Matching Artificial Intelligence and digital simulation to educational purposes in a competency-first pharmacy education framework.

OBJECTIVES: To synthesize pharmacy-education evidence across artificial intelligence (AI) and digital simulation technologies, compare modalities by educational function, evidence maturity, implementation requirements, and risk, and derive a competency-first framework for curricular selection, implementation, assessment, and governance. FINDINGS: A narrative search of PubMed, Scopus, and Web of Science prioritized pharmacy-education studies and reviews published from 2018 through August 2026. Educational function, rather than AI status alone, provided the primary organizing principle. Simulation modalities mainly support standardized rehearsal, contextualized practice, feedback, visualization, and debriefing; adaptive systems and large language models (LLMs) can add personalization or generative dialogue; and AI-assisted assessment can support item development, feedback, and workflow. Evidence maturity differed substantially across modalities, but comparisons reflect the type and volume of literature identified rather than formal certainty grading. Across the literature, the strongest and most consistent outcomes were feasibility, engagement, satisfaction, and selected short-term knowledge or skill measures. Evidence for durable competence, transfer to clinical performance, patient outcomes, cost-effectiveness, and equity remained limited. SUMMARY: Pharmacy programs should use a competency-first, not technology-first, approach that defines observable learner outcomes before selecting tools. The proposed function-evidence-risk principle and ALIGN roadmap are author-derived syntheses intended to support curricular decision-making, not validated implementation instruments. AI literacy, output verification, transparent disclosure, privacy protection, and professional accountability should be developed longitudinally within existing pharmacy competency expectations, while faculty retain responsibility for curricular decisions, assessment validity, and patient-centered judgment.