Predictors of Ethical Dilemmas Among Undergraduate Pharmacy Students in Saudi Arabia: A Multicenter Cross-Sectional Study

Abstract This multicenter cross-sectional study aimed to explore the factors influencing ethical dilemmas among undergraduate pharmacy students in Saudi Arabia, focusing on training duration, educational level, and type of training experiences. Participants included 259 students from eight universities, selected through stratified convenience sampling. Data were collected via questionnaires covering demographics, educational background, and ethical dilemmas encountered during training. The findings of the study revealed that students with more than six months of training were significantly more likely to report ethical dilemmas (53.09%) compared to those with shorter training periods (29.78%). Internship students reported more ethical issues (82.7%) than pre-internship students (17.3%), and students involved in clinical rounds with medical teams reported more dilemmas (41.98%) than those primarily engaged in dispensing (40.74%). Notably, no significant gender differences were found in reporting ethical dilemmas. The most common ethical dilemmas included treatment decisions (16.05%), obeying doctors' orders against their judgment (14.81%), and disclosing confidential patient data without consent (14.81%). Logistic regression analysis identified training duration and type as significant predictors of ethical dilemma reporting, with students in clinical rounds more likely to encounter dilemmas (OR = 0.56, p = 0.038). The findings emphasize on the importance of integrating practical, experiential learning and ethical training into pharmacy curricula to better prepare students for the ethical challenges they will face in professional practice.