Generational diversity is commonplace in Hospital Pharmacy Departments (HPD). Social and technological shifts, along with severe financial crises and accelerated digitalization, have differentially shaped the values and attitudes of individuals throughout history1. In this context, a generation is defined as a group of people born at around the same time who share historical and social experiences that determine their personal and professional attitudes and expectations. Although start and end dates have not been established to separate generations, the average period is generally considered to be 15–20 years2,3.

Currently, four generations coexist in HPDs: Baby Boomers (1946–1964); Generation X (1965–1980); Millennials – or Generation Y (1981–1996); and Generation Z (1997–2012). Every of these generations has been attributed with differential traits, namely: Baby Boomers are responsible and prefer face-to-face interaction and communication; Gen X is independent and experienced migration from the analogical to the digital era; Millennials are collaborative, purposeful and value work-life balance. Finally, Gen Z is characterized by hyperconnectivity and excellent learning and content-generation skills2,3.

In healthcare settings, age diversity has been identified both as an opportunity and a challenge. Intergenerational diversity sparks innovative decision-making practices and improves healthcare standards. However, tensions may also arise from differences in expectations regarding leadership, career progression, social recognition, and life-work balance1,3,4. The evidence available shows variations in the level of professional engagement and satisfaction across generations, making tailored organizational strategies necessary to improve team performance2,5,6. Recent studies warn about the risk of stereotyping and emphasize that differences across generations are context-dependent. Some authors underline that not all individuals within a specific generation share the same values, but some of the differences observed may stem from structural factors, including career stage or work conditions3. Hence, generational labels may misguide organizational or educational strategies3.

In the context of public health and health sciences education, studies have found Millennials and Gen Z to value collaborative work environments, career progression opportunities, social responsibility, and innovative organizational cultures, which determine their institutional loyalty and rapport with workmates7–10. Although cross-generational differences are not clear-cut, the institutional engagement and loyalty of younger generations can be strengthened by adopting tailored management strategies and organizing work according to their expectations11,12.

There is extensive evidence on the impact of intergenerational differences in the workplace1,5,7. In the setting of Hospital Pharmacy (HP), however, the evidence available is still limited. The clinical setting has witnessed rapid transformations, including digitalization, a paradigm shift toward outcome-oriented approaches, and the emergence of new professional roles13. In this context, the need arises to better understand how the different generations in work teams perceive these changes14. Understanding these dynamics will contribute to anticipating the challenges of generational change and maintaining professional motivation. A deeper knowledge will also help tailor management, education and development policies to the expectations and values of hospital pharmacy specialists15. This is crucial for creating more cohesive and sustainable work environments that attract and retain talent in an era where healthcare systems are under a deep transformation process16. Given the aforementioned, the objective of this study was to assess cross-generational differences in terms of priorities, motivations, concerns and expectations of hospital pharmacists in Spain. The ultimate purpose was to provide strategic directions to promote cross-generational rapport-building, enhance employee engagement, and support professional growth and well-being within teams.

A cross-sectional descriptive study was conducted through an electronic anonymous survey.

The study population included all Spanish Society of Hospital Pharmacy (SEFH) members working as hospital pharmacists or receiving HP training in Spain. Participation was voluntary. Non-probabilistic self-selection sampling (volunteer sample) was performed.

Overall, 620 questionnaires were returned, accounting for a response rate of 15.9% (620/3898 SEFH members). Responses were obtained from participants from all autonomous communities. The final sample was representative of SEFH members in terms of generation, sex and professional category (Table 1).

To the best of our knowledge, this is the first study to analyze generational differences in the priorities, motivations, concerns and expectations of hospital pharmacy specialists. The results demonstrate some consistencies across generations, including recommendations of their hospitals as a good place to work and the relevance attributed to work atmosphere. However, significant differences were observed in key aspects of the professional and social environment.

The most highly valued factors across all generations included work atmosphere, work-life balance, and stability. These top-priority role-related aspects have been consistently identified in the literature as determinants of talent retention and the well-being and motivation of healthcare professionals. The influence of these factors extends when combined with effective leadership styles and career progress opportunities17. However, variations in preferences were noted across generations, namely: Baby Boomers prioritize professional recognition and clearly defined goals; Gen X values independence and engagement in multidisciplinary teams; whereas Gen Z shows more interest in training opportunities. These differences may be influenced by career stage and the professional expectations tied to their developmental stage in the hospital18.

Work-related concerns differed significantly across generations, showing a strong correlation with personal and professional stages. Although stress, work-life balance and communication barriers were common to all generations, Gen Z was more concerned about working hours and salary, whereas work-life balance and job instability were common concerns among Millennials. Senior generations tended to value the work atmosphere more. These findings underline the need to adapt organizational strategies to the particularities of each generation. Initiatives should be implemented to improve work-life balance, flexibility, and professional recognition while building a positive work atmosphere. These initiatives would result in enhanced professional satisfaction and prevent burnout situations19,20.

There is cumulative evidence of a differential impact of stress across generations, added to distinctive reactions to stressful situations20,21. Measures should be adopted to provide flexible working hours and mental health support services and foster institutional recognition, with a more significant impact on younger generations8,15,17,22. In this context, organizations should transition from a homogeneous model into structures that are sensitive to intergenerational diversity, with tailored policies aimed at meeting the specific needs of each group.

Beyond specific concerns, our findings demonstrate a generational paradigm shift regarding the significance professionals attribute to work-life balance. Recent studies in other healthcare settings, including studies in surgery, underscore a paradigmatic transition from a work-life balance model toward a harmonized model in which work and personal life are dynamically integrated through adaptation and flexibility4,21,23. When these expectations are not adequately identified or fulfilled, friction arises between younger and older professionals in relation to working hours, allocation of responsibilities and the scope of engagement with the institution24. Advancing toward more inclusive work environments adapted to the different professional stages of their members may not only enhance intergenerational coexistence but also strengthen cohesion, talent retention and team performance25.

Our research also provides an insight into the professional motivations that drive hospital pharmacy specialists. Enhancing patient care and healthcare efficiency, as well as strengthening professional leadership, were among the most valued goals across all generations. However, significant nuances were identified among cohorts. Younger generations place greater importance on social visibility within their professional roles, reflecting Generation Z's strong orientation toward communication and meaningful social impact1,8,18. This value framework helps explain their interest in developing a more visible and widely recognized professional identity. Gen X prioritized the system's efficiency and health outcome measurement, which is aligned with a more consolidated professional stage focused on management. These variations are not opposing, but provide the opportunity to broaden strategic approaches in hospital pharmacy departments; strategies should include a combination of innovation, efficiency and visibility. In agreement with Huizing4, interpreting intergenerational differences from a constrained or simplistic perspective may strengthen stereotypes and limit the potential of a more cooperative intergenerational approach. Designing professional development policies that integrate differing intergenerational expectations is crucial for fostering collective engagement11,26.

The study additionally explored how specialists perceive the future of HP by examining the needs that should guide their professional activities and identifying the institutions with which they would like to strengthen bonds. Top priorities include integrating pharmacists into multidisciplinary teams, measuring health outcomes and ensuring active patient follow-up. The relevance attributed by younger cohorts to clinical integration demonstrates a novel professional perspective based on collaborative work, cross-functionality, and active involvement in multidisciplinary teams, thereby underlining their role as catalysts of a paradigm shift8,18,27. This orientation toward more cooperative work environments is a distinctive trait of younger healthcare professionals, who reject rigid hierarchies and value inclusive approaches. These preferences are aligned with the SEFH 2030 strategy, which adopts an outcome-oriented approach based on integration into multidisciplinary teams, digitalization and meaningful social impact28.

Participants consistently showed interest in connecting with scientific organizations and universities. Notably, younger cohorts exhibited a preference for international institutions, thereby reflecting a globally-oriented perspective, along with a willingness to engage in wider professional networks. This broadened approach may be crucial for meeting the ultimate goal of enhancing the visibility and role of hospital pharmacy in clinical settings. As exposed by the World Health Organization14, integrating young professionals into transformative processes reinforces their sense of belonging. These practices contribute to the renewal of healthcare structures through a more participative and innovative approach aligned with global challenges. Fostering youth participation in the definition of priorities and building alliances with other organizations is crucial for fostering professional leadership3 and driving change in hospital pharmacy.

Finally, participants demonstrated a positive perception of HP, although with significant intergenerational differences. Senior generations – Baby Boomers and Gen X11 – reported higher levels of satisfaction with their specialty. This finding is consistent with previous studies revealing higher levels of satisfaction among senior professionals29,30. This could be explained by a stronger engagement with their organizations and a consolidated sense of belonging, which is distinctive of professionals with longer, stable, professional careers29.

One of the strengths of this study lies in the size and representativeness of the sample, which included professionals from all active HPD generations from all autonomous communities, thereby guaranteeing an updated global overview of the national context. However, this research is not exempt from some limitations. Firstly, the cross-sectional design involving non-probabilistic self-selection sampling requires a cautious interpretation and generalization of results, as probabilistic sampling error cannot be estimated. Although the sample was large, it included professionals from across the country and showed a distribution by generation and sex comparable to that of the SEFH overall membership. Baby Boomers were the least represented cohort, which may reduce the precision of estimates for this group. In addition, as participation was voluntary, a potential self-selection bias may have occurred related to the interest or motivation of those who chose to respond. Furthermore, the cross-sectional design precludes the establishment of causal relationships between the variables analyzed.

Future research should move beyond descriptive approaches and focus on evaluating the impact of specific strategies for managing intergenerational dynamics. Further studies should be conducted to assess the impact of measures such as greater organizational flexibility, bidirectional mentorship programs, or individualized career pathways on key outcomes such as job satisfaction, retention, work atmosphere, and work-life balance across generations.

In conclusion, this study reveals intergenerational differences in the priorities, concerns, motivations, and expectations of hospital pharmacists. Work atmosphere and work-life integration remain among the most frequently selected priorities, with stress emerging as the main concern across all cohorts. The distinct generational patterns observed across the evaluated dimensions underscore the need for tailored management and professional development approaches in multigenerational teams.

This study describes generational differences in terms of priorities and motivations among age cohorts of hospital pharmacy specialists in Spain.

Understanding intergenerational differences enables the identification of specific needs and the development of tailored organizational and professional development practices aimed at improving the well-being of multigenerational teams.

Covadonga Pérez Menéndez Conde: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Methodology, Investigation, Data curation, Conceptualization. Beatriz Martínez Castro: Writing – review & editing, Visualization, Validation, Methodology, Formal analysis, Data curation, Conceptualization. María Pérez Abánades: Writing – review & editing, Writing – original draft, Validation, Methodology, Formal analysis, Data curation, Conceptualization. Edurne Fernández de Gamarra-Martínez: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Project administration, Methodology, Investigation, Formal analysis, Conceptualization. Eva Negro-Vega: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization.

This work did not receive any financial support.