods were performed in accordance with the relevant guidelines and regulations.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Elsy Ramia and Maya Zeineddine are co-first authors and contributed equally to this work.
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Supplementary Materials
Data Availability Statement
All data generated or analyzed during this study are included in this published article. Additional material is available from the corresponding author on reasonable request.