How did we get here? Evolution of specifications grading in a required skills-based course series.

BACKGROUND AND PURPOSE: Specifications grading is a mastery-based grading approach to unlock student potential and empower students to focus on learning goals while receiving and acting on meaningful feedback. Within specifications grading, bundles are created to group assignments and assessments. Based on student achievement within each bundle, overall course grade is determined. This article describes the development and implementation of a specifications grading schema in a required skills-based course series, along with lessons learned. EDUCATIONAL ACTIVITY AND SETTING: In a longitudinal course series with both a didactic and lab component, specifications grading was utilized for determination of the overall course grade. Key components of the specifications grading schema were defined by assignment bundles. Assignment bundles aligned with knowledge and skills taught and assessed in each course and also included summative capstone assessments. Each bundle was assigned a numeric grade linked to a letter grade which determined the students' final grade in the course. FINDINGS: Following first course offerings, several changes to the specifications grading schema were made to improve tracking of assignments and activities, to improve consistency across courses, and to aid in final course grade determination. All quizzes were changed to optional, formative quizzes to encourage student accountability. Additional changes were made to the processes of capstone remediation and reassessment, which led to changes in language of the grading schema. SUMMARY: Developing and implementing specifications grading was a crucial first step in building a required skills-based course series, which led to further refinement and improvement for future course offerings.

Perceptions and Utility of Course Evaluations in US Pharmacy Schools.

OBJECTIVE: This study aimed to describe the purpose, implementation, and perceived utility of course evaluations in pharmacy programs. METHODS: After a literature review, a 34-item survey was developed, pretested, and sent to assessment administrators at accredited pharmacy programs (N = 139) with at least 3 follow-ups. Descriptive and inferential statistics were performed in IBM SPSS Statistics software. RESULTS: A total of 90 programs responded (64.7% response rate). Most students (94%) were offered the opportunity to complete course evaluations. Some students completed evaluations during the course (47%), while others did so within 1 week of completion of the course (49%). Whether or not class time was given for students to complete the survey was often dependent on faculty choice (52.2%). Results were typically released after final grades were posted (92%), in time to use for the next semester of teaching (77%). Faculty were chosen to be evaluated by the number of teaching hours (50%) followed by all instructors (45.6%). Programs used the results for performance reviews by chairs (91%), course coordinator reviews (84%), and committee continuous quality improvement efforts (72%). Most programs did not provide faculty guidance on using evaluations (78%) nor development/mentoring (57%); only 22% of programs offered student development in completing evaluations. CONCLUSION: While most programs invite feedback from all students via evaluations, most did not provide guidance to faculty on how to use this feedback for faculty or course development purposes. A more robust process to optimize the use of course evaluations should be developed.

Making progress: A national study on the development and use of progression assessments in United States pharmacy curricula.

BACKGROUND: The objective was to determine the utilization, frequency, characteristics, and standard-setting methods of progression assessments in pharmacy education. METHODS: A survey was sent to 139 United States schools/colleges of pharmacy having an identifiable assessment lead and students enrolled in the doctor of pharmacy program. The survey examined programs' use, frequency, and characteristics of progression assessments within their curriculum. Respondents also reported any changes made due to the COVID-19 pandemic and which, if any, would be maintained in future years. Analysis consisted of descriptive statistics and thematic coding. This research was deemed exempt by the university's institutional review board. RESULTS: Seventy-eight programs responded to the survey (response rate = 56%). Sixty-seven percent of programs administered at least one progression assessment in 2019-2020. There was some variability in assessment practice, including professional year(s) administered, course(s) involved, and content. Approximately 75% of programs used assessments to ensure student competency in the programs' learning outcomes and to identify individual student learning deficiencies. Diversity was seen in validity and reliability practices, and most programs used pre-determined cut scores without formal standard setting. Because of the pandemic, 75% of programs changed the assessment delivery mode and 20 programs planned to maintain at least one pandemic-related change in future iterations. CONCLUSIONS: Most pharmacy programs utilize some type of progression assessment within their curriculum. While many schools administer progression assessments, there is little agreement on their purpose, development, and use. The pandemic changed the mode of delivery, which numerous programs will continue with in the future.

Successes and challenges in implementing specifications grading in skills-based laboratory courses: Experiences at two colleges of pharmacy.

BACKGROUND AND PURPOSE: Specifications grading, a grading schema focused on mastery of skills, may provide an alternative to traditional grading. Specifications grading uses three components (pass/fail grading, bundles, and tokens) to allow students to demonstrate competency in specific areas as part of competency-based education. The purpose of this article is to outline specifications grading and review its implementation at two colleges of pharmacy. EDUCATIONAL ACTIVITY AND SETTING: Two colleges of pharmacy used specifications grading within a first-year skills-based laboratory course. Instructors identified key skills for each course and the minimum performance levels for each grade (A, B, C, etc.). Each college evaluated skills that aligned with course learning objectives. FINDINGS: Incorporating specifications grading helped better align assignments and assessments to course learning objectives. Instructors felt specifications grading introduced more rigor into the course. Instructors identified four challenges when implementing specifications grading, including: (1) lack of integration into the learning management system, (2) initial student confusion, (3) modifications needed due to unforeseen circumstances, and (4) logistical issues when implementing token exchange. Many of these challenges can be overcome with instructor tracking of passed assignments and earned/redeemed tokens, periodic reinforcement of the grading schema with students, and creating flexibility within the course, especially the first time the schema is implemented. SUMMARY: Specifications grading was successfully implemented in two skills-based courses. Challenges encountered with implementing specifications grading will be continually addressed. Implementation of specifications grading in other forms of course deliveries (e.g., electives, didactic) may require adjustment and further evaluation.

Using Rasch measurement for instrument rating scale refinement.

OUR SITUATION: Rasch measurement is an analysis tool that can provide validity evidence for instruments that attempt to measure student learning or other psychosocial behaviors, regardless if tools are newly created, modified, or previously developed. Rating scales are exceedingly common among psychosocial instruments and properly functioning rating scales are critical to effective measurement. Rasch measurement can help investigate this. METHODOLOGICAL LITERATURE REVIEW: Aside from using Rasch measurement from the beginning to help create rigorous new measurement instruments, researchers can also benefit from employing Rasch measurement on previously developed instruments that had not included Rasch measurement during development. This article is focused on Rasch measurement's unique analysis of rating scales. That is, Rasch measurement can uniquely help examine if and how an instrument's rating scale is functioning among newly studied respondents (who will likely differ from the originally researched sample). OUR RECOMMENDATIONS AND THEIR APPLICATION: After reviewing this article, the reader should be able to describe Rasch measurement, including how it is focused on fundamental measurement and how it differs from classical test theory and item-response theory, and reflect on situations in their own research where a Rasch measurement analysis might be helpful for generating validation evidence with a previously developed instrument. POTENTIAL IMPACT: In the end, Rasch measurement can offer a helpful, unique, rigorous approach to further developing instruments that scientifically measure, accurately and precisely.

Student pharmacists' attitudes, perceptions, and knowledge regarding opioid use, misuse, and overdose: Four years of data.

INTRODUCTION: The American Association of Colleges of Pharmacy has urged pharmacy faculty to commit to actions to reduce the public health threat from opioid use and misuse. Optimizing student pharmacist training necessitates understanding changes in their attitudes and perceptions over time. This study assessed student attitudes, perceptions, and understanding of addiction, opioid use and misuse, and opioid overdose over four sequential years, from 2016 to 2019. METHODS: The participants were third-professional year doctor of pharmacy students enrolled in a required course. Participants voluntarily completed a 27-statement survey to determine student attitudes, perceptions, and understanding. RESULTS: A total of 452 participants completed the survey (response rate = 76.5%). Of the 27 survey items, five survey statements showed year on year positive increases in specific student attitudes towards addiction, hopefulness for its treatment, and confidence to use and train opioid overdose reversal agents. These yearly changes did not appear to be related to any changes in the academic aptitude of the students. The 22 remaining statements showed positive and stable attitudes towards self-perceived understanding of opioid use and misuse, hopefulness for its treatment, and the role of pharmacists. CONCLUSION: To our knowledge, this is the first large multiyear assessment of student pharmacists' attitudes, perceptions, and understanding of opioid use, misuse, and overdose. The data indicate favorable and improving attitudes. Knowledge of student attitudes, perceptions, and understanding regarding opioid use, misuse, and overdose will aid in the development of effective training programs for students in our, and other colleges of pharmacy.

Development of a script concordance test to assess clinical reasoning in a pharmacy curriculum.

INTRODUCTION: Clinical reasoning is a vital skill for student pharmacists in the provision of patient-centered care, but these skills are often difficult to assess in the didactic curriculum. A script concordance test (SCT) is an innovative assessment method that can be used to assess clinical reasoning skills. The objective of this study was to develop and refine an SCT to assess clinical reasoning skills of third year student pharmacists (P3s). METHODS: An SCT was written and administered to P3s. Pharmacy practice faculty members served as the expert group. The SCT was scored and Rasch analysis was performed. RESULTS: The SCT included 20 case vignettes and 60 questions. Test reliability was 0.34 with mean square values for all items between 0.7 and 1.3. Forty-two questions had a difficulty score between 0 and - 1 logits, indicating there were multiple questions with similar difficulty levels. Two case vignettes and 43.3% of questions (n = 26) were revised to enhance clarity and decrease ambiguity. CONCLUSIONS: The SCT is a tool to assess clinical reasoning in the didactic curriculum. Faculty can create the SCT and use statistical methods such as Rasch analysis to assess validity and reliability of the SCT.

Item response theory in high-stakes pharmacy assessments.

OUR SITUATION: Classical test theory (CTT) and item response theory (IRT) are two measurement models used to evaluate results from examinations, questionnaires, and instruments. To illustrate the benefits of IRT, we compared how results from multiple-choice tests can be interpreted using CTT and IRT. METHODOLOGICAL LITERATURE REVIEW: IRT encompasses a collection of statistical models that estimate the probability of providing a correct response for a test item. The models are non-linear and generate item characteristic curves that illustrate the relationship between the examinee's ability level and whether they answered the item correctly. Several models can be used to estimate parameters such as item difficulty, discrimination, and guessing. In addition, IRT can generate item and test information functions to illustrate the accuracy of ability estimates. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: Researchers interested in IRT should gather the necessary resources early in the research process and collaborate with those experienced in quantitative and advanced statistical models. Researchers should confirm IRT is the optimal choice and select the model ideal for their needs. Once data are acquired, confirm model assumptions are met and model fit is appropriate. Lastly, researchers should consider disseminating the findings with accompanying visuals. POTENTIAL IMPACT: IRT can be a valuable approach in assessment design and evaluation. Potential opportunities include supporting the design of computer adaptive tests, creating equivalent test forms that evaluate a range of examinee abilities, and evaluating whether items perform differently for examinee sub-groups. Further, IRT can have noteworthy visuals such as test information and functions.

Association Between NAPLEX Preparation Program Characteristics and First-Time Pass Rates.

Objective. The objectives of this study were to (1) describe characteristics of preparation programs for the North American Pharmacist Licensure Examination (NAPLEX) that are currently used by colleges and schools of pharmacy and (2) evaluate these program characteristics in relation to first-attempt NAPLEX pass rates.Methods. This cross-sectional study was based on an online survey administered between February and March 2020. Assessment leads from 143 PharmD programs were invited to answer questions on their schools' PharmD program characteristics and various aspects of NAPLEX preparation programs. The study included regression analyses to investigate associations between the NAPLEX first-attempt pass rates and PharmD demographic characteristics as well as between first-attempt pass rates and various aspects of the NAPLEX preparation programs. Finally, common themes from open-ended questions were identified.Results. Fifty-eight participants completed the survey out of 132 successfully delivered email invitations (response rate = 44%). Fifty participants (86%) indicated that their PharmD program offers a NAPLEX preparation program. Our data indicate that offering a NAPLEX preparation program was not significantly associated with higher NAPLEX first-attempt pass rates. The analysis identified possible explanations for this lack of association, including student concerns with balancing a preparation program with advanced pharmacy practice experiences (APPEs) and the faculty workload associated with delivering such programs.Conclusion. The current findings show no association between offering a NAPLEX preparation program and NAPLEX first-attempt pass rates. Future research should continue to examine the impact of these programs on individual school pass rates and factors that may enhance student motivation to engage in these programs.

Enhancing the "What" and "Why" of the Pharmacists' Patient Care Process With the "How" of Clinical Reasoning.

Objectives. Clinical reasoning is integral to the provision of patient-centered care as outlined in the Pharmacists' Patient Care Process (PPCP). However, the PPCP was not created to foster clinical reasoning in student pharmacists and cannot be the sole tool used to characterize or cultivate these skills. This article describes elements of clinical reasoning, the relationship between clinical reasoning and PPCP, and concepts from the clinical reasoning literature that should inform the teaching of clinical reasoning skills.Findings. Key elements of the PPCP were identified in clinical reasoning definitions, but differences emerged. The literature supports clinical reasoning as a bidirectional, fluid process that is highly collaborative. Effective clinical reasoning requires multiple types of "thinking," interaction with others and the environment, self-assessment, and a tolerance for nuance or ambiguity. Teaching strategies can be used in the didactic and experiential setting to target the cognitive and contextual factors associated with clinical reasoning.Summary. Educators should consult the literature to enhance our understanding of clinical reasoning in seeking to teach, model, and foster these skills in our students. Future scholarship should include the development of models to support clinical reasoning within the profession of pharmacy, adoption and experimentation with clinical reasoning teaching techniques, and valuation of the utility of various assessment tools and processes.

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.

Comparing perceptions of student abilities in diabetes self-management education and support among students, faculty and patients.

BACKGROUND AND PURPOSE: Diabetes self-management education and support (DSMES) equips patients with diabetes with the knowledge needed for appropriate management. The purpose of this study was to compare perceptions of student confidence/aptitude held by students, pharmacy faculty preceptors, and patients regarding student teaching of a DSMES class. EDUCATIONAL ACTIVITY AND SETTING: The study was a prospective assessment of fourth-year ambulatory care advanced pharmacy practice experience students. Students taught a single DSMES class and evaluated their confidence using a 14-item survey before and after the class. Patients who participated in the class and a pharmacy faculty observer completed the same instrument. Responses were compared using Friedman and Wilcoxon signed-rank tests, as appropriate. FINDINGS: Twenty-six students completed the survey. Overall, students' self-perceived confidence scores significantly increased for all questions after teaching the DSMES class (P < .001 for all questions). Confidence scores among students and faculty preceptors were similar with no significant differences in perceived confidence. There were some significant differences found among student and patient scores, with patients assessing student's perceived self-confidence higher than the students on three items (P < .05). SUMMARY: Student pharmacists' perceptions of their own confidence and abilities improved from before to after teaching a DSMES class. Student and faculty preceptor confidence scores were similar. There were few differences between student and patient confidence scores, with patients rating students highly on their perceived confidence in teaching a DSMES class. Patient feedback is important to consider when evaluating student confidence and abilities.

Description of a novel co-curricular professional engagement program for student pharmacists.

INTRODUCTION: Development of professionalism is essential for student pharmacists. This paper describes the development of a novel co-curricular professional engagement program for student pharmacists. METHODS: At admission, all student pharmacists are enrolled in a faculty-developed professional engagement program. The program was designed to address various key elements of Standards 3 and 4 of the Accreditation Council for Pharmacy Education Accreditation Standards. The program requires student pharmacists to complete a variety of required and electives activities each professional year. Student progression and completion of these activities is monitored and evaluated by an assigned faculty member. Each year, the program is reviewed using various measures, including activity completion rate and student feedback. RESULTS: Approximately 1000 student pharmacists, across four years and seven cohorts of students, have completed at least one portion of the program. All students in the aforementioned groups completed the program in its entirety. Example activities included professional seminars and professional organization involvement, leadership, and community service. Program activities were mapped to key elements of Standards 1 through 4 with an emphasis on Standards 3 and 4. Student feedback was used for continuous quality improvement, and programmatic revisions were made. CONCLUSIONS: The development and implementation of a co-curricular professional engagement program offered the opportunity for student pharmacists to actively participate in a variety of experiences supporting accreditation standards. Other colleges of pharmacy may benefit from the adoption of a similar program to support student pharmacist professional development.

Simulated medication adherence: First and second-year pharmacy students' perceptions of adhering to a multi-drug medication regimen.

BACKGROUND AND PURPOSE: Through a realistic medication adherence activity, the objective was to improve students' ability to identify non-adherent patients, build empathy toward patients, and prepare them to provide patient-centered care. EDUCATIONAL ACTIVITY AND SETTING: First- and second-year student pharmacists completed a two-month activity, which required adherence to a pre-specified medication regimen. Prior to starting, a survey was administered to assess students' perceived difficulty and success of the medication adherence activity. Upon completion, students were asked their perceived success and difficulty with the activity, challenges to maintaining adherence, and lessons learned from the project. Changes in perceived difficulty and success were analyzed using Wilcoxon signed rank tests. Challenges and lessons learned were coded for similar themes and frequencies. FINDINGS: 298 student pharmacists completed the pre- and post-survey (response rate 99%). Students' perceived difficulty of adherence was higher on the post-survey (median on post = 7.0 (out of 10) versus median on pre = 6.0, p = 0.023). Students' perceived success was higher on the presurvey (median on pre = 8.0 versus median on post = 6.0, p < 0.001). The most frequent challenges were remembering to take the medications (n = 133) and medication regimen timing (n = 98). The most frequent lesson learned was that "adherence is a difficult concept" (n = 143). SUMMARY: Students participated in a "hands-on" medication adherence activity. Students found that medication adherence is more difficult than perceived. Future research should examine the long-term impact of students maintaining empathy toward patients and provision of medication adherence services.

Co-Curriculum Implementation and Assessment in Accredited Doctor of Pharmacy Programs.

Objective. To determine how accredited Doctor of Pharmacy programs implement and evaluate 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 how co-curriculum models were being implemented, including types of activities, structure, learning outcomes, oversight, and assessment. The frequency of responses to items were presented to describe the general features of co-curriculum models. Results. The types of co-curricular activities reported by programs were generally consistent, with the majority of programs categorizing these activities and allowing students to choose which they would engage in. Most respondents reported that the program mapped co-curricular activities to learning outcomes, primarily ACPE Standards 1-4. The structural oversight of the co-curriculum typically included a co-curriculum committee, subcommittee, or task force, and supporting offices. The most common offices/departments involved in the co-curriculum were assessment, student affairs/services, experiential education, and academic/curricular affairs. The most common assessments were reflections, self-assessment surveys, and checklists. Conclusion. In most programs, implementation of the co-curriculum was a joint effort among various individuals, committees, and offices. Given the developing nature of programs, descriptive studies should be repeated to identify how programs develop and enhance co-curriculum models. The study results may be useful to members of the Academy when evaluating the current state of co-curriculum implementation and potential areas for program development.

Impact of Student Pharmacists Teaching a Diabetes Self-Management Education and Support Class.

Objective. To evaluate student pharmacists' knowledge of diabetes and self-perceptions of aptitude and confidence before and after teaching a diabetes self-management education and support (DSMES) class. Methods. Students enrolled in an advanced pharmacy practice experience (APPE) in ambulatory care were randomly assigned to the intervention group (taught a DSMES class) or control group (did not teach a DSMES class) between June 2016 to April 2018. Students self-assessed their aptitude and confidence using a 14-item pre- and post-intervention survey instrument. Additionally, participants completed a 10-item diabetes knowledge evaluation at baseline and during week three or four of the APPE. Results. Forty-six students participated in the study (26 students in the intervention group and 20 in the control group). Students in the intervention cohort demonstrated a significant improvement in their knowledge score (81.8% post-intervention vs 68.4% pre-intervention). Students in the control cohort did not experience a significant change in knowledge scores from pre- to post-intervention evaluation (70.0% vs 74.1%). The intervention cohort achieved a significantly greater improvement in confidence scores compared to the control group (11.8 vs 6.7 increase in scores, respectively). Conclusion. A student pharmacist team-taught DSMES class resulted in significant improvement in diabetes knowledge, aptitude, and confidence. Student pharmacist participation in a DSMES class may improve knowledge and enhance confidence, while offering an opportunity to advance the pharmacy practice model in ambulatory care.

A Classroom Activity to Increase Student Pharmacists Confidence in Dealing with the Opioid Epidemic.

Objective. To implement and assess the impact of a hybrid flipped-classroom activity designed to increase the motivation and confidence of Doctor of Pharmacy (PharmD) students in addressing the opioid crisis. Methods. Third-professional year student pharmacists were provided with reading material developed by federal agencies and professional pharmacy organizations, as well as Georgia-specific information covering medical amnesty and local resources for opioid-overdose prevention prior to class. They then attended a four-hour classroom session that included hearing a lecture on opioid pharmacology and opioid overdose, viewing training videos, and engaging in extensive discussion. The students voluntarily completed pre- and post-intervention assessments regarding opioid abuse and opioid overdose prevention. Results. Seventy of the 107 third-year students enrolled in the course completed the pre-intervention assessment (65% response rate), and 33 of the 70 completed the post-intervention assessment (47% retention rate). The students exhibited a high baseline motivation to assist in combating the opioid crises, but less confidence in their ability to intervene. Significant increases were seen in areas related to student confidence on the post-intervention assessment. Fewer changes were seen in areas related to student motivation. Conclusion. A "hybrid" flipped classroom activity increased the confidence of student pharmacists in their understanding of the physical and adverse effects of opioids and the application of reversal agents. Increased confidence may support increased intervention.

National Trends in the Adoption of Pharmacy Curriculum Outcomes Assessment for Student Assessment and Remediation.

Objective. To determine and describe the current uses of the Pharmacy Curriculum Outcomes Assessment (PCOA) by US schools and colleges of pharmacy. Methods. Assessment professionals from 135 US schools and colleges of pharmacy were invited to complete a 38-item electronic survey. Survey items were designed to investigate common uses of the PCOA, cut points, and "stakes" assigned to the PCOA, identification of at-risk students, and remediation approaches. Results. The school response rate was 68%. The most common uses of the PCOA included curricular assessment (76%), individual student performance assessment (74%), and cohort performance assessment (71%). The PCOA was most frequently administered to third-year pharmacy (P3) students. The approach for assigning "stakes" to PCOA performance varied among programs depending on the student's professional year in the curriculum. Programs used a variety of approaches to establish the benchmark (or cut point) for PCOA performance. Remediation for at risk students was required by less than 25% of programs. Remediation was most commonly required for P3 students (22%). Conclusion. Survey results indicate wide variability between programs regarding PCOA cut points (benchmarks), stakes, and remediation approaches. In the future, it will be important for pharmacy educators to identify and study best practices for use of PCOA within student assessment and remediation plans.

Improving rating scales: Applying Rasch analysis to student pharmacists' attitudes towards herbal medications.

BACKGROUND: This study analyzed the psychometric properties of a cross-sectional survey of student pharmacists' attitudes regarding herbal medications using a polytomous Rasch model. Seven items assessed students' attitudes towards herbal medications using a 6-point agreement scale (0 to 5). Student responses were reviewed to identify outliers and aberrant response patterns, assess scale fit, and perform item analysis. Scale performance was assessed to determine if response categories were independent and equally represented. Items were reviewed for model fit and construct validity with significant item gaps identified using a z-test. IMPACT: A total of 324 students completed the survey. The initial 6-point scale was analyzed. Student responses with outfit mean-square (MNSQ) values >5 were removed, yet the scale did not have appropriate functionality. The categories were merged to form a 4-point scale with no improvement. Therefore, two different 3-point scale options were analyzed: response categories of 0, 1 to 3, and 4 to 5; and response categories of 0, 1 to 4, and 5. With ten students removed, both 3-point scales met the requirements for functionality and all items exhibited good fit with MNSQ values between 0.6 and 1.4, person-separation value of 1.29, and person-reliability value of 0.62. RECOMMENDATIONS: Both 3-point scales met the requirements for Rasch analysis. The most optimal scale was the 0, 1 to 4, and 5 option. DISCUSSION: This study provides findings from the survey validity assessment alongside the survey results, which is useful for readers to have confidence in the quality of the study findings.

Academic success plans in advanced pharmacy practice experiences to promote self-awareness and improve performance.

INTRODUCTION: Pharmacy schools should encourage self-awareness, provide exposure to the continuous professional development cycle, and intervene early when students exhibit performance deficiencies. Academic success plans (ASPs) have been shown in other disciplines to be successful intervention tools which encourage student reflection and self-awareness. This study evaluates the impact of ASPs used during the advanced pharmacy practice experience (APPE) curriculum at two schools. METHODS: ASPs were assigned to students who had either a "needs development" or lower documented for the same learning outcome during more than one APPE, for poor overall performance during an APPE, or for documented professionalism issues. Average scores were calculated by assigning point values to each learning outcome assessment score (exceeds expectations = 1; competent = 0; needs development, needs significant development, remediation required = -1). RESULTS: During AY2014-2015 and AY2015-2016, 104 ASPs were assigned to 75 students (13.5% of students). The majority (89.6%) were assigned due to repeated deficiencies in the same learning outcome(s), with the most frequent being "Develop, Implement, and Monitor Drug Therapy Plans." After completion of an ASP, average scores significantly improved (p < 0.05) in 9 out of 12 learning outcomes among all students who completed an ASP. Thirteen students completed 15 ASPs for professionalism reasons, most commonly punctuality. CONCLUSIONS: Prior to 2015, Experiential Education Office interventions were primarily grades-based, not necessarily based on achievement of specific learning outcomes. ASPs were successfully used to allow students to practice self-awareness skills, to engage in the CPD process, and to improve APPE performance.