A National Survey of Perceptions Around Conditions Associated With Pharmacy Faculty Workload Equity.

OBJECTIVE: To assess pharmacy faculty members' perceptions of conditions associated with workload equity and factors that can improve workload equity. METHODS: A 26-item survey instrument was developed and distributed via email to members of the American Association of Colleges of Pharmacy Council of Faculties. Questions pertained to the workload distribution, fairness in assignment, and perception of the conditions associated with workload equity (transparency, context, credit, clarity, norms, and accountability) as well as institutional and individual demographics. RESULTS: A total of 662 responses were obtained (response rate 15.9%). Respondents' demographics were comparable to available national data. Approximately 41% of respondents reported their institutions did not have a written faculty workload policy. Most respondents reported their workload assignment was fair (highest with research/scholarship) but reported only moderate alignment between assigned and actual workloads. The rating level for what domains the primary decision maker uses to assign workload was highest for context, followed by credit, clarity, and transparency. Transparency was reported as the most needed condition to improve faculty perception of workload equity. Respondents also rated increasing trust between leadership and faculty and increasing productivity and accountability as the most important reasons to minimize workload inequities. CONCLUSION: This was the first national survey of pharmacy faculty perceptions around the conditions associated with workload equity. Though additional research is needed in this area, programs can work to implement strategies associated with all of the conditions, particularly transparency, to improve faculty perceptions of equity.

A Multicenter Study Assessing Burnout and Work Engagement in Student Pharmacists and Faculty Members.

OBJECTIVE: The objective of this study was to characterize work engagement and burnout as well as potential demographic factors associated with each student and faculty member at 2 pharmacy programs in the US. METHODS: A survey including the Utrecht Work Engagement Scale-9 (UWES-9) and a single-item burnout measure was conducted from April to May 2020. Demographic data including age range, gender, and other characteristics were also collected. Mean UWES-9 scores, scoring category results, and the proportion of the cohorts reporting symptoms of burnout were reported. Point biserial correlation was used to compare the relationship between UWES-9 mean scores and burnout rates. Regression analyses were also performed to assess variables predictive of work engagement and burnout. RESULTS: Students (N = 174) reported a mean UWES-9 score of 3.0 (SD = 1.1), while faculty members (N = 35) reported a mean of 4.5 (SD = 0.7). Over half (58.6%) of the students and 40% of faculty members reported symptoms of burnout. Faculty members demonstrated a strong significant negative correlation between work engagement and burnout (r = -0.35), while students did not (r = 0.04). Regression analyses found no significant demographic factors predictive of UWES-9 scores in students or faculty, while first year students were less likely to report burnout symptoms, and no significant factors for burnout were found in faculty. CONCLUSION: Our study found that work engagement scores and burnout symptoms were inversely correlated in pharmacy faculty members surveyed but lacked correlation in students. Larger, more robust studies should be conducted to further elucidate the relationship between work engagement and burnout.

The Role of Artificial Intelligence in the Future of Pharmacy Education.

Recent developments making an artificial intelligence (AI) large language model available for public use have generated significant interest and angst among educators. Viewed as both a time saver and a threat to academic integrity, several questions have arisen about AI's role in education. Numerous opportunities exist to use AI for teaching and learning, but new questions have also arisen regarding AI's impact on the future of healthcare. The pharmacy Academy should be at the center of these discussions to address the technical, philosophical, and ethical issues that AI presents for the future of pharmacy and pharmacy education.

The intersectionality of professional and personal identity formation in a virtual pre-health pathway program.

BACKGROUND AND PURPOSE: To describe the development and implementation of professional and personal identity formation content in a virtual pre-health pathway program. EDUCATIONAL ACTIVITY AND SETTING: Content within a six-week pre-health program for underrepresented and/or disadvantaged college students was redesigned to a virtual format with enhanced focus on professional and personal identity formation. Sessions on personal identity formation were also enhanced through a partnership with local mental health clinicians specializing in trauma-informed care and culturally relevant practices and strategies. FINDINGS: The 2020 and 2021 programs were restructured to include pharmacy professional identity formation content around the following weekly themes: Roadmap to Pharmacy, What Does it Mean to be a Pharmacist?, Expanding Knowledge of Pharmacy, Gaining Insight and Dispelling Myths, Practicing Knowledge and Exploration, and Moving Forward. These pre-pharmacy components emphasized diversity of career paths, pharmacy-based clinical services, and the pharmacist's role in promoting health equity. Overarching components of interprofessional collaboration coupled with health policy applications further emphasized the professional identity of a pharmacist in the collaborative design and delivery of health care. New personal identity formation sessions were implemented in tandem with this content and centering around the following themes: Supporting Scholars in Self-Authorship, Building a Community among Peers, and Strategies for Coping in Times of Challenge. SUMMARY: This project has the potential to serve as a model for the implementation of both personal and professional identity formation initiatives at other programs to promote pharmacy as a desirable and attainable career to pre-health students.

Revising the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes and Entrustable Professional Activities (EPAs): The Report of the 2021-2022 Academic Affairs Standing Committee.

EXECUTIVE SUMMARY. The 2021-22 Academic Affairs Committee was charged to 1) Update the Center for the Advancement of Pharmacy Education (CAPE) Outcomes and Entrustable Professional Activity (EPA) statements for new pharmacy graduates; 2) Nominate at least one person for an elected AACP or Council Office; and 3) Consider ways that AACP can improve its financial health. This report primarily focuses on the process undertaken by the committee to revise the CAPE Educational Outcomes and EPAs. Proposed changes to the current outcomes are discussed and the reasoning behind these revisions are described. AACP members will have the opportunity to provide feedback prior to the final document being approved and published later this year.

Finalizing the Work Related to the Curriculum Outcomes and Example Objectives and Entrustable Professional Activities (COEPA) Document: The Report of the 2022-2023 Academic Affairs Standing Committee.

The 2022-2023 Academic Affairs Committee (AAC) was charged to (1) complete the Center for the Advancement of Pharmacy Education Outcomes and Entrustable Professional Activities (EPAs) revisions (now renamed as COEPA - Curriculum Outcomes and Entrustable Professional Activities) after receiving feedback at the 2022 American Association of Colleges of Pharmacy (AACP) Annual Meeting; (2) offer guidance on how the revised COEPA education outcomes and EPA statements should be used by member institutions, faculty, preceptor, and students; (3) guide input into the ongoing revision of the Accreditation Council for Pharmacy Education (ACPE) standards for the Doctor of Pharmacy program. The published report of the 2021-2022 AAC outlines the work of the Committee through the spring of 2022.1 This 2022-2023 AAC report focuses on the work related to finalizing the COEPA educational outcomes, EPAs, preamble, and glossary and formally receiving approval from the AACP Board of Directors.2 This report also describes the creation of a COEPA guidance document, including educational outcomes example learning objectives, and EPA example tasks for the Academy, however, the actual guidance document will be published separately. Finally, this current report outlines the feedback the AAC sought, received, synthesized, summarized, and prioritized from key interested and affected parties about the ACPE 2016 standards revisions for the ACPE 2025 draft standards.3 The Committee offers revisions for 1 AACP policy statement pertaining to diversity, equity, inclusion, accessibility, justice, and anti-racism. One new policy statement is also offered that urges ACPE to create accreditation standards for pharmacy education that support diversity, equity, inclusion, accessibility, justice, and anti-racism, despite presence of laws, executive orders, and policies that oppose these concepts.

The AACP Academic Affairs Committee's Final 2022 Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates to Replace 2013 CAPE and 2016 EPAs.

The American Association of Colleges of Pharmacy (AACP) Academic Affairs Committee was charged with revising both the 2013 Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes (EOs) and the 2016 Entrustable Professional Activities (EPAs). The Committee changed the document name from the CAPE outcomes to COEPA, (Curricular Outcomes and Entrustable Professional Activities) since the EOs and EPAs would now be housed together. A draft of the COEPA EOs and EPAs was released at the AACP July 2022 Annual meeting. After receiving additional stakeholder feedback during and after the meeting, the Committee made additional revisions. The final COEPA document was submitted to and approved by the AACP Board of Directors in November 2022. This COEPA document contains the final version of the 2022 EOs and EPAs. The revised EOs have been reduced to 3 domains and 12 subdomains (from 4 domains and 15 subdomains previously in CAPE 2013) and the revised EPAs have been reduced from 15 to 13 activities.

The AACP Academic Affairs Committee's Guidance for Use of the Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates.

The 2021-2023 American Association of Colleges of Pharmacy Academic Affairs Committee (AAC) was charged with and completed the revision of the 2013 Center for the Advancement of Pharmacy Education Outcomes and the 2016 Entrustable Professional Activity (EPA) statements for new pharmacy graduates. This work resulted in a new combined document, the Curricular Outcomes and Entrustable Professional Activities (COEPA) that was unanimously approved by the American Association of Colleges of Pharmacy Board of Directors and was published in the Journal. The AAC was also charged with providing stakeholders with guidance about how to use the new COEPA document. To achieve this charge, the AAC created example objectives for all 12 Educational Outcomes (EOs) and example tasks for all 13 EPAs. Although programs are asked to retain the EO domains, subdomains, one-word descriptors, and descriptions, unless they are adding more EOs or increasing the taxonomy level of a description, colleges and schools of pharmacy can expand or edit the example objectives and example tasks to meet local needs, as these are not designed to be prescriptive. This guidance document is published separately from the COEPA EOs and EPAs to reinforce the message that the example objectives and tasks are modifiable.

Prevalence of phubbing by student pharmacists at two colleges of pharmacy.

INTRODUCTION: Problematic smartphone use has been associated with numerous factors of mental health including depression, stress, and anxiety. Most of the research in this area has focused on the effects to the smartphone user. One relatively new phenomenon in this area of research is phone snubbing ("phubbing") and its effect on others. The purpose of this pilot study was to determine the prevalence of phubbing behavior among a group of student pharmacists. METHODS: The validated Generic Scale of Phubbing (GSP) was administered to a convenience sample of student pharmacists at two different doctor of pharmacy programs. The scale is scored from 15 to 105, with higher scores indicating a greater degree of phubbing behavior. RESULTS: Of 555 eligible students, 262 (47.2%) responded to the survey. Scores were similar to, but lower than, scores from other studies. Institution was a significant factor in predicting GSP score. Gender and age group, when taking into account institution, were not significant predictors of GSP scores. Overall, the data in our study showed good internal consistency with a Cronbach's alpha for the combined group of 0.86. CONCLUSIONS: As a relatively new phenomenon, limited data are available about the long-term effects of phubbing on mental health. Our research showed comparable, but lower levels of phubbing behavior to previous studies and establishes a baseline measurement for which further research can be added.

Assessment of Impostor Phenomenon in Student Pharmacists and Faculty at Two Doctor of Pharmacy Programs.

Objective. To evaluate the prevalence of impostor phenomenon in student pharmacists and faculty members at two educational institutions in the United States.Methods. Participants anonymously completed an electronic self-report survey instrument that included the validated Clance Impostor Phenomenon Scale (CIPS) from April 2020 to May 2020. Demographic data including age range, gender, and other characteristics were collected. The Clance Impostor Phenomenon Scale scores were reported as means (SDs), and data were compared between institutions and demographic groups using t tests.Results. The overall mean CIPS survey score (N=209, 35.5% response rate) was 63.8 (SD=15.1). The mean student pharmacist CIPS score for Northeast Ohio Medical University (NEOMED) was 64.7 (SD=14.4) vs 63.8 (SD=16.1) for Sullivan University College of Pharmacy and Health Sciences (SUCOPHS), which was statistically similar. Mean faculty CIPS score for NEOMED was 59.2 (SD=14.0) vs 64.7 (SD=16.8) for SUCOPHS, which was statistically similar. Mean CIPS score for the combined student pharmacist group (NEOMED and SUCOPHS) was 64.3 (SD=15.1) vs 61.2 (SD=15.1) for the combined group of faculty members, which was statistically similar. Overall, most respondents fell in the "moderate" to "frequent" CIPS score classification range (36.4% and 44%, respectively).Conclusion. Impostor phenomenon feelings were common among responding student pharmacists and faculty members at the institutions surveyed; however, little is known about the implications of these findings. Future research should seek to elucidate factors predictive of or associated with impostor phenomenon as well as assess the impact of strategies to prevent or manage impostor phenomenon.

Overcoming Past Perceptions and a Profession-Wide Identity Crisis to Reflect Pharmacy's Future.

The profession of pharmacy has come to encompass myriad identities, including apothecary, dispenser, merchandiser, expert advisor, and health care provider. While these identities have changed over time, the responsibilities and scope of practice have not evolved to keep up with the goals of the profession and the level of education of practicing pharmacists in the United States. By assuming that the roles of the aforementioned identities involve both product-centric and patient-centric responsibilities, our true professional identity is unclear, which can be linked to the prevalence of the impostor phenomenon within the profession. For pharmacy to truly move forward, a unified definition for the profession is needed by either letting go of past identities or separating these identities from each other by altering standards within professional degree programs and practice models. Without substantial changes to the way we approach this challenge as a profession, the problems described will only persist and deepen.

A multicenter study of gender bias in student evaluations of teaching in pharmacy programs.

INTRODUCTION: Student evaluations of teaching (SET) are widely used to assess effectiveness of teaching. Studies conducted to assess the presence of gender bias in SET have produced mixed results. The purpose of this study was to evaluate the presence and degree of gender bias in SET of didactic courses in United States pharmacy programs. METHODS: A three-year, retrospective, multi-institutional analysis of anonymous SET data were analyzed from required didactic courses. Analysis included gender, SET questions, mean scale score, and number of students responding to each question. A hierarchical linear model was used to compare the gender difference with the normalized SET scores as the outcome. RESULTS: A total of 2114 SET scores were included from seven pharmacy schools across eight campuses. Analysis of the results revealed that the combined data were skewed secondary to one institution whose results fell significantly outside the mean. When this school was excluded, the difference between SET scores did not differ by gender, b = 0.021, t(1,702) = 0.69, P = .49, with similar SET scores for female faculty (mean = 4.41, SD = 0.35, range = 2.54-5) and male faculty (mean = 4.44, SD = 0.32, range = 2.67-5). CONCLUSIONS: After secondary analysis, the aggregated data showed no significant difference between ratings of male and female instructors. However, there were differences within individual programs. This illustrates the importance of applying assessment principles to SET to determine the presence of bias so that continuous quality improvement strategies may be applied.

Impact of High-Dose Intravenous Vitamin C for Treatment of Sepsis on Point-of-Care Blood Glucose Readings.

BACKGROUND: Intravenous vitamin C therapy has been associated with reduced mortality in patients with sepsis. Of potential concern with this therapy are falsely elevated point-of-care (POC) blood glucose values vs laboratory analyzed (LA) readings. The purpose of this study was to compare POC and LA blood glucose measurements in patients receiving intravenous vitamin C therapy. METHODS: All adults (≥18 years old) admitted from January 2017 to December 2018 who received at least two doses of intravenous vitamin C and had at least one paired blood glucose collection were eligible for inclusion. The primary endpoint was the accuracy in paired blood glucose values determined using the International Organization for Standardization (ISO) 15197:2013 criteria. Paired values were assessed for clinical impact using the Parkes consensus error grid analysis. A subgroup analysis was conducted to determine the impact of impaired renal function on outcomes. RESULTS: Fourteen patients were included for analysis with 46 paired blood glucose levels. Compliance with ISO15197:2013 criteria was met in 34 (73.9%) paired values, which did not meet the minimum criteria for accuracy. Subgroup analysis showed that the paired values from patients with impaired renal function did not meet the minimum requirements for compliance, while those from patients without impaired renal function did. The Parkes error grid showed that the variation in POC measurements likely had minimal clinical impact. CONCLUSIONS: Our study suggests that most patients receiving vitamin C for sepsis may still be monitored at POC with the glucose meter used in our study with minimal clinical impact.

Multisite Study Assessing the Effect of Cognitive Test Anxiety on Academic and Standardized Test Performance.

Objective. To evaluate the degree of cognitive test anxiety (CTA) present in student pharmacists at multiple pharmacy programs in the United States and to determine if there are associations between self-reported CTA and relevant academic outcomes.Methods. All 2018-2019 advanced pharmacy practice experience (APPE) students from three US Doctor of Pharmacy (PharmD) programs (N=260) were invited to participate in the study. Participants completed a validated 37-question survey that included the Cognitive Test Anxiety Scale-2 (CTAS-2) along with demographics-related questions. Responses were analyzed using analysis of variance (ANOVA), Kruskal Wallace, and multiple linear regression where appropriate.Results. One hundred twenty-four students (48%) from the three programs participated in the study, and the individual data of 119 (46%) were included in the final analysis. Twenty-two students (18.5%) were classified as having high CTA, 41 (34.5%) as having moderate CTA, and 56 (47.1%) as having low CTA. High CTA predicted a 8.9 point lower NAPLEX total scaled score after accounting for other variables and was also correlated with lower cumulative didactic GPA, performance on the Pharmacy Curriculum Outcomes Assessment (PCOA), and increased likelihood of requiring course remediation.Conclusion. High cognitive test anxiety affects 18% of pharmacy students and may significantly impact their performance on a variety of traditional student success measures, including the NAPLEX. Pharmacy educators should consider further use and adoption of test anxiety measurements to identify and assist potentially struggling students.

Challenges to Implementation of the Co-Curriculum in Accredited Pharmacy Programs.

Objective. To determine areas of concern, and challenges to implementing and assessing the co-curriculum in accredited Doctor of Pharmacy programs, along with how confident programs are in their ability to meet the co-curriculum requirement as mandated by the Accreditation Council for Pharmacy Education (ACPE).Methods. A survey was administered to all ACPE-accredited pharmacy programs to collect information regarding areas of concern, challenges, and confidence in their ability to meet the co-curriculum requirement. The frequency of responses to items are presented along with comparisons based on characteristics, including institution type, cohort size, most recent ACPE accreditation review, and supporting offices.Results. The most common concerns centered on the documentation and assessment process. The most commonly reported challenges were lack of enthusiasm or buy-in from faculty, staff, and students; lack of a clear definition of co-curriculum; and faculty time and insufficient staff. Overall, programs had a high level of confidence in their ability to meet the requirements for co-curriculum. The only differences found were related to supporting offices and cohort size.Conclusion. The results suggest that having supporting offices may reduce the co-curriculum burden. Similarly, student cohort size may have an impact on the challenges for some programs, particularly those with moderate-sized cohorts reporting challenges related to faculty and staff. Further research is needed to determine how programs address these critical issues, and to explore whether programs report differently on these areas after completing an accreditation review. The study results may be useful to members of the Academy when evaluating co-curriculum.

Assessing the Relationship Between Didactic Performance and Standardized Examination Scores in Pharmacy Students.

Objective. To examine the effect size of third professional (P3) year students' grade point average (GPA) on Pharmacy Curriculum Outcomes Assessment (PCOA) scores and to summarize the effect size of PCOA scores on North American Pharmacist Licensure Examination (NAPLEX) scores. Methods. To accomplish the objective, meta-analyses were conducted. For inclusion in the meta-analysis, studies were required to compare PCOA scores to and report data that permitted calculation of a numeric effect size for the chosen outcome variables. Multiple databases were searched, including PubMed, CINAHL, EMBASE, ProQuest Dissertations and Thesis (abstract limited), Academic Search Complete, and Google Scholar. Correlations were used as the effect size metric for all outcomes. All analyses used an inverse variance weighted random effects model. Study quality was reviewed for each study included in the meta-analyses. Results. This study found that PCOA scores were moderately correlated with P3 GPAs, accounting for 14% to 48% of the variability in PCOA scores. The meta-analyses also showed that PCOA scores were moderately correlated with NAPLEX and accounted for 25% to 53% of the variability in NAPLEX scores. Both meta-analyses showed a high degree of heterogeneity and many studies included were of low quality. Conclusion. This first set of meta-analyses to be conducted on the PCOA showed that third professional year GPA does correlate with PCOA results and that PCOA scores correlate with NAPLEX results. Though there are significant limitations to interpretation of the results, these results do help further elucidate the role of the PCOA as a benchmark of progress within the pharmacy curriculum.

Applying safety lessons from aviation to pre-licensure health professions education: A narrative critical review.

BACKGROUND: Significant numbers of patients continue to be harmed annually by healthcare systems in the United States (US) and around the world. Through a lens of safety, the fields of aviation and healthcare share many similarities in the non-technical skills required by team members, including situational awareness, communication, problem-solving, and leadership. Despite these links and evidence of effective interventions in the clinical setting, there is a lack of a guidance on how to incorporate non-technical skills training into pre-licensure health professions curricula. METHODS: Following guidance for a narrative critical review, a comprehensive literature search was conducted looking for studies incorporating non-technical skills training including crew resource management (CRM) and human factors and ergonomics (HFE) into pre-licensure health professions curricula. RESULTS: Eleven example articles were organized into three broad themes: (1) changing the teaching paradigm around errors, (2) targeted curricular interventions, and (3) interprofessional team training. Several useful tools for evaluating training effectiveness were highlighted, but consistent measures of efficacy for CRM/HFE training are lacking. Interprofessional team training may have the most tangible and broadly applicable link to pre-licensure curricula. IMPLICATIONS: Additional research is needed to identify best practices for consistent incorporation of non-technical skills into pre-licensure curricula. A cultural shift to focus on error management (vs. solely error avoidance) is also needed early in training with development of a common language to discuss patient safety issues and opportunities for improvement across various healthcare settings.

An Exploratory Assessment of Epistemic Curiosity in Students at Three Doctor of Pharmacy Programs.

Objective. To determine the level of epistemic curiosity in a sample of student pharmacists from three Doctor of Pharmacy (PharmD) programs as well as any differences in epistemic curiosity levels that exist between programs and with regard to professional year. Methods. Litman's Epistemic Curiosity Scale (ECS) was administered to student pharmacists at three different PharmD programs. Descriptive statistics were calculated, and overall mean ECS scores as well as mean scores on epistemic curiosity motivated by intellectual interest (I-type) and informational deprivation (D-type) were compared among student pharmacists at the three institutions using analysis of variance. Reliability analyses were also performed on the data. Results. A total of 569 out of 1143 eligible students responded to the survey, for an overall response rate of 49.8%. The mean overall ECS score was 27.6 (SD=4.9). Mean I-type epistemic curiosity was 14.9 (SD=2.8) overall, but was statistically different among the schools. Mean D-type epistemic curiosity was 12.7 (SD=3.2) overall, but was statistically similar among the programs. Overall, the data demonstrated good internal consistency, with a Cronbach's alpha of .81. Conclusion. This study was the first to characterize epistemic curiosity in student pharmacists and included data from multiple years and multiple programs. Future analyses should investigate associations between epistemic curiosity and other factors of interest to help elucidate how better understanding epistemic curiosity or enhancing it in student pharmacists may help facilitate student success.

A Paradigm Shift in US Experiential Pharmacy Education Accelerated by the COVID-19 Pandemic.

The coronavirus identified in 2019 (COVID-19) has caused dramatic disruptions in pharmacy experiential education. Administrators and programs have worked to help external preceptors, faculty members, and students cope with the new realities of virtual or remote experiences and new or increased use of telemedicine. Clear and effective lines of communication as well as well-reasoned and resourced alternative plans are necessary to help manage the current issues and prepare for future challenges. Doctor of Pharmacy programs should enhance their focus not just on the physical health and well-being of students, faculty members, and external preceptors, but also on their mental and emotional health. The full scope of the impact of the pandemic on experiential education in pharmacy is still unclear, but this situation should serve as a stimulus for innovation and rethinking the paradigm of how pharmacy programs educate and prepare students for pharmacy practice.

Impact of Intersession Course Remediation on NAPLEX/PCOA Scores in an Accelerated Doctor of Pharmacy Program.

Objective. To compare Pharmacy Curriculum Outcomes Assessment (PCOA) scaled scores and North American Pharmacist Licensure Examination (NAPLEX) pass rates in students who completed a two-week intersession remediation or repeated a course with the scaled scores and pass rates of students who did not require any form of didactic remediation and did not have to repeat a course. Methods. Data examined for this study included NAPLEX/PCOA scores, NAPLEX pass/fail status, and remediation history for students at one college of pharmacy. Students from the graduating classes of 2016, 2017, and 2018 were organized into four groups: non-remediation, one course remediation and no repeats, more than one course remediation and no repeats, and one or more course repeats. Differences were analyzed using linear regression, logistic regression, and Pearson correlations. Results. The PCOA scores for students in the remediation groups were significantly lower than scores for students in the non-remediation groups, with a reduction of 37.8 to 50.9 points from the expected non-remediators' score. The NAPLEX scores for students who remediated more than one course or repeated one or more courses were 16-20 points lower compared to students who did not remediate. The likelihood of a student failing the NAPLEX was also not significantly lower for students who remediated one course but was significantly lower for other remediation groups. Conclusion. Although single course remediation in this curricular model appears to have minimal impact on NAPLEX outcomes and may be an acceptable intervention for many students, additional support and interventions may be warranted for students who qualify for remediation in multiple courses and/or for repeating a course.