The factor analysis results showed that the pharmaceutical knowledge and professional communication competency scales were unidimensional (results not shown), while the emergency preparedness and response (PP) scale exhibited a bi-dimensional structure (Table 1). All Emergency Preparedness and Response Competencies (PPE) and all Operation Management Competencies (PPO) items (behaviors) showed robust loadings on factor 1, designating it as the "operational aspect" of pharmacists' emergency preparedness. Furthermore, all Patient Care and Population Health Interventions Competencies (PPC) and all Evaluation, Research, and Dissemination for Impact and Outcomes Competencies (PPERD) had their highest loadings on factor 2, which can be labeled as the "clinical and research aspect" of pharmacists' readiness for emergencies. This factor analysis confirms the original two-subscale structure of the PP scale.

Cronbach alpha coefficients were calculated for the measurement of internal consistency (Table 2); they were higher for Professional Communication Skills (PCS) and PP scales because they were obtained from longer scales (70 items in PCS and 21 items in PP). However, it was smaller for the six-item PK scale since it was the shortest scale. The measurements were reliable (> 0.8) (Table 2).

Of the 230 participant pharmacists working in sales and marketing, 71.74% were females. Educational variables showed that 40.87% had a BS in pharmacy as the highest degree related to the main field of work, 14.78% a PharmD, 22.61% a master’s degree, and 2.6% a Ph.D. or equivalent. The highest percentage graduated from Saint-Joseph University of Beirut (USJ; 19.60%), 17.40% from the Lebanese University (UL), which is the only public university in Lebanon, 16.50% from the Lebanese American University (LAU), 16.10% from the Lebanese International University (LIU), 13.00% from the Beirut Arab University (BAU), and 16.6% from other Lebanese and foreign universities.

The majority of participants (66.52%) graduated after 2011, 27.39% between 2000 and 2010, and 6.09% before 2009. Furthermore, 52.61% worked in Beirut, 19.13% in Mount Lebanon, 5.22% in Beqaa, 3.48% in South Lebanon, and 6.96% were not currently working. Regarding their work experience, 68.21% had less than ten years of experience in the sales and marketing field, 26.52% had between 11 and 20 years of experience, and 5.22% had more than 20 years of experience. The mean age of respondents was 34.31 years (SD = 6.51). The majority were English-educated (63%) and not recently graduated (median = 2012); the sample was well distributed among universities and work locations (Additional file 2: Table S1).

Self-declared competencies are described in detail in Additional file 2 (Additional file 2: Tables S2 and S3). Pharmaceutical knowledge, communication, emergency response, and operation management during emergencies were satisfactory (more than 80/100). Other activities during emergencies, such as patient care and population health interventions, and evaluation, research, and dissemination of research outcomes, received a moderate score (75-78/100), similar to legal practice (78/100), teamwork (76/100), and management skills (75/100). The lowest reported confidence was related to professional communication skills (other than communication per se), mainly negotiation, data processing skills, information technology, self-management, and ethical practice (< 75/100) (Fig. 1). Most participants (70%) declared having acquired their competencies through experience (Additional file 2: Table S2).

Self-assessment of specialized competencies among sales and marketing pharmacists

Bivariate analysis for all competency scales was conducted (Additional file 2: Tables S4, S5, and S6). The detailed multivariable analysis is presented in Additional file 2: Table S7.

Table 3 presents the significant results of the multivariable analysis. Extended experience and acquiring competencies by experience were associated with higher scores on the majority of the scales and subscales while gaining competencies during undergraduate, postgraduate, or continuing education was associated with lower scores.

A significantly lower pharmaceutical knowledge was found among pharmacists who reported MBA as the highest degree related to their main field of work and those who considered that most (51% to 75%) of their communication competencies were acquired during undergraduate studies, followed by those who gained them during continuing education and postgraduate studies. A significantly lower negotiation competency was found among those who indicated that the majority of their negotiation competencies were acquired during postgraduate studies.

A significantly higher data processing analysis competency was found with increased years of experience, while a significantly higher information technology competency was found in those who worked in Mount Lebanon. A significantly lower self-management skills score was found in PharmD pharmacists and those who considered that most of their self-management skills were acquired during postgraduate studies. A significantly lower management skills competency was found among those considering that most management skills were acquired during postgraduate studies, while significantly higher management skills were found among pharmacists who do not have another field of work.

As for practice, pharmacists who considered that most of their standard practice competencies were acquired during postgraduate studies had a significantly lower standard practice competency, while those who had 21 to 30 years of experience and those who graduated between 2000 and 2010 demonstrated higher standard practice competency. A significantly lower ethical practice competency was found among participants who reported that 51% to 75% of their ethical practice competencies were acquired by continuing education. No significant association was found between legal practice competency and pharmacists’ sociodemographic characteristics.

Regarding communication skills, lower role modeling competency was found among male pharmacists, those who graduated between 2011 and 2020, and those who reported that most of their role modeling competencies were acquired by continuing education. Furthermore, a significantly higher role modeling competency was found among pharmacists who had 21 to 30 years of experience and those who graduated between 2000 and 2010. A significantly higher teamwork skills competency was found in those who worked an average of 8.5 h per day.

A significantly lower emergency and preparedness response competency was found among pharmacists who had another field of work, while a significantly higher emergency and preparedness response competency was found in those who had no other field of work, who considered that more than 75% of their competencies were acquired during undergraduate studies and those who reported that 51% to 75% of their competencies were acquired during postgraduate studies. A significantly lower operation management competency was found in pharmacists with a PharmD degree and those who had another field of work, while higher operation management competency was found among those who had no other field of work, those who worked in Mount Lebanon, and those who were not currently working. A significantly lower patient care and population health interventions competency was found in pharmacists who held a PharmD and those who graduated from BAU and USJ, while a significantly higher patient care and population health interventions competency was found among pharmacists who considered that more than 75% of these competencies were acquired during undergraduate studies. Finally, a significantly lower evaluation, research, and dissemination for impact and outcomes competency was found among pharmacists who had PharmD and those who graduated from LIU, while this competency was significantly higher in pharmacists who considered that more than 76% of these competencies were acquired during undergraduate studies (Table 3).