Beyond knowledge acquisition: the role of problem-based learning in supporting competency and skills development in pharmacy education — a systematic review

Abstract

To synthesize evidence on the role of PBL in pre-registration pharmacy education in fostering metacognitive and interpersonal competency development, with particular emphasis on self-regulation, learner autonomy, and professional collaboration. A systematic search of MEDLINE, Embase, ERIC, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) identified peer-reviewed primary studies exploring PBL-related competency and skill development among undergraduate pharmacy students. Quantitative, qualitative, and mixed methods studies were included. Two reviewers independently screened studies and extracted data. Findings were synthesized narratively, and methodological quality was appraised using the Mixed Methods Appraisal Tool 2018. Twenty-six studies met the inclusion criteria (12 mixed methods, 11 quantitative descriptive, 3 qualitative). Three domains emerged from the narrative synthesis: (1) Self-regulated clinical reasoning, decision-making, and metacognitive development ( n  = 16); (2) Communication and teamwork skills ( n  = 12); and (3) Engagement, motivation, and learning management skills, including organization and accountability ( n  = 9). Across studies, PBL was associated with enhanced reflective capacity, greater ownership of learning, improved confidence in complex decision-making, and strengthened collaborative communication. However, experiences were not uniformly positive; some studies reported learner anxiety, resistance, or reduced engagement when cultural alignment was limited. Most studies were rated medium to high quality. Beyond cognitive gains, PBL appears to cultivate self-regulation, learner autonomy, and collaborative competencies essential for preparing pharmacists capable of navigating the evolving scope of contemporary practice. Further longitudinal, theory-informed research is needed to clarify the contextual conditions under which PBL most effectively supports sustained learner development.