Scoping and developing a genomic competency framework to inform genomic inclusion within pharmacy undergraduate curricula

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E. Harding, A. Guirguis This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7014428/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction The application of genomics is due to have a significant impact on the role of pharmacy within future healthcare systems. Since 2021, the updated GPhC education standards have included a requirement to apply the principles of genomics, but a lack of consistency across UK pharmacy programmes has led to inequity of genomics literacy for pharmacy students. There is a lack of UK research exploring pharmacy undergraduate genomic education requirements. Aim Scope and develop a genomic competency framework for undergraduate pharmacy curricula. Methods Ethics approval obtained from Swansea University. Fifteen multi-professional expert stakeholders from across the UK were selected using purposive sampling and invited to participate within a virtual semi-structured interview to scope and two consecutive focus groups to refine the competency framework. Both qualitative methods were facilitated and recorded using Microsoft® Teams using pre-designed open question interview schedules. All data anonymously transcribed verbatim and thematically analysed. Results Fourteen participants interviewed between September/October 2023. Five themes identified: Competency development - Participants described how pharmacists need a basic level of comprehensive genomic knowledge with a focus on clinical practice related to medicines use; Curriculum approach – the requirement for genomics to be spiralled throughout the undergraduate curriculum was described; Future practice roles - the need for pharmacy curricula to focus on the application of genomics to medicines rather than as a diagnostic tool was described; Genomic topics - participants acknowledged the complex nature of determining undergraduate competencies but suggested competencies and topics; Level of knowledge - participants described that overall genomic knowledge is needed but to focus on pharmacogenomics across all healthcare sectors. Two further consecutive focus groups further developed the framework through iterative refinement. Conclusions Genomic competencies should support delivery of pharmacist roles as implementation develops. The varied backgrounds of participants impacted their opinions influenced by a lack of knowledge to the role of the pharmacist and training career. Study limitations are small participant numbers and low data generalisability. A genomic competency framework is needed to standardise pharmacy training and study findings will be used to develop a UK consensus for UK genomic undergraduate pharmacy training. education genomics pharmacist pharmacogenomics undergraduate/curriculum Impacts On Practice A new competency framework for pharmacy undergraduates to guide and standardise training in the United Kingdom The competency framework should be used to benchmark pharmacy undergraduate curriculum both within and between academic institutions This study uses a novel and equitable approach to developing a competency framework The competency framework will support the implementation of pharmacogenomics in the UK healthcare system Introduction The application of genomics is due to have a significant impact within future healthcare systems as described within the Genome UK strategy published by the UK government in 2020 [ 1 ]. All UK nations signed a shared commitments publication in 2021, to unite all UK nations to progress the mainstreaming of genomics aligned with a key multi-disciplinary vision [ 2 ]. Since 2021, the pharmacy profession has acknowledged these developments by the inclusion of the need to apply genomic principles within the updated General Pharmaceutical Council (GPhC) Initial education and training standards for pharmacists,[ 3 ] but a lack of consistency of genomic inclusion across UK pharmacy programmes has led to an inequity in pharmacy student genomic literacy. Inconsistencies in the implementation of UK pharmacogenomic services has developed due to differences in the approach, commissioning and infrastructure of pharmacogenomic testing across the UK but the Centre for Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx) network [ 4 ] project has been recently established to explore and address some of these differences across the UK where possible [ 4 ]. In 2022, the Royal Pharmaceutical Society defined the leadership role of pharmacy in pharmacogenomics within a nationally recognised published position statement[ 5 ] to set the scene for the acknowledged leadership role that pharmacy is believed to provide in future pharmacogenomic and genomic service delivery. For the pharmacy workforce to deliver these pharmacogenomic services, there is a need to ensure the pharmacy profession’s genomic knowledge and understanding for both established postgraduate pharmacists and undergraduate pharmacy students increases in the future. This will involve appropriate genomic focussed learning within curricula to assure competence when delivering pharmacogenomic testing services. Additionally, national UK genomic workforce strategies have developed genomic workforce and education aspects within both England and Wales [ 6 , 7 ]. In 2024, National Health Service (NHS) England published a pharmacy specific workforce strategy framework for genomics [ 7 ] which includes a requirement to develop UK undergraduate curricula, whilst NHS Wales led on the development of a multi-professional genomic strategic workforce plan [ 6 ] to upskill and progress genomics across NHS Wales with specific actions for pharmacy within pharmacogenomics. In 2023, the NHSE pharmacy specific undergraduate indicative syllabus gave guidance and examples to suggest how genomics could be embedded within the undergraduate curricula with current available resources to support education delivery [ 8 ]. Despite the availability of this guidance, there are perceived inconsistencies in UK undergraduate pharmacy genomic education and a lack of UK-based research to support standardisation of the educational content and competency required by UK pharmacy undergraduates. Study aim To scope and develop the requirements of a genomic and pharmacogenomic competency framework (CF) for undergraduate pharmacy curricula in the UK. Ethical approval Ethics approval obtained from Swansea University Ethics C Methods A literature search (June 2025) via EMBASE and MEDLINE search found 766 references and 261 were identified as duplicates. The remaining articles were then sifted (n=505) for any relevant articles. Search terms focused on pharmacogenomics, genomics, and competency frameworks. MeSH terms were used. Included studies explored the use of competency frameworks to inform curricula development and were published in English, whilst conference abstracts and publications not published in English were excluded. Although many were predominantly focused on nursing competence, only three studies were identified related to pharmacy professional competence specifically. Study design Fifteen UK multi-professional stakeholders were selected using purposive sampling by the lead researcher to participate within a one-to-one virtual semi-structured interview (SSI). Each SSI involved the lead researcher using pre-prepared structured open questions (Table 1) as part of an interview schedule developed using McNamara guidelines [9]. Interview questions were initially reviewed using think aloud testing by the researchers. Interviews were piloted by three participants selected once they agreed to participate. No changes to interview questions were needed following the pilot. Following the SSIs, the data was used to develop an initial draft of the competency framework for pharmacy undergraduates by the lead researcher (SH). The draft was then reviewed within two consecutive focus groups for further iterative discussion. Following each focus group, the lead researcher used the focus group data to further amend the CF, and a final draft sent to all participants via email for validation. (*Table 1 – interview schedule and focus group questions) Participant recruitment and sampling Purposive sampling was used by SH to invite 15 multi-professional individuals from the UK nations. Fifteen individuals were chosen to provide multi-professional and UK wide representation, to ensure equity of inclusion addressing the needs of all UK pharmacy students. The individuals were chosen due to their roles as UK pharmacy educationalists and/or genomic experts. Data collection Once study participant written consent was returned, a convenient Microsoft® Teams (version 25122.1415.3698.6812.,2025, UK) meeting invitation was arranged for the SSI (all held between September 2023 to October 2023). Each SSI and focus groups were facilitated virtually using reflexivity by the lead researcher[10] and SSI and focus group data was recorded and transcribed verbatim through Microsoft® Teams. All pre-piloted topic questions validated by the ethics committee at Swansea University and the pilot interviews were included in the main study data. The two virtual 2-hour focus group sessions were held respectively, December 2023 and December 2024. Data analysis All transcripts and analysis checked for accuracy by AG. The data from the SSIs was thematic analysis[11] manually by SH within Microsoft® Excel (Microsoft 365 subscription) and involved coding data and developing emerging themes. Representative quotations used to evidence and support analysis, each coded with participant number. Data protection measures were adhered to for storage, data collection and focus group data used to directly amend the draft iterations of the CF. The study was designed and conducted in accordance with COREQ principles [12]. Results Participant characteristics All participants were either practising within genomics or pharmacy education at the time of the study. Fourteen participants included in the study representing different professional backgrounds from across the UK (Table 2). Further specific information of study participants omitted to ensure anonymity. The medically trained participants were either practising clinicians with a specialty training in genomics or had a specialist interest in genomics implementation and educational requirements. The pharmacist participants were either senior level genomic speciality pharmacists or pharmacists with ‘real life experience’ of pharmacogenomic implementation delivery. The clinical scientists were experts in genomic test delivery and the pharmacy educationalists were either experts in the design and delivery of pharmacy undergraduate training within various UK schools of pharmacy or involved in the regulation of pharmacy undergraduate education. One individual participant represented the UK pharmacy regulatory body. (*insert Table 2-Participant demographics) Key themes from semi-structured interviews Analysis using a thematic approach of the data identified five main themes: competency development, curriculum approach, future practice roles, genomic topics and level of knowledge. The key points within these themes are described below. Competency Development Overall, the participants described the need for a CF for pharmacy undergraduates. “Frameworks should support the development of training for undergraduates to support development in pharmacogenomics.” (Participant Six) Participants all described how pharmacists should have a basic level of comprehensive genomic knowledge with a focus on clinical practice specifically related to medicines use. “...pharmacists need the genomic basics but a bit more in-depth understanding on how that relates to medicines... ” Participant Eight One medical participant described the need for pharmacists to focus on pharmacogenomics only as the genomic aspect directly related to their role, but other professional participants described a need to include testing of disease related to chronic disease management to support use of therapeutic agents. "...(knowledge) needs to be relevant to what a pharmacist will be doing in day-to-day practice, which should be targeted around pharmacogenetics..." (Participant One) Three participants also described how there is a relevance for pharmacists to understand the basic concepts to rare disease involving medicine use. “...I don't think you could expect a pharmacist to learn about every rare disease, but they need to understand that there are rare diseases where drugs are important” (Participant Four) All participants identified linked resources that could be used to develop the CF. Participants from across the devolved nations described the need for these resources to be UK wide, not exclusively England focussed and accessible to all UK healthcare staff. If international resources are used, then one participant acknowledged the role of the pharmacist varies in other countries. “There are documents from other countries, but it's difficult to use them because the role of a US pharmacist for example, is quite different and even in Europe. ” (Participant Two) Curriculum Approach All pharmacist participants described how students should know the fundamentals of genomics, but two medical participants disagreed, and explained that an introduction to genomics is needed that enables them to deliver their day-to-day role. “...there is almost this weird insistence that people need to know this huge breadth of the fundamentals of genomics, but this isn’t always the case...” (Participant Four) Six participants also described how genomics should not be added to the curricula as a separate entity but should be spiralled throughout. One example of spiralling is when all participants explained how this would involve adding a pharmacogenomic element to relevant disease management components. "...when they are learning about underlying disease causes and treatments, the genomic clinical applications should be added" (Participant Ten) Two participants described a need for a ‘re-cap’ on topics previously delivered as the student moves through each year of the undergraduate course. “Maybe a refresher with a bit more in depth understanding added at each stage and how that relates to medicines” (Participant Five) Future Practice Roles One academic participant described how the current MSc postgraduate pharmacogenomic module could be used to determine the future undergraduate requirements. "...often new subjects or topics (such as pharmacogenomics) are introduced at postgraduate level but then absorbed into undergraduate courses over time..." (Participant Eight) Participants all described how pharmacists should focus on genomics informed medicines use not diagnostic testing due to their role. “I would imagine that anything that's more diagnosis focused won't be as much in the remit of a pharmacist as it would be of a medical professional doctor...” (Participant Five) The pharmacist participants described that developing pharmacogenomic competencies is complex with only a few pharmacogenomic examples. Although they recognised that current undergraduate curriculum genomic content was needed to develop competent pharmacists to deliver pharmacogenomic developments. “...it's about not just what's happening now, it's about and what's coming down the line and what will be in practice potentially by the time they are there...” Participant Eleven Genomic Topics There were many suggestions on the genomic topics that should be added to the pharmacy undergraduate genomic competencies from all participants but an acknowledgement that they need evaluation and updating at short time intervals e.g. every three years (Table 3). "… (pharmacy genomic competencies) depend on whether you're planning for the future or whether you're planning for current practice today..." (Participant Twelve) (*See Table 3– Genomic topics and competence themes suggested within SSI to develop the framework draft) Level of Knowledge Overall, the participants described how undergraduates need overall genomic pharmacy knowledge needed with a deeper level of pharmacogenomic knowledge as previously described. Between participants with different professional backgrounds, there were variations in the depth of general genomic training and appropriate topics needed by pharmacists. Pharmacists believed they should have a deeper level of understanding, but other professionals believed they could manage with a minimal level if supported by clinical guidelines. “You can use genetic information such as metaboliser status and functional states without knowing too much about that granular detail...” (Participant Five) Most participants described how undergraduate knowledge levels should be built upon later in their pharmacy career related to their practice. “...they need a base layer of awareness and how genomics might impact their practice... and then postgraduate qualifications to become experts in certain genomic areas...” ( Participant Nine) A need for the CF to include a Millers triangle level of knowledge [13] required from each competency was described. “...it should also be linked to the Millers triangle to inform the level of competence expected for undergraduates” (Participant Seven) Three participants described how the CF should be relevant and achievable across healthcare sectors. "...we need to think about what is required and how is that going to be used in practice across healthcare..." (Participant Six) Focus group findings Two focus groups were held to explore the draft CF. Within the first focus group (n=5), the structure of the CF was explored as there was an initial divergence of participants regarding the detail that is required for pharmacist genomic education at undergraduate level. Participants described a potential need for two frameworks to encompass the different depth of knowledge required for genomics and pharmacogenomics. Despite many of the participants describing cancer related genomics requirements for undergraduates, most participants felt the need for this to be removed from the first draft in any depth to focus on pharmacogenomics. The group refined the draft CF with a focus on what the pharmacists will be delivering in the next three years and provided consensus that although it is difficult to define future pharmacy roles, a realistic starting point was needed which can be evaluated and updated regularly. The draft CF was updated aligned with focus group one data by SH and a further focus group (focus group two; n=8) explored a new draft which separated genomic and pharmacogenomic requirements but still held within one CF. The participants complemented the new succinct nature of the CF defining the four competencies with clear separation and pharmacogenomic focus. The consensus of focus group two was to add the need for pharmacy undergraduates to understand genetic inheritance but conflicting opinions on the genetic technology and method requirements. The focus group participants supported the final draft via email following focus group two data amendment and expressed willingness to be named participants. The focus group discussion and data overall reinforced the interview themes. Discussion This study explored the scoping and development of a CF as a research project under research ethics. The novel approach to CF development has enabled a robust document to be developed aligned with UK expertise to standardise and guide UK pharmacy undergraduate curricula development aligned with national UK genomic developments. Key findings The need for a pharmacy undergraduate competency framework was acknowledged but needed to relate to the role of the pharmacist in genomic delivery. Once genomics is widely implemented, clarity around genomic competence requirements will develop, following workforce upskilling. A basic level of comprehensive genomic knowledge of the aspects and factors affecting the use of genomic testing is needed by pharmacists to fulfil their day-to-day role, which should include a focus on clinical medicine use not diagnostics. There should be a strong focus on pharmacogenomics but also include testing of disease related to chronic disease management include rare disease. UK wide accessible resources should be referred to in the CF, acknowledging variation in pharmacy roles internationally. Genomics should be spiralled throughout the curricula within different diseases with opportunities to recap to consolidate prior learning. We need to align competencies with national implementation developments over time and the postgraduate PGx course should be referred to for future undergraduate content. Topics and potential competencies were suggested for inclusion in the CF. Levels of knowledge should be built upon throughout a pharmacy professional career and that the Millers triangle [13] should be set for each competency to demonstrate this. The competencies for pharmacy undergraduates need to be relevant and achievable across all healthcare sectors. Strengths and limitations The key study strength is the inclusion of UK multi-professional experts. The participants ensured a national sample of genomic and/or educational experts observed the pharmacist role within genomics from many aspects. The inclusion of pharmacy educators who have a clear view and experience of pharmacy student training and development requirements was valuable as well as increased the level of knowledge of other participants with regards to pharmacist training to become genomically competent. The participants were also interviewed on a one-to-one basis initially to explore the scope of the competency framework from their perspective and then further refined as a collective focus group to reach consensus. Limitations to this study are the small sample size which demonstrates limited generalisability although an expert equitable sample was used. Variation in roles and knowledge may have impacted the data if the participants had limited knowledge of pharmacogenomics or alternatively pharmacy undergraduate training. Although an even mix of multi-professional representatives were invited to be participants to negate this effect, but equal numbers from each UK nation was not possible at the time of commencing the study due to differences in pharmacogenomic developments across the UK. Trustworthiness in qualitative studies involves ensuring confirmability, credibility, dependability, and transferability. The credibility of the study data was supported by including genomic and educational experts using purposive sampling, but a greater number could have been included to improve credibility further and potentially reach data saturation. Having the analysis checked by another researcher (AG) ensuring dependability and following initial analysis by SEH [14]. Interpretation As UK genomic implementation progresses, the competence that pharmacists need to deliver a pharmacogenomic service will gain clarity, but a need to upskill the pharmacy workforce has already been identified and documented within various forums due to pharmacists’ medicines optimisation role [5,15]. To deliver routine pharmacogenomic testing, pharmacists are believed to need a basic level of genomic knowledge to fulfil their future day-to-day role which can be delivered during the pharmacy undergraduate training programmes but there is a lack of standardisation in UK pharmacy school curricula focusing on the competency needs for undergraduates. In the US, a pharmacy pharmacogenomic CF has been established and updated since 2002 [16] and has enabled US schools of pharmacy to benchmark themselves against other schools or to streamline their own approach ensuring competencies are achieved. This US competency has a strong focus on pharmacogenomics, but our study findings suggest that a more rounded combined genomic and pharmacogenomic CF was needed related to all UK genomic informed medicines use. The US competencies cannot be utilised in the UK, as the role of pharmacists vary between countries due to healthcare system infrastructures [17]. The NHSE genomic medicine pharmacy undergraduate indicative curricula [8] was developed by NHSE colleagues and describes how genomics could be woven into the pharmacy curricula but may not be relevant to all UK schools of pharmacy curricula delivery approaches as these are varied. The UK CF produced because of this study could be used to complement the NHS indicative curricula, guiding all UK Pharmacy schools. The genomic content for UK schools could then be evaluated and compared against these resources as within similar approaches in the US [18,19]. Genomics should be spiralled through the curricula i.e. with relevance to different diseases and there should be opportunities to recap and consolidate prior learning which aligns with the Marcinak [20] and Galvez-Peralta study [21] findings which evaluated knowledge and perceptions throughout each year of the US pharmacy course. Updating the UK competencies with UK national implementation developments over time was recommended by participants and mirrors the same process undertaken by the UK nursing genomic CF [22] and the US pharmacy competencies for pharmacogenomics[16]. The current postgraduate pharmacogenomics course could also be referred to for future undergraduate content as we build the genomic literacy of UK pharmacy professionals their knowledge requirements may increase aligned with the perceived leadership role of pharmacists within areas such as pharmacogenomics [5]. The requirement for increased knowledge is acknowledged within the RPS pharmacy professionals and genomic medicine position statement [23]. Participants believed that pharmacists should focus on genomics informed medicines use but not on diagnostic aspects as this is related to the doctors’ role. The UK genomic generic syllabus [24] also has a focus on diagnostic testing with a strong focus on medical training learning outcomes despite being aimed at all UK health professionals and is less relevant for pharmacy professionals but should be used to evaluate within UK medical school curricula. Two studies by Pichini et al have also developed competencies for all healthcare professionals focused on certain aspects of genomic delivery such as facilitating and communicating genomic testing [25,26]. Many of the topics and competence suggested by participants within our study focussed on the role of pharmacy in pharmacogenomics but their varied suggestions could have been due to their varied prior knowledge of pharmacy education. The Miller's triangle level described for each competency within the framework explains the level of competency required for pharmacy undergraduates aligned with the GPhC Initial education and training learning outcomes published in 2021 [3]. These outcomes may need to be updated aligned with developments and experience gained within the delivery of pharmacogenomics. However, genomic developments may develop at a different pace across different healthcare sectors and become more of the pharmacist’s day-to-day role which may be different to the role that pharmacists deliver in other international countries. The study participants varied by clinical background, geographical background and genomic or educational experience which may have led to competing priorities for pharmacy professionals’ practice. UK nursing professionals were not included in the study participants but could have demonstrated relevant input as they also have a UK genomic nursing CF which was recently updated in 2023 [22]. The nursing competencies are not specific to any stage of a nursing degree and describe relevance to all nursing professionals. They were updated within one workshop session with nursing colleagues. Implications for pharmacy education By creating a pharmacy undergraduate genomic and pharmacogenomic competency framework, this enables guidance and support to UK pharmacy schools to develop standardisation for undergraduate training and to ensure all pharmacy graduates achieve the same level of genomic and pharmacogenomic competence regardless of the UK study location chosen. This will be of great importance if a student chooses to study in another UK nation from a different country or location that they may then choose to permanently reside in in the future. Standardised competencies would also enable development of evidence-based shared nationally available educational resources such as the US AI software driven resource described by Roosan et al. [27], to deliver genomic education relevant to practice. The US based train-the-trainer approaches described by Lee et al could also be used so that it is not essential for all pharmacy schools to employ genomic specialist faculty members [28]. Although UK competence standardisation (alike the US competency framework model) is ideal, there is a requirement for the CF to ensure flexibility as undergraduate curriculums and academic university infrastructures can vary despite all delivering a pharmacy undergraduate curriculum aligned with GPhC standards [3]. Curriculum mapping exercises would need to be undertaken by UK schools of pharmacy against the CF to ensure the integration of the competencies into pharmacy undergraduate curricula. The University of Minnesota took their approach when they mapped their pharmacy curricula to the newly updated American Association of Colleges of Pharmacy (AACP) pharmacogenomic competencies [19]. Standardised assessments and educational methods and tools for delivery could be developed and shared if evaluation shows benefit in the UK, some US methods within published literature may also be useful to explore and adapt for use in the UK [21,27,29–33]. Future research Further work could include evaluating the pharmacy student’s competence at different stages of their training once the CF is in use within one or more academic institutions. This will establish whether the pharmacist competence is achieved using the CF and to inform further CF iterations. Recommendations for practice The output of this study is a proposed co-created UK-wide pharmacy genomic CF which could be used to guide the standardised development of UK wide pharmacy undergraduate curricula for genomics and pharmacogenomics. Conclusions Setting genomic competencies for the pharmacy profession especially at undergraduate level has been shown to underpin a standardised approach to developing pharmacy education aligned with current practice in countries such as the US. This study has explored and demonstrated a novel UK equitable multi-professional expert model approach to scoping and developing a genomic and pharmacogenomic CF for pharmacy undergraduates and a similar approach could be used to develop other CFs both within genomics for other professionals and outside of the speciality to guide pharmacy professional training in the future. There is now a need for national collaboration and inclusion of pharmacy genomic curriculum stakeholders to develop a nationwide genomic curriculum planned approach to align this CF with training needs. Declarations Acknowledgements The authors express thanks to the study participants for their time and contributions, and to other individuals involved in the design and delivery of the study. Special thanks to Anne Cleves at Velindre Library Cardiff for development of the literature search strategy and study retrieval. Study participants (agreed to be named): Alex Matos, Dr Alex Murray, Dharmisha Chandra, Prof Dyfrig Hughes, Emma Groves, Dr James Birchall, Jessica Keen, Dr John McDermott, Dr Judith Hayward, Laura Doyle, Mark Voce, Dr Michelle Wood, Roisin O’Hare and Sian Morgan. Funding The lead author and researcher Sophie Harding declares receiving a fellowship bursary from Precision Healthcare Technology Accelerator (PHTA) working in partnership with Swansea University to support development of this study, but PHTA had no input into the research study choice, design or data collection phases of this study development. Author information Authors and Affiliations Cardiff & Vale University Health board, Cardiff, UK Sophie E. Harding Pharmacy, Swansea University Medical School, Swansea, UK Sophie E. Harding, Amira Guirguis Authorship roles S.E.H and A.G. conceived the idea and S.E.H conceived the methods in this paper and carried out the SSIs and focus group methods of gaining participant data. Data was analysed by S.E.H and checked by A.G. The originaldraft was completed by S.E.H. All stages of the work were supervised by A.G. and wasconsulted during the entire process of method development and data analysis. A.G. reviewed the first draft once completed. All authors contributed to the article, revised it, and approved the submitted version. All authors have read and agreed to the published version of this manuscript. Conflicts of interest All authors declare no conflict of interests. References UK Government. Genome UK: The future of healthcare [Internet]. [cited 2025 Jun 27]. Available from: https://www.gov.uk/government/publications/genome-uk-the-future-of-healthcare UK Government. Genome UK: shared commitments for UK wide implementation [Internet]. [cited 2025 Jun 27]. Available from: https://www.gov.uk/government/publications/genome-uk-shared-commitments-for-uk-wide-implementation-2022-to-2025 General Pharmaceutical Council. Initial Education and training standards [Internet]. 2021. Available from: https://assets.pharmacyregulation.org/files/2024-01/Standards%20for%20the% 20initial%20education%20and%20training%20of%20pharmacists%20January%202021%20final%20v1.4.pdf University of Liverpool. CERSI-PGx [Internet]. [cited 2025 Jun 27]. Available from: https://news.liverpool.ac.uk/2025/01/28/new-pharmacogenomics-centre-to-help-uk-move-towards-personalised-prescribing/ Royal Pharmaceutical Society. The role of pharmacy in pharmacogenomics [Internet]. 2022 [cited 2025 Jun 27]. Available from: https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/PGx/RPS% 20Statement%20for%20the%20Role%20of%20Pharmacy%20in%20Pharmacogenomics.pdf?ver=-6zrIf4CyWUJl74AEO41nA%3d%3d Health Education and Improvement Wales. Strategic genomic workforce plan for Wales [Internet]. [cited 2025 Jun 27]. Available from: https://heiw.nhs.wales/workforce/strategic-workforce-plan-for-genomics/ NHS England. Pharmacy genomics workforce education and training strategic framework [Internet]. [cited 2025 Jun 27]. Available from: https://www.england.nhs.uk/long-read/pharmacy-genomics-workforce-education-and-training-strategic-framework/ NHS England. Initial Education and Training of Pharmacists: Genomic medicine indicative curricula [Internet]. [cited 2025 Jun 27]. Available from: https://www.hee.nhs.uk/sites/default/files/documents/NHS%20England%20Pharmacy% 20Indicative%20Curriculum%20Genomics%20Mar%202025.pdf McNamara C. General Guidelines for Conducting Research Interviews. [Internet]. Available from: http://managementhelp.org/businessresearch/interviews.ht Barrett A, Kajamaa A. How to be reflexive when conducting qualitative research. The clinical teacher, 17(1), 9-12. The clinical teacher. 2020;17:9–12. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. Tong A, Sainsbury P, Craig J. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57. Witheridge A, Ferns G, Scott-Smith W. Revisiting Miller’s pyramid in medical education: the gap between traditional assessment and diagnostic reasoning. Int J Med Educ. 2019;10:191–2. Lincoln YS, Guba EG. Naturalistic inquiry. sage; 1985. British Pharmacological Society. Personalised Prescribing – Using pharmacogenomics to improve patient outcomes [Internet]. [cited 2025 Jun 30]. Available from: https://www.bps.ac.uk/about/our-campaigns/personalised-prescribing Gammal RS, Lee YM, Petry NJ, Iwuchukwu O, Hoffman JM, Kisor DF, et al. Pharmacists Leading the Way to Precision Medicine: Updates to the Core Pharmacist Competencies in Genomics. American journal of pharmaceutical education. 2022;86:8634. Anandaciva S. How does the NHS compare to the healthcare systems of other countries? [Internet]. 2023 [cited 2025 Jun 30]. Available from: https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries Latif DA, McKay AB. Pharmacogenetics and pharmacogenomics instruction in colleges and schools of pharmacy in the United States. American Journal of Pharmaceutical Education. 2005;69:152–6. Brown JT, Sorge LA, Oetting WS, Jacobson PA, Pereira C. Meeting the New AACP Competencies in Genetics and Clinical Pharmacogenomics at the University of Minnesota. Inov Pharm. 2023;14:1–7. Marcinak R, Paris M, Kinney SRM. Pharmacogenomics Education Improves Pharmacy Student Perceptions of Their Abilities and Roles in Its Use. Am J Pharm Educ. 11AD;82:6424. Galvez-Peralta M, Szklarz GD, Geldenhuys WJ, Lockman PR. An Effective Approach to Teaching Pharmacogenomics in the First Year of Pharmacy Curriculum. Am J Pharm Educ. 10AD;82:6345. NHS England. The 2023 Genomic competencies for UK Nurses [Internet]. [cited 2025 Jun 30]. Available from: https://www.genomicseducation.hee.nhs.uk/wp-content/uploads/2023/12/2023-Genomic-Competency-Framework-for-UK-Nurses.pdf Royal Pharmaceutical Society. Pharmacy professionals and Genomic Medicine: A position statement [Internet]. [cited 2025 Jun 30]. Available from: https://www.rpharms.com/development/pharmacogenomics/genomic-statement Academy of medical royal colleges. Genomics Generic syllabus [Internet]. 2021 [cited 2025 Jun 30]. Available from: https://www.aomrc.org.uk/wp-content/uploads/2021/11/Genomics_syllabus_1121.pdf Pichini A, Tatton-Brown K, Thomas E, Bishop M. A cross-professional competency framework for communicating genomic results. Journal of genetic counseling. 2024;33:222–31. Pichini A, Bishop M. A nationally agreed cross-professional competency framework to facilitate genomic testing. Genetics in Medicine. 2022;24:1743 EP – 1752. Roosan D, Chok J, Baskys A, Roosan MR. PGxKnow: a pharmacogenomics educational HoloLens application of augmented reality and artificial intelligence. Pharmacogenomics. 3AD;23:235–45. Lee KC, Ma JD, Hudmon KS, Kuo GM. A train-the-trainer approach to a shared pharmacogenomics curriculum for US colleges and schools of pharmacy. Am J Pharm Educ. 2012;76:193. Armstrong KJ, Hysolli M, Kinney SRM. Implementing a longitudinal poster project to engage pharmacy students beyond the classroom in a foundational sciences course. Pharmacy Education. 2024;24(1):79–90. Frick A, Benton C, Suzuki O, Dong O, Howard R, El-Sabae H, et al. Implementing Clinical Pharmacogenomics in the Classroom: Student Pharmacist Impressions of an Educational Intervention Including Personal Genotyping. Pharmacy (Basel). 2018;6:23. Kisor DF, Bright DR, Chen J, Smith TR. Academic and professional pharmacy education: a pharmacogenomics certificate training program. Per Med. 2015;12:563–73. Rao PS, Endicott R, Mullins R, Rao US. A 6-week laboratory research rotation in pharmacogenomics: a model for preparing pharmacy students to practice precision medicine. Pharmacogenomics J. 7AD;18:601–8. Remsberg CM, Bray BS, Wright SK, Ashmore J, Kabasenche W, Wang S, et al. Design, Implementation, and Assessment Approaches Within a Pharmacogenomics Course. Am J Pharm Educ. 2017;81:11. Tables Table 1 Interview schedule guide for SSI and focus groups Interview questions • what do you think of the genomic training needs of pharmacy undergraduates? • what documents or strategies are you aware of that should be used to develop the competency frameworks for pharmacy undergraduates? • what genomic competencies or topics are essential for pharmacy undergraduates? • any other comments or any other thoughts you had or anything you hadn't mentioned which you thought maybe relevant? Focus group questions 1. Please discuss your opinion on the content of the draft competencies presented and the level of Millers triangle. 2. Are there sufficient draft competencies to meet the genomic training needs of pharmacy undergraduates? 3. Reading through each competency one by one, please comment on the clarity of the competencies 4. Reading through each competencies one by one, please comment on the relevance of the competencies to pharmacy undergraduates 5. What is your opinion on how the competency framework should be further developed? 6. Do you have any further comments? Table 2 Participant demographics Profession/expertise background UK nation represented No. of participants Medicine England & Wales 3 Pharmacy England & Scotland 4 Clinical Science Wales 2 Pharmacy educationalist Wales & Northern Ireland 4 Pharmacy regulator UK wide 1 Table 3 Suggested topic areas and competence pharmacists require to develop competency from SSIs Themes Genomic topics suggested Areas to include related to medicines use • Pharmacogenomics • Rare disease related to medicines use only e.g. chronic disease management such as familial hypercholesterolemia in the context of lipids optimisation • Cancer/oncology – precision medicines • Infectious disease - vaccines and how you monitor outbreaks • Gene therapy and CRISPR Genomic Knowledge • what is pharmacogenomics? • genomic variance and how might it impact my practice • basics around DNA and RNA and gene expression • what are star alleles and their relevance • awareness of the structure of the genome and that there is different types of variation that can have different effects by affecting the function of certain proteins, enzymes and affect drug catabolism • understanding the difference, for instance between homozygotes, heterozygotes and different patterns of inheritance (but not in depth) • Understanding of the relationship between different gene drug pairs then needs to be an awareness of what these are the relationships Clinical application • ability to collate and appraise resource evidence • understanding of the kind of testing pathways associated with those variants of how you can access those tests and what are the advantages and relative disadvantages of each of the tests. • how you would approach a multidisciplinary and informed counselling session around the use of those results. So as an example, someone in the community is being treated for depression with citalopram and that patient is a CYP2C19 ultrarapid metabolizer. How do you work with the healthcare professional? • how do you work with other colleagues and how do you work with the patient to come to a kind of shared care decision around what therapy you should use? • The testing pathways available • different sources of guidance there and how it interacts with other pharmacy infrastructure like the pharmacovigilance structures, with the MHRA and BNF etc. e.g. DPYD linking to the MHRA, drug safety alert, and how that's relevant to prescribing if fluoropyrimidines. • understand about genomic technologies because of the limitations. • Use case studies that include pharmacogenetic reports. Addition aspects to include • Ethical and legal considerations to testing • Understanding that there are resources out there that help informaticians make their decisions and that there is that that they can be uncertainty and grey areas about that • Patient counselling and communication • keep up to date with the latest developments • understand the limitations of testing including gaps in evidence • understand how genomics links in with the multidisciplinary team and actually what are the different roles Resources • NHSE Undergraduate indicative curriculum • GeNotes • PharmGKB • CPIC • Royal College Guidelines Competence suggested within their role • Communicating to patients what the implications are and being able to talk to them about genomics • develop the skills and competencies to have conversations with patients around genomics and signpost patients appropriately. And identify any red flags. – culturally competent consultant skills • Use genomic data when prescribing • Capable of reading genomic reports • Able to identify appropriate tests and how to optimise therapy with them and what are the pathways for certain test available Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7014428","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":481244572,"identity":"845622da-3350-4f1b-905e-4f54acc60c65","order_by":0,"name":"S. E. Harding","email":"data:image/png;base64,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","orcid":"","institution":"Swansea University","correspondingAuthor":true,"prefix":"","firstName":"S.","middleName":"E.","lastName":"Harding","suffix":""},{"id":481244573,"identity":"a43d087b-c6fe-4952-a9b4-27936bd3037f","order_by":1,"name":"A. Guirguis","email":"","orcid":"","institution":"Swansea University","correspondingAuthor":false,"prefix":"","firstName":"A.","middleName":"","lastName":"Guirguis","suffix":""}],"badges":[],"createdAt":"2025-06-30 22:38:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7014428/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7014428/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87720040,"identity":"2fcdc70a-0cf8-471b-8d58-b8a8187af832","added_by":"auto","created_at":"2025-07-28 09:39:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":745083,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7014428/v1/2953b49b-e7f0-4436-8932-bbfc61c9a278.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Scoping and developing a genomic competency framework to inform genomic inclusion within pharmacy undergraduate curricula","fulltext":[{"header":"Impacts On Practice","content":"\u003cul\u003e\n \u003cli\u003eA new competency framework for pharmacy undergraduates to guide and standardise training in the United Kingdom\u003c/li\u003e\n \u003cli\u003eThe competency framework should be used to benchmark pharmacy undergraduate curriculum both within and between academic institutions\u003c/li\u003e\n \u003cli\u003eThis study uses a novel and equitable approach to developing a competency framework\u003c/li\u003e\n \u003cli\u003eThe competency framework will support the implementation of pharmacogenomics in the UK healthcare system\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eThe application of genomics is due to have a significant impact within future healthcare systems as described within the Genome UK strategy published by the UK government in 2020 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. All UK nations signed a shared commitments publication in 2021, to unite all UK nations to progress the mainstreaming of genomics aligned with a key multi-disciplinary vision [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Since 2021, the pharmacy profession has acknowledged these developments by the inclusion of the need to apply genomic principles within the updated General Pharmaceutical Council (GPhC) Initial education and training standards for pharmacists,[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] but a lack of consistency of genomic inclusion across UK pharmacy programmes has led to an inequity in pharmacy student genomic literacy. Inconsistencies in the implementation of UK pharmacogenomic services has developed due to differences in the approach, commissioning and infrastructure of pharmacogenomic testing across the UK but the Centre for Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx) network [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] project has been recently established to explore and address some of these differences across the UK where possible [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn 2022, the Royal Pharmaceutical Society defined the leadership role of pharmacy in pharmacogenomics within a nationally recognised published position statement[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] to set the scene for the acknowledged leadership role that pharmacy is believed to provide in future pharmacogenomic and genomic service delivery. For the pharmacy workforce to deliver these pharmacogenomic services, there is a need to ensure the pharmacy profession\u0026rsquo;s genomic knowledge and understanding for both established postgraduate pharmacists and undergraduate pharmacy students increases in the future. This will involve appropriate genomic focussed learning within curricula to assure competence when delivering pharmacogenomic testing services.\u003c/p\u003e\u003cp\u003eAdditionally, national UK genomic workforce strategies have developed genomic workforce and education aspects within both England and Wales [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In 2024, National Health Service (NHS) England published a pharmacy specific workforce strategy framework for genomics [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] which includes a requirement to develop UK undergraduate curricula, whilst NHS Wales led on the development of a multi-professional genomic strategic workforce plan [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] to upskill and progress genomics across NHS Wales with specific actions for pharmacy within pharmacogenomics. In 2023, the NHSE pharmacy specific undergraduate indicative syllabus gave guidance and examples to suggest how genomics could be embedded within the undergraduate curricula with current available resources to support education delivery [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Despite the availability of this guidance, there are perceived inconsistencies in UK undergraduate pharmacy genomic education and a lack of UK-based research to support standardisation of the educational content and competency required by UK pharmacy undergraduates.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy aim\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTo scope and develop the requirements of a genomic and pharmacogenomic competency framework (CF) for undergraduate pharmacy curricula in the UK.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval obtained from Swansea University Ethics C\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA literature search (June 2025) via EMBASE and MEDLINE\u0026nbsp;search found 766 references and 261 were identified as duplicates. The remaining articles were then sifted (n=505) for any relevant articles. Search terms\u0026nbsp;focused on pharmacogenomics, genomics, and competency frameworks. MeSH terms were used. Included studies explored the use of competency frameworks to inform curricula development and were published in English, whilst conference abstracts and publications not published in English were excluded. Although many were predominantly focused on nursing competence, only three studies were identified related to pharmacy professional competence specifically.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStudy design\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFifteen UK multi-professional stakeholders were selected using purposive sampling by the lead researcher to participate within a one-to-one virtual semi-structured interview (SSI). Each SSI involved the lead researcher using pre-prepared structured open questions (Table 1) as part of an interview schedule developed using McNamara guidelines\u0026nbsp;[9].\u0026nbsp;Interview questions were initially reviewed using think aloud testing by the researchers.\u0026nbsp;\u0026nbsp;Interviews were piloted by three participants selected once they agreed to participate. No changes to interview questions were needed following the pilot.\u0026nbsp;Following the SSIs, the data was used to develop an initial draft of the competency framework for pharmacy undergraduates by the lead researcher (SH). The draft was then reviewed within two consecutive focus groups for further iterative discussion. Following each focus group, the lead researcher used the focus group data to further amend the CF, and a final draft sent to all participants via email for validation.\u003c/p\u003e\n\u003cp\u003e(*Table 1 – interview schedule and focus group questions)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eParticipant recruitment and sampling\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePurposive sampling was used by SH to invite 15 multi-professional individuals from the UK nations. Fifteen individuals were chosen to provide multi-professional and UK wide representation, to ensure equity of inclusion addressing the needs of all UK pharmacy students. The individuals were chosen due to their roles as UK pharmacy educationalists and/or genomic experts.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData collection\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOnce study participant written consent was returned, a convenient Microsoft® Teams (version\u0026nbsp;25122.1415.3698.6812.,2025, UK) meeting invitation was arranged for the SSI (all held between September 2023 to October 2023). Each SSI and focus groups were facilitated virtually using reflexivity by the lead researcher[10]\u0026nbsp;and SSI and focus group data was recorded and transcribed verbatim through Microsoft® Teams. All\u0026nbsp;pre-piloted topic questions validated by the ethics committee at Swansea University and the pilot interviews were included in the main study data. The two virtual 2-hour focus group sessions were held respectively, December 2023 and December 2024.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll transcripts and analysis checked for accuracy by AG. The data from the SSIs was thematic analysis[11] manually by SH within Microsoft® Excel (Microsoft 365 subscription) and involved coding data and developing emerging themes. Representative quotations used to evidence and support analysis, each coded with participant number. Data protection measures were adhered to for storage, data collection and focus group data used to directly amend the draft iterations of the CF. The study was designed and conducted in accordance with COREQ principles [12].\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eParticipant characteristics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll participants were either practising within genomics or pharmacy education at the time of the study. Fourteen participants included in the study representing different professional backgrounds from across the UK (Table 2). Further specific information of study participants omitted to ensure anonymity. The medically trained participants were either practising clinicians with a specialty training in genomics or had a specialist interest in genomics implementation and educational requirements. The pharmacist participants were either senior level genomic speciality pharmacists or pharmacists with \u0026lsquo;real life experience\u0026rsquo; of pharmacogenomic implementation delivery. The clinical scientists were experts in genomic test delivery and the pharmacy educationalists were either experts in the design and delivery of pharmacy undergraduate training within various UK schools of pharmacy or involved in the regulation of pharmacy undergraduate education. One individual participant represented the UK pharmacy regulatory body.\u003c/p\u003e\n\u003cp\u003e(*insert Table 2-Participant demographics)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eKey themes from semi-structured interviews\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAnalysis using a thematic approach of the data identified five main themes: competency development, curriculum approach, future practice roles, genomic topics and level of knowledge.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe key points within these themes are described below.\u003c/p\u003e\n\u003cp\u003eCompetency Development\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOverall, the participants described the need for a CF for pharmacy undergraduates.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Frameworks should support the development of training for undergraduates to support development in pharmacogenomics.\u0026rdquo;\u003c/em\u003e\u003cem\u003e\u0026nbsp;(Participant Six)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants all described how pharmacists should have a basic level of comprehensive genomic knowledge with a focus on clinical practice specifically related to medicines use.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cem\u003e\u0026ldquo;...pharmacists need the genomic basics but a\u0026nbsp;\u003c/em\u003e\u003cem\u003ebit more in-depth understanding on how that relates to medicines...\u003c/em\u003e\u0026rdquo; Participant Eight\u003c/p\u003e\n\u003cp\u003eOne medical participant described the need for pharmacists to focus on pharmacogenomics only as the genomic aspect directly related to their role, but other professional participants described a need to include testing of disease related to chronic disease management to support use of therapeutic agents.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;...(knowledge) needs to be relevant to what a pharmacist will be doing in day-to-day practice, which should be targeted around pharmacogenetics...\u0026quot; (Participant One)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThree participants also described how there is a relevance for pharmacists to understand the basic concepts to rare disease involving medicine use.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;...I don\u0026apos;t think you could expect a pharmacist to learn about every rare disease, but they need to understand that there are rare diseases where drugs are important\u0026rdquo; (Participant Four)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll participants identified linked resources that could be used to develop the CF. Participants from across the devolved nations described the need for these resources to be UK wide, not exclusively England focussed and accessible to all UK healthcare staff. If international resources are used, then one participant acknowledged the role of the pharmacist varies in other countries.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;There are documents from other countries, but it\u0026apos;s difficult to use them because the role of a US pharmacist for example, is quite different and even in Europe.\u003c/em\u003e\u0026rdquo; (Participant Two)\u003c/p\u003e\n\u003cp\u003eCurriculum Approach\u003c/p\u003e\n\u003cp\u003eAll pharmacist participants described how students should know the fundamentals of genomics, but two medical participants disagreed, and explained that an introduction to genomics is needed that enables them to deliver their day-to-day role.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;...there is almost this weird insistence that people need to know this huge breadth of the fundamentals of genomics, but this isn\u0026rsquo;t always the case...\u0026rdquo; (Participant Four)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSix participants also described how genomics should not be added to the curricula as a separate entity but should be spiralled throughout. One example of spiralling is when all participants explained how this would involve adding a pharmacogenomic element to relevant disease management components.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;...when they are learning about underlying disease causes and treatments, the genomic clinical applications should be added\u0026quot; (Participant Ten)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTwo participants described a need for a \u0026lsquo;re-cap\u0026rsquo; on topics previously delivered as the student moves through each year of the undergraduate course.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Maybe a refresher with a bit more in depth understanding added at each stage and how that relates to medicines\u0026rdquo; (Participant Five)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFuture Practice Roles\u003c/p\u003e\n\u003cp\u003eOne academic participant described how the current MSc postgraduate pharmacogenomic module could be used to determine the future undergraduate requirements.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;...often new subjects or topics (such as pharmacogenomics) are introduced at postgraduate level but then absorbed into undergraduate courses over time...\u0026quot; (Participant Eight)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants all described how pharmacists should focus on genomics informed medicines use not diagnostic testing due to their role.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I would imagine that anything that\u0026apos;s more diagnosis focused won\u0026apos;t be as much in the remit of a pharmacist as it would be of a medical professional doctor...\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e(Participant Five)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe pharmacist participants described that developing pharmacogenomic competencies is complex with only a few pharmacogenomic examples. Although they recognised that current undergraduate curriculum genomic content was needed to develop competent pharmacists to deliver pharmacogenomic developments.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;...it\u0026apos;s about not just what\u0026apos;s happening now, it\u0026apos;s about and what\u0026apos;s coming down the line and what will be in practice potentially by the time they are there...\u0026rdquo;\u003c/em\u003e Participant Eleven\u003c/p\u003e\n\u003cp\u003eGenomic Topics\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere were many suggestions on the genomic topics that should be added to the pharmacy undergraduate genomic competencies from all participants but an acknowledgement that they need evaluation and updating at short time intervals e.g. every three years (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;\u0026hellip; (pharmacy genomic competencies) depend on whether you\u0026apos;re planning for the future or whether you\u0026apos;re planning for current practice today...\u0026quot; (Participant Twelve)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(*See Table 3\u0026ndash; Genomic topics and competence themes suggested within SSI to develop the framework draft)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eLevel of Knowledge\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOverall, the participants described how undergraduates need overall genomic pharmacy knowledge needed with a deeper level of pharmacogenomic knowledge as previously described.\u003c/p\u003e\n\u003cp\u003eBetween participants with different professional backgrounds, there were variations in the depth of general genomic training and appropriate topics needed by pharmacists. Pharmacists believed they should have a deeper level of understanding, but other professionals believed they could manage with a minimal level if supported by clinical guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;You can use genetic information such as metaboliser status and functional states without knowing too much about that granular detail...\u0026rdquo; (Participant Five)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost participants described how undergraduate knowledge levels should be built upon later in their pharmacy career related to their practice.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;...they need a base layer of awareness and how genomics might impact their practice... and then postgraduate qualifications to become experts in certain genomic areas...\u0026rdquo; (\u003c/em\u003eParticipant Nine)\u003c/p\u003e\n\u003cp\u003eA need for the CF to include a Millers triangle level of knowledge\u0026nbsp;[13]\u0026nbsp;required from each competency was described.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;...it should also be linked to the Millers triangle to inform the level of competence expected for undergraduates\u0026rdquo; (Participant Seven)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThree participants described how the CF should be relevant and achievable across healthcare sectors.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;...we need to think about what is required and how is that going to be used in practice across healthcare...\u0026quot; (Participant Six)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFocus group findings\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTwo focus groups were held to explore the draft CF. Within the first focus group (n=5), the structure of the CF was explored as there was an initial divergence of participants regarding the detail that is required for pharmacist genomic education at undergraduate level. Participants described a potential need for two frameworks to encompass the different depth of knowledge required for genomics and pharmacogenomics. Despite many of the participants describing cancer related genomics requirements for undergraduates, most participants felt the need for this to be removed from the first draft in any depth to focus on pharmacogenomics. The group refined the draft CF with a focus on what the pharmacists will be delivering in the next three years and provided consensus that although it is difficult to define future pharmacy roles, a realistic starting point was needed which can be evaluated and updated regularly.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe draft CF was updated aligned with focus group one data by SH and a further focus group (focus group two; n=8) explored a new draft which separated genomic and pharmacogenomic requirements but still held within one CF. The participants complemented the new succinct nature of the CF defining the four competencies with clear separation and pharmacogenomic focus. The consensus of focus group two was to add the need for pharmacy undergraduates to understand genetic inheritance but conflicting opinions on the genetic technology and method requirements. The focus group participants supported the final draft via email following focus group two data amendment and expressed willingness to be named participants. The focus group discussion and data overall reinforced the interview themes.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study explored the scoping and development of a CF as a research project under research ethics. The novel approach to CF development has enabled a robust document to be developed aligned with UK expertise to standardise and guide UK pharmacy undergraduate curricula development aligned with national UK genomic developments.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eKey findings\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe need for a pharmacy undergraduate competency framework was acknowledged but needed to relate to the role of the pharmacist in genomic delivery. Once genomics is widely implemented, clarity around genomic competence requirements will develop, following workforce upskilling. A\u0026nbsp;basic level of comprehensive genomic knowledge of the aspects and factors affecting the use of genomic testing is needed by pharmacists to fulfil their day-to-day role, which should include a focus on clinical medicine use not diagnostics. There should be a strong focus on pharmacogenomics but also include testing of disease related to chronic disease management include rare disease. UK wide accessible resources should be referred to in the CF, acknowledging variation in pharmacy roles internationally.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGenomics should be spiralled throughout the curricula within different diseases with opportunities to recap to consolidate prior learning. We need to align competencies with national implementation developments over time and the postgraduate PGx course should be referred to for future undergraduate content. Topics and potential competencies were suggested for inclusion in the CF.\u003c/p\u003e\n\u003cp\u003eLevels of knowledge should be built upon throughout a pharmacy professional career and that the Millers triangle\u0026nbsp;[13]\u0026nbsp;should be set for each competency to demonstrate this. The competencies for pharmacy undergraduates need to be relevant and achievable across all healthcare sectors.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStrengths and limitations\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe key study strength is the inclusion of UK multi-professional experts. The participants ensured a national sample of genomic and/or educational experts observed the pharmacist role within genomics from many aspects. The inclusion of pharmacy educators who have a clear view and experience of pharmacy student training and development requirements was valuable as well as increased the level of knowledge of other participants with regards to pharmacist training to become genomically competent. The participants were also interviewed on a one-to-one basis initially to explore the scope of the competency framework from their perspective and then further refined as a collective focus group to reach consensus.\u003c/p\u003e\n\u003cp\u003eLimitations to this study are the small sample size which demonstrates limited generalisability although an expert equitable sample was used. Variation in roles and knowledge may have impacted the data if the participants had limited knowledge of pharmacogenomics or alternatively pharmacy undergraduate training. Although an even mix of multi-professional representatives were invited to be participants to negate this effect, but equal numbers from each UK nation was not possible at the time of commencing the study due to differences in pharmacogenomic developments across the UK.\u003c/p\u003e\n\u003cp\u003eTrustworthiness in qualitative studies involves ensuring confirmability, credibility, dependability, and transferability. The credibility of the study data was supported by including genomic and educational experts using purposive sampling, but a greater number could have been included to improve credibility further and potentially reach data saturation. Having the analysis checked by another researcher (AG) ensuring dependability and following initial analysis by SEH\u0026nbsp;[14].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eInterpretation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAs UK genomic implementation progresses, the competence that pharmacists need to deliver a pharmacogenomic service will gain clarity, but a need to upskill the pharmacy workforce has already been identified and documented within various forums due to pharmacists\u0026rsquo; medicines optimisation role\u0026nbsp;[5,15]. To deliver routine pharmacogenomic testing, pharmacists are believed to need a basic level of genomic knowledge to fulfil their future day-to-day role which can be delivered during the pharmacy undergraduate training programmes but there is a lack of standardisation in UK pharmacy school curricula focusing on the competency needs for undergraduates. In the US, a pharmacy pharmacogenomic CF has been established and updated since 2002\u0026nbsp;[16]\u0026nbsp;and has enabled US schools of pharmacy to benchmark themselves against other schools or to streamline their own approach ensuring competencies are achieved. This US competency has a strong focus on pharmacogenomics, but our study findings suggest that a more rounded combined genomic and pharmacogenomic CF was needed related to all UK genomic informed medicines use. The \u0026nbsp;US competencies cannot be utilised in the UK, as the role of pharmacists vary between countries due to healthcare system infrastructures\u0026nbsp;[17]. The NHSE genomic medicine pharmacy undergraduate indicative curricula\u0026nbsp;[8]\u0026nbsp;was developed by NHSE colleagues and describes how genomics could be woven into the pharmacy curricula but may not be relevant to all UK schools of pharmacy curricula delivery approaches as these are varied. The UK CF produced because of this study could be used to complement the NHS indicative curricula, guiding all UK Pharmacy schools. The genomic content for UK schools could then be evaluated and compared against these resources as within similar approaches in the US\u0026nbsp;[18,19].\u003c/p\u003e\n\u003cp\u003eGenomics should be spiralled through the curricula i.e. with relevance to different diseases and there should be opportunities to recap and consolidate prior learning which aligns with the Marcinak\u0026nbsp;[20]\u0026nbsp;and Galvez-Peralta study\u0026nbsp;[21]\u0026nbsp;findings which evaluated knowledge and perceptions throughout each year of the US pharmacy course. Updating the UK competencies with UK national implementation developments over time was recommended by participants and mirrors the same process undertaken by the UK nursing genomic CF\u0026nbsp;[22]\u0026nbsp;and the US pharmacy competencies for pharmacogenomics[16]. The current postgraduate pharmacogenomics course could also be referred to for future undergraduate content as we build the genomic literacy of UK pharmacy professionals their knowledge requirements may increase aligned with the perceived leadership role of pharmacists within areas such as pharmacogenomics\u0026nbsp;[5]. The requirement for increased knowledge is acknowledged within the RPS pharmacy professionals and genomic medicine position statement\u0026nbsp;[23]. Participants believed that pharmacists should focus on genomics informed medicines use but not on diagnostic aspects as this is related to the doctors\u0026rsquo; role. The UK genomic generic syllabus\u0026nbsp;[24]\u0026nbsp;also has a focus on diagnostic testing with a strong focus on medical training learning outcomes despite being aimed at all UK health professionals and is less relevant for pharmacy professionals but should be used to evaluate within UK medical school curricula. Two studies by Pichini et al have also developed competencies for all healthcare professionals focused on certain aspects of genomic delivery such as facilitating and communicating genomic testing\u0026nbsp;[25,26].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMany of the topics and competence suggested by participants within our study focussed on the role of pharmacy in pharmacogenomics but their varied suggestions could have been due to their varied prior knowledge of pharmacy education. The Miller\u0026apos;s triangle level described for each competency within the framework explains the level of competency required for pharmacy undergraduates aligned with the GPhC Initial education and training learning outcomes published in 2021\u0026nbsp;[3]. These outcomes may need to be updated aligned with developments and experience gained within the delivery of pharmacogenomics. However, genomic developments may develop at a different pace across different healthcare sectors and become more of the pharmacist\u0026rsquo;s day-to-day role which may be different to the role that pharmacists deliver in other international countries.\u003c/p\u003e\n\u003cp\u003eThe study participants varied by clinical background, geographical background and genomic or educational experience which may have led to competing priorities for pharmacy professionals\u0026rsquo; practice. UK nursing professionals were not included in the study participants but could have demonstrated relevant input as they also have a UK genomic nursing CF which was recently updated in 2023\u0026nbsp;[22]. The nursing competencies are not specific to any stage of a nursing degree and describe relevance to all nursing professionals. They were updated within one workshop session with nursing colleagues.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eImplications for pharmacy education\u003c/p\u003e\n\u003cp\u003eBy creating a pharmacy undergraduate genomic and pharmacogenomic competency framework, this enables guidance and support to UK pharmacy schools to develop standardisation for undergraduate training and to ensure all pharmacy graduates achieve the same level of genomic and pharmacogenomic competence regardless of the UK study location chosen. This will be of great importance if a student chooses to study in another UK nation from a different country or location that they may then choose to permanently reside in in the future. Standardised competencies would also enable development of evidence-based shared nationally available educational resources such as the US AI software driven resource described by Roosan et al.\u0026nbsp;[27], to deliver genomic education relevant to practice. The US based train-the-trainer approaches described by Lee et al could also be used so that it is not essential for all pharmacy schools to employ genomic specialist faculty members\u0026nbsp;[28]. Although UK competence standardisation (alike the US competency framework model) is ideal, there is a requirement for the CF to ensure flexibility as undergraduate curriculums and academic university infrastructures can vary despite all delivering a pharmacy undergraduate curriculum aligned with GPhC standards\u0026nbsp;[3].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCurriculum mapping exercises would need to be undertaken by UK schools of pharmacy against the CF to ensure the integration of the competencies into pharmacy undergraduate curricula. The University of Minnesota took their approach when they mapped their pharmacy curricula to the newly updated American Association of Colleges of Pharmacy (AACP) pharmacogenomic competencies\u0026nbsp;[19]. Standardised assessments and educational methods and tools for delivery could be developed and shared if evaluation shows benefit in the UK, some US methods within published literature may also be useful to explore and adapt for use in the UK\u0026nbsp;[21,27,29\u0026ndash;33].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFuture research\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFurther work could include evaluating the pharmacy student\u0026rsquo;s competence at different stages of their training once the CF is in use within one or more academic institutions. This will establish whether the pharmacist competence is achieved using the CF and to inform further CF iterations.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRecommendations for practice\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe output of this study is a proposed co-created UK-wide pharmacy genomic CF which could be used to guide the standardised development of UK wide pharmacy undergraduate curricula for genomics and pharmacogenomics. \u003c/p\u003e"},{"header":"Conclusions","content":"Setting genomic competencies for the pharmacy profession especially at undergraduate level has been shown to underpin a standardised approach to developing pharmacy education aligned with current practice in countries such as the US. This study has explored and demonstrated a novel UK equitable multi-professional expert model approach to scoping and developing a genomic and pharmacogenomic CF for pharmacy undergraduates and a similar approach could be used to develop other CFs both within genomics for other professionals and outside of the speciality to guide pharmacy professional training in the future. There is now a need for national collaboration and inclusion of pharmacy genomic curriculum stakeholders to develop a nationwide genomic curriculum planned approach to align this CF with training needs."},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express thanks to the study participants for their time and contributions, and to other individuals involved in the design and delivery of the study. Special thanks to Anne Cleves at Velindre Library Cardiff for development of the literature search strategy and study retrieval.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudy participants (agreed to be named): Alex Matos, Dr Alex Murray, Dharmisha Chandra, Prof Dyfrig Hughes, Emma Groves, Dr James Birchall, Jessica Keen, Dr John McDermott, Dr Judith Hayward, Laura Doyle, Mark Voce, Dr Michelle Wood, Roisin O’Hare and Sian Morgan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe lead author and researcher Sophie Harding declares receiving a fellowship bursary from Precision Healthcare Technology Accelerator (PHTA) working in partnership with Swansea University to support development of this study, but PHTA had no input into the research study choice, design or data collection phases of this study development.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors and Affiliations\u003c/strong\u003e\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003e\u003cstrong\u003eCardiff \u0026amp; Vale University Health board, Cardiff, UK\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eSophie E. Harding\u003c/p\u003e\n\u003col start=\"2\" type=\"1\"\u003e\n \u003cli\u003e\u003cstrong\u003ePharmacy, Swansea University Medical School, Swansea, UK\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eSophie E. Harding,\u0026nbsp;Amira Guirguis\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthorship roles\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS.E.H and A.G. conceived the idea and S.E.H conceived the methods in this paper and carried out the SSIs and focus group methods of gaining participant data. Data was analysed by S.E.H and checked by A.G. The originaldraft was completed by S.E.H. All stages of the work were supervised by A.G. and wasconsulted during the entire process of method development and data analysis. A.G. reviewed the first draft once completed. All authors contributed to the article, revised it, and approved the submitted version. All authors have read and agreed to the published version of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare no conflict of interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eUK Government. Genome UK: The future of healthcare [Internet]. [cited 2025 Jun 27]. Available from: https://www.gov.uk/government/publications/genome-uk-the-future-of-healthcare\u003c/li\u003e\n\u003cli\u003eUK Government. Genome UK: shared commitments for UK wide implementation [Internet]. [cited 2025 Jun 27]. Available from: https://www.gov.uk/government/publications/genome-uk-shared-commitments-for-uk-wide-implementation-2022-to-2025\u003c/li\u003e\n\u003cli\u003eGeneral Pharmaceutical Council. Initial Education and training standards [Internet]. 2021. Available from: https://assets.pharmacyregulation.org/files/2024-01/Standards%20for%20the%\u003cbr\u003e20initial%20education%20and%20training%20of%20pharmacists%20January%202021%20final%20v1.4.pdf\u003c/li\u003e\n\u003cli\u003eUniversity of Liverpool. CERSI-PGx [Internet]. [cited 2025 Jun 27]. Available from: https://news.liverpool.ac.uk/2025/01/28/new-pharmacogenomics-centre-to-help-uk-move-towards-personalised-prescribing/\u003c/li\u003e\n\u003cli\u003eRoyal Pharmaceutical Society. The role of pharmacy in pharmacogenomics [Internet]. 2022 [cited 2025 Jun 27]. Available from: https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/PGx/RPS%\u003cbr\u003e20Statement%20for%20the%20Role%20of%20Pharmacy%20in%20Pharmacogenomics.pdf?ver=-6zrIf4CyWUJl74AEO41nA%3d%3d\u003c/li\u003e\n\u003cli\u003eHealth Education and Improvement Wales. Strategic genomic workforce plan for Wales [Internet]. [cited 2025 Jun 27]. Available from: https://heiw.nhs.wales/workforce/strategic-workforce-plan-for-genomics/\u003c/li\u003e\n\u003cli\u003eNHS England. Pharmacy genomics workforce education and training strategic framework [Internet]. [cited 2025 Jun 27]. Available from: https://www.england.nhs.uk/long-read/pharmacy-genomics-workforce-education-and-training-strategic-framework/\u003c/li\u003e\n\u003cli\u003eNHS England. Initial Education and Training of Pharmacists: Genomic medicine indicative curricula [Internet]. [cited 2025 Jun 27]. Available from: https://www.hee.nhs.uk/sites/default/files/documents/NHS%20England%20Pharmacy%\u003cbr\u003e20Indicative%20Curriculum%20Genomics%20Mar%202025.pdf\u003c/li\u003e\n\u003cli\u003eMcNamara C. General Guidelines for Conducting Research Interviews. [Internet]. Available from: http://managementhelp.org/businessresearch/interviews.ht\u003c/li\u003e\n\u003cli\u003eBarrett A, Kajamaa A. How to be reflexive when conducting qualitative research. The clinical teacher, 17(1), 9-12. The clinical teacher. 2020;17:9\u0026ndash;12.\u003c/li\u003e\n\u003cli\u003eBraun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77\u0026ndash;101.\u003c/li\u003e\n\u003cli\u003eTong A, Sainsbury P, Craig J. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349\u0026ndash;57.\u003c/li\u003e\n\u003cli\u003eWitheridge A, Ferns G, Scott-Smith W. Revisiting Miller\u0026rsquo;s pyramid in medical education: the gap between traditional assessment and diagnostic reasoning. Int J Med Educ. 2019;10:191\u0026ndash;2.\u003c/li\u003e\n\u003cli\u003eLincoln YS, Guba EG. Naturalistic inquiry. sage; 1985.\u003c/li\u003e\n\u003cli\u003eBritish Pharmacological Society. Personalised Prescribing \u0026ndash; Using pharmacogenomics to improve patient outcomes [Internet]. [cited 2025 Jun 30]. Available from: https://www.bps.ac.uk/about/our-campaigns/personalised-prescribing\u003c/li\u003e\n\u003cli\u003eGammal RS, Lee YM, Petry NJ, Iwuchukwu O, Hoffman JM, Kisor DF, et al. Pharmacists Leading the Way to Precision Medicine: Updates to the Core Pharmacist Competencies in Genomics. American journal of pharmaceutical education. 2022;86:8634.\u003c/li\u003e\n\u003cli\u003eAnandaciva S. How does the NHS compare to the healthcare systems of other countries? [Internet]. 2023 [cited 2025 Jun 30]. Available from: https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries\u003c/li\u003e\n\u003cli\u003eLatif DA, McKay AB. Pharmacogenetics and pharmacogenomics instruction in colleges and schools of pharmacy in the United States. American Journal of Pharmaceutical Education. 2005;69:152\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eBrown JT, Sorge LA, Oetting WS, Jacobson PA, Pereira C. Meeting the New AACP Competencies in Genetics and Clinical Pharmacogenomics at the University of Minnesota. Inov Pharm. 2023;14:1\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eMarcinak R, Paris M, Kinney SRM. Pharmacogenomics Education Improves Pharmacy Student Perceptions of Their Abilities and Roles in Its Use. Am J Pharm Educ. 11AD;82:6424.\u003c/li\u003e\n\u003cli\u003eGalvez-Peralta M, Szklarz GD, Geldenhuys WJ, Lockman PR. An Effective Approach to Teaching Pharmacogenomics in the First Year of Pharmacy Curriculum. Am J Pharm Educ. 10AD;82:6345.\u003c/li\u003e\n\u003cli\u003eNHS England. The 2023 Genomic competencies for UK Nurses [Internet]. [cited 2025 Jun 30]. Available from: https://www.genomicseducation.hee.nhs.uk/wp-content/uploads/2023/12/2023-Genomic-Competency-Framework-for-UK-Nurses.pdf\u003c/li\u003e\n\u003cli\u003eRoyal Pharmaceutical Society. Pharmacy professionals and Genomic Medicine: A position statement [Internet]. [cited 2025 Jun 30]. Available from: https://www.rpharms.com/development/pharmacogenomics/genomic-statement\u003c/li\u003e\n\u003cli\u003eAcademy of medical royal colleges. Genomics Generic syllabus [Internet]. 2021 [cited 2025 Jun 30]. Available from: https://www.aomrc.org.uk/wp-content/uploads/2021/11/Genomics_syllabus_1121.pdf\u003c/li\u003e\n\u003cli\u003ePichini A, Tatton-Brown K, Thomas E, Bishop M. A cross-professional competency framework for communicating genomic results. Journal of genetic counseling. 2024;33:222\u0026ndash;31.\u003c/li\u003e\n\u003cli\u003ePichini A, Bishop M. A nationally agreed cross-professional competency framework to facilitate genomic testing. Genetics in Medicine. 2022;24:1743 EP \u0026ndash; 1752.\u003c/li\u003e\n\u003cli\u003eRoosan D, Chok J, Baskys A, Roosan MR. PGxKnow: a pharmacogenomics educational HoloLens application of augmented reality and artificial intelligence. Pharmacogenomics. 3AD;23:235\u0026ndash;45.\u003c/li\u003e\n\u003cli\u003eLee KC, Ma JD, Hudmon KS, Kuo GM. A train-the-trainer approach to a shared pharmacogenomics curriculum for US colleges and schools of pharmacy. Am J Pharm Educ. 2012;76:193.\u003c/li\u003e\n\u003cli\u003eArmstrong KJ, Hysolli M, Kinney SRM. Implementing a longitudinal poster project to engage pharmacy students beyond the classroom in a foundational sciences course. Pharmacy Education. 2024;24(1):79\u0026ndash;90.\u003c/li\u003e\n\u003cli\u003eFrick A, Benton C, Suzuki O, Dong O, Howard R, El-Sabae H, et al. Implementing Clinical Pharmacogenomics in the Classroom: Student Pharmacist Impressions of an Educational Intervention Including Personal Genotyping. Pharmacy (Basel). 2018;6:23.\u003c/li\u003e\n\u003cli\u003eKisor DF, Bright DR, Chen J, Smith TR. Academic and professional pharmacy education: a pharmacogenomics certificate training program. Per Med. 2015;12:563\u0026ndash;73.\u003c/li\u003e\n\u003cli\u003eRao PS, Endicott R, Mullins R, Rao US. A 6-week laboratory research rotation in pharmacogenomics: a model for preparing pharmacy students to practice precision medicine. Pharmacogenomics J. 7AD;18:601\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eRemsberg CM, Bray BS, Wright SK, Ashmore J, Kabasenche W, Wang S, et al. Design, Implementation, and Assessment Approaches Within a Pharmacogenomics Course. Am J Pharm Educ. 2017;81:11.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cdiv class=\"SimplePara\"\u003eInterview schedule guide for SSI and focus groups\u003c/div\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eInterview questions\u003c/div\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; what do you think of the genomic training needs of pharmacy undergraduates?\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; what documents or strategies are you aware of that should be used to develop the competency frameworks for pharmacy undergraduates?\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; what genomic competencies or topics are essential for pharmacy undergraduates?\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; any other comments or any other thoughts you had or anything you hadn't mentioned which you thought maybe relevant?\u003c/div\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eFocus group questions\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e1. Please discuss your opinion on the content of the draft competencies presented and the level of Millers triangle.\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e2. Are there sufficient draft competencies to meet the genomic training needs of pharmacy undergraduates?\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e3. Reading through each competency one by one, please comment on the clarity of the competencies\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e4. Reading through each competencies one by one, please comment on the relevance of the competencies to pharmacy undergraduates\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e5. What is your opinion on how the competency framework should be further developed?\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e6. Do you have any further comments?\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003cbr/\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cdiv class=\"SimplePara\"\u003eParticipant demographics\u003c/div\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eProfession/expertise background\u003c/div\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eUK nation represented\u003c/div\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cdiv class=\"SimplePara\"\u003eNo. of participants\u003c/div\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eMedicine\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eEngland \u0026amp; Wales\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003ePharmacy\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eEngland \u0026amp; Scotland\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eClinical Science\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eWales\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003ePharmacy educationalist\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eWales \u0026amp; Northern Ireland\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003ePharmacy regulator\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eUK wide\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/br\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cdiv class=\"SimplePara\"\u003eSuggested topic areas and competence pharmacists require to develop competency from SSIs\u003c/div\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eThemes\u003c/div\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003eGenomic topics suggested\u003c/div\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eAreas to include related to medicines use\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ePharmacogenomics\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eRare disease related to medicines use only e.g. chronic disease management such as familial hypercholesterolemia in the context of lipids optimisation\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eCancer/oncology \u0026ndash; precision medicines\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eInfectious disease - vaccines and how you monitor outbreaks\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eGene therapy and CRISPR\u003c/span\u003e\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eGenomic Knowledge\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ewhat is pharmacogenomics?\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003egenomic variance and how might it impact my practice\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ebasics around DNA and RNA and gene expression\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ewhat are star alleles and their relevance\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eawareness of the structure of the genome and that there is different types of variation that can have different effects by affecting the function of certain proteins, enzymes and affect drug catabolism\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eunderstanding the difference, for instance between homozygotes, heterozygotes and different patterns of inheritance (but not in depth)\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eUnderstanding of the relationship between different gene drug pairs then needs to be an awareness of what these are the relationships\u003c/span\u003e\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eClinical application\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eability to collate and appraise resource evidence\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eunderstanding of the kind of testing pathways associated with those variants of how you can access those tests and what are the advantages and relative disadvantages of each of the tests.\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ehow you would approach a multidisciplinary and informed counselling session around the use of those results. So as an example, someone in the community is being treated for depression with citalopram and that patient is a CYP2C19 ultrarapid metabolizer. How do you work with the healthcare professional?\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ehow do you work with other colleagues and how do you work with the patient to come to a kind of shared care decision around what therapy you should use?\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eThe testing pathways available\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003edifferent sources of guidance there and how it interacts with other pharmacy infrastructure like the pharmacovigilance structures, with the MHRA and BNF etc. e.g. DPYD linking to the MHRA, drug safety alert, and how that's relevant to prescribing if fluoropyrimidines.\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eunderstand about genomic technologies because of the limitations.\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eUse case studies that include pharmacogenetic reports.\u003c/span\u003e\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eAddition aspects to include\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eEthical and legal considerations to testing\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eUnderstanding that there are resources out there that help informaticians make their decisions and that there is that that they can be uncertainty and grey areas about that\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ePatient counselling and communication\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ekeep up to date with the latest developments\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eunderstand the limitations of testing including gaps in evidence\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eunderstand how genomics links in with the multidisciplinary team and actually what are the different roles\u003c/span\u003e\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eResources\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eNHSE Undergraduate indicative curriculum\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eGeNotes\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ePharmGKB\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eCPIC\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eRoyal College Guidelines\u003c/span\u003e\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cdiv class=\"SimplePara\"\u003eCompetence suggested within their role\u003c/div\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eCommunicating to patients what the implications are and being able to talk to them about genomics\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003edevelop the skills and competencies to have conversations with patients around genomics and signpost patients appropriately. And identify any red flags. \u0026ndash; culturally competent consultant skills\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eUse genomic data when prescribing\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eCapable of reading genomic reports\u003c/span\u003e\u003c/div\u003e\u003cdiv class=\"SimplePara\"\u003e\u0026bull; \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eAble to identify appropriate tests and how to optimise therapy with them and what are the pathways for certain test available\u003c/span\u003e\u003c/div\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003cbr/\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"education, genomics, pharmacist, pharmacogenomics, undergraduate/curriculum","lastPublishedDoi":"10.21203/rs.3.rs-7014428/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7014428/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e The application of genomics is due to have a significant impact on the role of pharmacy within future healthcare systems. Since 2021, the updated GPhC education standards have included a requirement to apply the principles of genomics, but a lack of consistency across UK pharmacy programmes has led to inequity of genomics literacy for pharmacy students. There is a lack of UK research exploring pharmacy undergraduate genomic education requirements.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e Scope and develop a genomic competency framework for undergraduate pharmacy curricula.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e Ethics approval obtained from Swansea University. Fifteen multi-professional expert stakeholders from across the UK were selected using purposive sampling and invited to participate within a virtual semi-structured interview to scope and two consecutive focus groups to refine the competency framework. Both qualitative methods were facilitated and recorded using Microsoft® Teams using pre-designed open question interview schedules. All data anonymously transcribed verbatim and thematically analysed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e Fourteen participants interviewed between September/October 2023. Five themes identified: \u003cem\u003eCompetency development\u003c/em\u003e - Participants described how pharmacists need a basic level of comprehensive genomic knowledge with a focus on clinical practice related to medicines use; \u003cem\u003eCurriculum approach\u003c/em\u003e – the requirement for genomics to be spiralled throughout the undergraduate curriculum was described; \u003cem\u003eFuture practice roles\u003c/em\u003e - the need for pharmacy curricula to focus on the application of genomics to medicines rather than as a diagnostic tool was described; \u003cem\u003eGenomic topics\u003c/em\u003e - participants acknowledged the complex nature of determining undergraduate competencies but suggested competencies and topics; \u003cem\u003eLevel of knowledge\u003c/em\u003e - participants described that overall genomic knowledge is needed but to focus on pharmacogenomics across all healthcare sectors. Two further consecutive focus groups further developed the framework through iterative refinement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e Genomic competencies should support delivery of pharmacist roles as implementation develops. The varied backgrounds of participants impacted their opinions influenced by a lack of knowledge to the role of the pharmacist and training career. Study limitations are small participant numbers and low data generalisability. A genomic competency framework is needed to standardise pharmacy training and study findings will be used to develop a UK consensus for UK genomic undergraduate pharmacy training.\u003c/p\u003e","manuscriptTitle":"Scoping and developing a genomic competency framework to inform genomic inclusion within pharmacy undergraduate curricula","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-07 05:29:57","doi":"10.21203/rs.3.rs-7014428/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a48b53d3-e7e1-4517-abb3-1c42081c2394","owner":[],"postedDate":"July 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-28T09:39:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-07 05:29:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7014428","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7014428","identity":"rs-7014428","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}