Impact of high-stakes exams, incentives, and preparation on student performance: Insights from the pharmacy curriculum outcomes assessment.

INTRODUCTION: Efforts to ensure success of pharmacy students in passing pharmacy standardized exams require substantial investments. Engaging students effectively can be a challenge when there are no consequences for non-participation or poor performance. This study examined how engagement reinforcement, including high-stake exam requirements, instructional strategies, and incentives, impacted student performance on the Pharmacy Curriculum Outcomes Assessment (PCOA). METHODS: PCOA scores, milestone exams, grade point averages (GPAs), and PCOA preparedness assessments for cohorts (Co) that received high-stakes exams, incentives, and preparation (Co2019, Co2020, and Co2021) was compared with those that did not receive these interventions (Co2017 and Co2018). Students' perceptions regarding reinforcement, incentive, and preparedness were evaluated using an anonymous survey. RESULTS: Analyzing data from 545 students over five years, mandated PCOA preparedness, high-stakes PCOA requirements, and incentives for Co2019, Co2020, and Co2021 improved scores by 11% to 18% compared to Co2017 and Co2018. This corresponded to a rise in performance from the 12th to 27th percentile for Co2017 and Co2018 to the 39th to 49th percentile for Co2019, Co2020, and Co2021. In these later cohorts, PCOA scores consistently correlated with the school's milestone exams and students' cumulative GPAs (correlation coefficients 0.47-0.70, P < .001), while no such correlation was observed in Co2017 and Co2018. Faculty-led PCOA preparation yielded better results (48.2% in Co2020, 45.8% in Co2021) than self-learning (42% in Co2019). Students using faculty-prepared assessments reported increased confidence in biomedical and pharmaceutical sciences. CONCLUSIONS: This study highlights the importance of high-stakes requirements, incentives, and thorough preparation in improving PCOA results.

Student perceptions of the utility of the Pharmacy Curriculum Outcomes Assessment.

INTRODUCTION: This study assessed student perceptions, preparation, and result use strategies of the Pharmacy Curriculum Outcomes Assessment (PCOA). Secondarily, it studied the effect of schools/colleges of pharmacy (S/COP) PCOA management on student perceptions. METHODS: A 52-item electronic questionnaire assessed PCOA preparation of final year students, review/use of results, remediation participation, self-reported motivation, and perceptions of the exam's ability to measure PCOA blueprint areas and North American Pharmacy Licensure Examination (NAPLEX)/advanced pharmacy practice experience (APPE) readiness. Programs were given a questionnaire to determine their PCOA practices. RESULTS: The student survey was completed by 341 students (40% response rate). Students prepared very little for the PCOA and few reported participation in PCOA-based remediation (6%). Students perceived the PCOA to measure the four domains moderately well, although administrative sciences were significantly lower. Students reported less confidence in the exam's ability to measure APPE/NAPLEX-readiness. Although few used the PCOA to guide their NAPLEX preparation (18%), they were more likely to do so than for APPEs (4%). Students reported a higher perceived increase in motivation if PCOA results were connected to APPE placement, remediation, and progression as opposed to prizes, rewards, or other recognitions. CONCLUSION: This is the first multi-institutional study to review student perceptions about the PCOA. These data can be used along with other PCOA data to help schools develop incentive, remediation, and examination administration procedures depending on the programs desired use for the PCOA exam.