Predictors of student preparedness for advanced pharmacy practice experiences.

BACKGROUND: A capstone course often serves as the final checkpoint of student readiness before the commencement of experiential training. The purpose of this study was to determine if the assessment components from the capstone course can serve as predictors of student performance during their Advanced Pharmacy Practice Experiences (APPEs). METHODS: Student data was analyzed to observe the correlation between performance in the Pharmacy Curriculum Outcomes Assessment (PCOA), student performance in the capstone course, and the overall grade point average (GPA) earned during APPEs. Spearman rank correlation analysis, multiple linear regression, and Mann-Whitney U test were used for statistical analysis. RESULTS: A statistically significant positive correlation was observed between the overall APPE GPA and students' capstone course grade, top drug competency exam score, pharmacy calculation competency exam score, and PCOA exam score. A significant regression equation was obtained during the analysis: (F(5, 97) = 5.62, p < 0.001), with an R2 = 0.225 (adjusted R2 = 0.185). In the linear regression model, capstone GPA emerged as a significant predictor (ß = 0.155; p = 0.019) of APPE GPA amongst the tested variables. Additionally, students scoring < 73% on the top drug competency exam in the capstone course or less than the reference group in the PCOA exam were found to have significantly lower GPA during their APPEs compared to other students. CONCLUSION: Performance on the top drug competency exam and the PCOA exam can serve as potential predictors of success during APPEs.

A scoping review of advanced pharmacy practice experience readiness assessment measures across schools of pharmacy.

BACKGROUND: The development and implementation of Advanced Pharmacy Practice Experience (APPE) readiness assessments has been an area of increased interest to the academy since the publication of the Accreditation Council for Pharmacy Education (ACPE) standards in 2016. This scoping literature review aims to provide an updated summary of current APPE readiness assessment practices among ACPE-accredited institutions in the United States (US). METHODS: A literature search was conducted between 2022 and 2024 using the terms "APPE student readiness," "APPE readiness assessment," "APPE preparedness," "APPE student preparedness," "pharmacy" AND "readiness assessment", "pharmacy" AND "practice readiness," and "pharmacy" AND "student practice readiness" in Pubmed and Embase. The websites for the American Journal of Pharmaceutical Education and Currents in Pharmacy Teaching and Learning were also searched using these terms. Abstracts for all results were reviewed. Abstract only and poster presentations were excluded, as well as articles centered on non-US and/or non-ACPE-accredited institutions. Data was collected regarding the outcomes assessed, type of assessment activity, and how the assessment was implemented. Results were reviewed by a second author to ensure consistency in reporting. RESULTS: A total of 289 unique abstracts were reviewed by author pairs for inclusion based on relevance to the review objectives. A total of 13 articles were included in the final analysis. Each institution measured different knowledge areas, abilities, and entrustable professional activities (EPAs). Most programs had a summative component, with APPE readiness being primarily assessed in the final didactic year of the pharmacy curriculum. Most programs report at least one source of validity. IMPLICATIONS: Given the lack of specific APPE readiness assessment requirements in the ACPE Standards 2016, the different assessment methods among programs were not surprising. However, the commonalities identified can be leveraged with the release of the Curricular Outcomes and Entrustable Professional Activities (COEPA) 2022 to promote a standardized definition of APPE readiness. Future research should focus on formative assessment methods embedded throughout the didactic curriculum to identify "at-risk" students prior to a "high-stakes" summative assessment at the end of the didactic curriculum that impedes student progression to the APPE year.

Preceptor Feedback on Utilization and Pre-APPE Performance Expectations of Pharmacy Practice Skills.

OBJECTIVE: This study aimed to determine the frequency with which preceptors perform skills in their practice setting and the degree of competency that preceptors expect from students to perform those skills upon starting their advanced pharmacy practice experiences (APPEs). METHODS: A survey assessing skill utilization and expected pre-APPE student competency level upon entry to APPEs was developed by pharmacy practice faculty and distributed to preceptors. Preceptors were asked to rank their utilization of skills and expected pre-APPE student competency of each skill. Investigators assigned each skill a categorical ranking of high, moderate, or low priority. RESULTS: The survey was completed by 448 pharmacy preceptors. Skills related to communication, patient education, documentation, collecting medication histories, and drug therapy review/reconciliation were the most utilized. Skills related to physical assessment and point-of-care testing were the least utilized, and the expected student competency level was also low. Skills identified as highest-priority included those related to patient counseling/education, problem-solving/critical thinking, and information gathering and management. CONCLUSION: The results of this survey suggest that the frequency with which preceptors perform specific skills in practice and their corresponding competency expectations for APPE students vary and are skill-dependent, allowing for prioritization. Stratifying individual skills according to how commonly they are encountered in practice and the competency levels expected by APPE preceptors can assist institutions in prioritizing skills-based laboratory content and assessment and in addressing curricular bloat and hoarding.

APPE unreadiness - The other side of the coin.

INTRODUCTION: Student readiness for Advanced Pharmacy Practice Experiences (APPEs) has not been explicitly defined in literature or standards. Readiness for APPEs is a programmatic requirement of all schools and colleges of pharmacy (schools), leaving schools to determine their own assessments of APPE readiness. Current literature provides no consensus on the definition of APPE readiness nor the assessments or benchmarks used to evaluate APPE readiness. Schools have an opportunity to improve efforts to identify students at risk for poor APPE performance and provide early intervention. COMMENTARY: Due to a lack of consensus, it may be easier to describe students who are not ready for APPEs than it is to describe students who are APPE ready. APPE unreadiness is defined by the authors as those who require significant preceptor instruction on foundational competencies such as knowledge, skills, and/or attitudes and therefore are unable to meaningfully engage in application-based patient care activities. By adding focus to APPE unreadiness within APPE readiness programs, pharmacy schools may be able to more readily identify and remediate students who are at risk of failing one or more APPE rotations. IMPLICATIONS: We provide four recommendations for schools to consider. These are focused on assessing APPE readiness to qualify and quantify APPE unready students. By assessing APPE unreadiness, schools can make continuous quality improvement to ensure that preceptors, sites, students, and faculty can have the ongoing confidence that APPE students are all ready to meaningfully engage on rotation.

You'll have to call the attending: Impact of a longitudinal, "real-time" case-based infectious diseases elective on entrustable professional activities to enhance APPE readiness.

BACKGROUND AND PURPOSE: Transitioning from the didactic to experiential setting is challenging for student pharmacists, perhaps due to lack of experiences providing "real-time" clinician interaction. We describe findings from a semester-long infectious diseases (ID) didactic elective that utilized a national cohort of preceptors and faculty across the United States to mimic clinician interaction and "real-time" ID management of various disease states. The mechanics of this elective provide a framework for others to implement to enhance advanced pharmacy practice experience (APPE) readiness. EDUCATION ACTIVITY AND SETTING: Students enrolled in an ID elective course at a school of pharmacy participated in "real-time" acute care scenarios. They assisted in multidisciplinary management of a patient's infection, mimicking "rounds" on an APPE, via interaction with external pharmacist volunteers (playing the roles of other healthcare personnel). Additionally, students formally presented and discussed their cases within the class, further promoting learning while optimizing presentation skills. Pharmacist volunteers were surveyed to assess student performances as measured by four entrustable professional activities (EPAs). FINDINGS: A total of 48 volunteer opportunities occurred during two course offerings. Results from 43 surveys were analyzed (90% response rate). Of those responses, 22/24 (92%) played the role of attending physician, and 19/24 (79%) played the role of technician. Volunteers agreed that students met the four EPAs evaluated (agreement was 85-100%). SUMMARY: This semester-long elective provided "real-time" experience and feedback for pre-APPE students to enhance APPE readiness and reinforce EPAs. Students are likely to benefit from mimicked intra-professional interaction and augmented critical thinking skills that could be adapted to various disease states within pharmacy curricula.

Preceptors' perceptions of an entrustable professional activities-based community introductory pharmacy practice experience curriculum.

INTRODUCTION: In 2021, the Southeastern Pharmacy Experiential Education Consortium implemented Entrustable Professional Activities (EPAs) into the community introductory pharmacy practice experience (IPPE) curriculum at five colleges/schools of pharmacy. The objective of this study was to evaluate community IPPE preceptors' perceptions regarding the newly implemented EPA-based community IPPE curriculum and corresponding preceptor training. METHODS: Community IPPE preceptors who precepted first-year student pharmacists in the EPA-based curriculum during the 2021 and 2022 community IPPE cycles were invited to complete a voluntary electronic survey. The survey collected preceptor feedback regarding the required EPA tasks, assessment tool, and preceptor development module. RESULTS: Eighty-eight preceptors began the survey, and approximately half completed the entire survey. Greater than 92% of preceptors surveyed agreed or strongly agreed EPA domain tasks were developed at an appropriate level for a student to complete by the end of the community IPPE, and ≥ 94% agreed or strongly agreed tasks prepared a community IPPE student for the community advanced pharmacy practice experience (APPE). Overall, most preceptors agreed or strongly agreed that the assessment tool was easy to navigate and effective at evaluating students' performance. All preceptors who viewed the recorded preceptor development module found it helpful to their understanding of the new assessment tool. CONCLUSIONS: Preceptors' feedback supports the use of an EPA-based community IPPE curriculum to assess student performance and prepare students for community APPEs. Preceptor involvement is valuable in the evaluation of a revised experiential curricula to assure IPPE expectations are appropriate and align with contemporary pharmacy practice.

Don't worry, be APPE: Developing and refining a skills-based assessment of student preparedness for advanced pharmacy practice experiences.

BACKGROUND: The Accreditation Council for Pharmacy Education (ACPE) 2025 Standards charge pharmacy programs to assess student readiness for Advanced Pharmacy Practice Experiences (APPEs), but the method of assessment is not defined. This report describes the process of developing, implementing, and refining an APPE readiness assessment (ARA) that can be adapted to individual institutional needs and learning outcomes. EDUCATIONAL ACTIVITY: The ARA at The University of Texas at El Paso School of Pharmacy, a Hispanic-serving institution, is comprised of two practice areas: drug information and the Pharmacist Patient Care Process, each with multiple objective structured clinical examinations (OSCEs) to mimic how students will apply these skills in required APPE rotations. The ARA has been adapted for administration both virtually and in-person. Students are required to attain a 70 % average across all five OSCEs, with an opportunity to retest on any failed areas prior to progression into the APPE year. CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY: Since initial implementation in 2021, faculty experience and student performance informed changes to the assessment, rubrics, and integration of skills throughout the curriculum. The average overall ARA score was an 89.13 % in 2021 and ranged from 79.74 to 82.3 % in 2022-2024. Typically, less than 10 % of the class required re-testing, however, in 2023 16 % of the class had an ARA average less than 70 % requiring re-testing. Written skills are consistently the lowest performing area for students, potentially due to language discordance between students' preferred language and the language of the assessment.

Validation of Longitudinal Progression Examinations for Prediction of APPE Readiness.

OBJECTIVE: To study curricular outcomes for the purpose of holistic improvement of the curriculum. METHODS: A single-institution retrospective cohort study evaluated 3 cohorts of Doctor of Pharmacy students entering the program through performance in Advanced Pharmacy Practice Experience (APPE) rotations. Assessment scores and pass/fail outcomes were collected from the 3 examinations to use as predictors, and the numbers of "needs improvement" (NI) and "unsatisfactory" (U) ratings from preceptors during the APPE rotations served as outcome measures. RESULTS: Pharmacy mathematics competency and Milemarker 1 (MM1) examination first-time scores, but not those from Milemarker 2 (MM2), were significantly associated with NI or U scores on required APPE rotations. Significant correlations for all examinations (pharmacy mathematics competency, MM1, and MM2) were found for the Acute Care/Inpatient APPE rotation for each cohort and the combined cohorts. Significant correlations were also found between all examinations and the APPE rotation courses Advanced Hospital and Ambulatory Care, with the exception of the 2021 cohort. Performance in the Advanced Community rotation was not associated with any of the examinations. MM1 and MM2 are both reliable measures of competence in our didactic curriculum and predictive of scoring an NI or U rating in the APPE Acute Care/Inpatient rotation. CONCLUSION: The longitudinal milestone examinations used in our institution provide a mechanism to identify students likely to struggle in required APPE rotations and target them for remediation activities.

Design and Evaluation of an APPE Readiness Dashboard Tool.

OBJECTIVE: To describe the design and evaluation of a dashboard tool to assess the readiness for advanced pharmacy practice experiences (APPEs). METHODS: The investigators developed a dashboard tool for the appraisal of APPE readiness consisting of indicators of pharmacy student knowledge, skills, and noncognitive attributes. For the 2018-2019 and 2019-2020 rotation years, a panel of stakeholders used the dashboard to evaluate APPE readiness. Students deemed not ready (5 or more dashboard indicators) had a remediation experience before the APPEs. The investigators monitored the students who were deemed ready but at risk for substandard performance (3 or 4 indicators or completion of remediation experience) and tracked the incidence of substandard performance for all APPE students. The outcomes were presented using descriptive statistics. Performance of the tool between years was compared using the χ2 test. RESULTS: For 2 APPE rotation cycles, the investigators evaluated readiness in 499 students. A total of 3 students were deemed not ready, and 78 students were considered at risk for substandard performance. The tool predicted 52.1% of students who experienced a substandard performance. It had a negative predictive value of 93.6% and a positive predictive value of 38.5% for substandard performance. The predictive value was similar across the risk categories of knowledge, skills, and noncognitive attributes. CONCLUSION: A dashboard tool facilitating holistic evaluation of APPE readiness was helpful in identifying students who were not ready for APPEs or at risk for substandard performance. The next steps include refinement of the tool through the evaluation of characteristics of students who experienced substandard performance and were not identified by the tool.

Determining preceptor perceptions of APPE readiness through the use of entrustable professional activities.

INTRODUCTION: Pharmacy programs are required to demonstrate that students are advanced pharmacy practice experience (APPE) ready, but neither a professionally recognized definition of nor a consistent approach to assess APPE readiness exists. METHODS: APPE preceptors were surveyed about the relationship of EPAs to APPE readiness in three domains, including: (1) each EPA's relative importance, (2) indicators that a student is not ready to begin APPEs, and (3) each EPA's expected level of entrustment on the first day of the first APPE. We determined consensus of EPA importance and expected level of entrustment by adapting previously published thresholds. We analyzed the association between preceptor or practice setting characteristics with ranking of EPA importance. RESULTS: Of the 431 preceptors queried, 31% responded. Ten EPAs, primarily those reflecting the first three steps of the Pharmacists' Patient Care Process (PPCP), were identified as important with strong consensus. Ambulatory care preceptors placed higher importance on EPAs, primarily in the final steps of the PPCP and within the public health domain. Professionalism issues were most often cited as reasons for a lack of APPE readiness. There was considerable variability (weak or moderate consensus) in preceptors' expected level of entrustment per EPA. CONCLUSIONS: Pharmacy programs can consider prioritizing EPAs in the domains of patient care and information master when developing APPE readiness plans; professionalism should also be emphasized. Further work is needed to better understand what level of entrustment preceptors expect of an APPE ready student.

A consortium's approach to developing an EPA-based community IPPE curriculum.

INTRODUCTION: Currently, there are limited data on the use of entrustable professional activities (EPAs) within introductory pharmacy practice experiences (IPPEs). The objective of this study was to identify supporting EPA tasks community IPPE students should perform at the "Competent with Support" level to prepare them for advanced pharmacy practice experiences (APPEs). METHODS: The Southeastern Pharmacy Experiential Education Consortium utilized a modified Delphi process to incorporate EPAs into community IPPE curricula to mirror the consortium's community APPE curricula. Community IPPE and APPE preceptors (N = 140) were invited to participate in focus groups and two surveys to identify and build consensus on EPA-based activities community IPPE students should perform to prepare them for APPEs. The primary outcome was development of an EPA-based community IPPE curriculum. RESULTS: Nine preceptors (6.43%) participated in a focus group, 34 preceptors completed survey one (24.29%), and 20 preceptors completed survey two (14.29%). The initial list of 62 tasks for 14 EPAs was tailored to reflect an IPPE student skill set. Survey consensus led to a community IPPE curricula with 12 required EPAs and 54 tasks (40 required and 14 suggested). CONCLUSIONS: The modified Delphi process provided a mechanism for preceptor collaboration with experiential programs to build consensus on community IPPE curricula redesigned around EPAs and supporting tasks. A unified IPPE curriculum adds value to colleges and schools of pharmacy with shared preceptors by improving continuity of experience, expectations, and evaluation of student learners and allows for targeted regional preceptor development.

Exploring the Effect of Virtual Education on Student Pharmacists' Confidence toward APPE Readiness.

A drop in confidence in Advanced Pharmacy Practice Experience (APPE) readiness was observed in students in the Class of 2022 prior to starting APPEs. We aim to investigate potential causes of students' low confidence in APPE preparedness to provide solutions and to prevent this outcome with future students. We evaluated students' perceived confidence to start APPEs and compared this to curricular changes, employment obligations, and the impact of COVID-19 on delivery of the pre-APPE and APPE curriculum. Students' low confidence with APPE readiness was not indicative of the following factors: (1) delivery of the didactic curriculum, (2) students' performance in the didactic curriculum, or (3) number of summative assessments in key didactic courses. Rather, the low confidence perception may have been due to differences such as a fully remote didactic experience in the P3 year, more virtual Introductory Pharmacy Practice Experiences (IPPEs), a reduced course load in the P3 spring semester, and changes to a pre-APPE preparatory course compared to other class years. The students' self-reported midpoint scores during their first APPE block and preceptor's evaluations on their performance contrasted their pre-APPE perceptions. Frequent in-person and on-site skills assessments throughout the didactic curriculum seem to reinforce confidence before APPEs.

A classroom-based patient case activity as a potential formative indicator of pre-advanced pharmacy practice experience readiness.

BACKGROUND AND PURPOSE: Pharmacy programs must assess student readiness for advanced pharmacy practice experiences (APPEs). This study evaluated: (1) if a relationship exists between student performance on a classroom-based patient case activity (Rx Review) and (2) performance on direct patient care and perceptions of the transferability of Rx Reviews to the APPE setting. EDUCATIONAL ACTIVITY AND SETTING: Rx Reviews are timed, independent, prospective reviews of a patient's medical record intended to simulate pre-rounding activities common in acute and ambulatory care settings. Students complete 12 Rx Reviews across a skills laboratory course sequence. Rx Review scores were compared to performance on acute care and ambulatory care APPEs for students in the Class of 2019 using descriptive statistics for student scores and bivariate logistic regression for the association between Rx Review scores and performance outcomes on patient care APPEs. Student perceptions of the Rx Reviews were assessed through a survey. Descriptive statistics and qualitative responses were used to analyze responses to the multiple-choice survey questions and open-ended question, respectively. FINDINGS: One hundred twenty-two students participated in the study. A relationship was found between students' Rx Review scores and performance in certain direct patient care APPEs, with students performing in the bottom 50% on Rx Reviews being more likely to perform poorly on those APPEs. Over 93% of students identified Rx Reviews as at least somewhat helpful in preparing them for APPEs. SUMMARY: This study indicated that a classroom-based patient case activity could be used as a formative measure of APPE readiness.

Revisiting the Socratic method of teaching to improve third-year pharmacy students critical thinking and advanced pharmacy practice experience readiness in a critical care elective.

BACKGROUND: One of the most important abilities we look to nurture and develop in pharmacy students is critical thinking. A critical care elective course was re-designed to optimize high-pressure situations to engage and target critical thinking, clinical reasoning, and advanced pharmacy practice experience (APPE) readiness using the Socratic method of teaching. EDUCATIONAL ACTIVITY: Pharmacy students at Loma Linda University School of Pharmacy were selected and exposed to a high-pressure classroom environment with each day structured around the Socratic method of teaching. Pass/fail grades were earned daily based solely on verbal responses and discussions. The assessment tools used were: Health Sciences and Reasoning Test (HSRT) to measure critical thinking, an APPE-readiness survey of the entire third-year class for peer comparison, and a survey of the style and pedagogies used. CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY: The elective students showed noteworthy gains on their HSRT results in an eight-week critical care elective course. They also had significantly more positive responses on the APPE-readiness survey relative to their classmates and rated this teaching style higher than a typical course. Revisiting and applying the Socratic method of teaching in a high-pressure course is an effective way to engage pharmacy students, producing substantial improvements in critical thinking, clinical reasoning, and APPE readiness in a short time. Lastly, it offers one way to incorporate a validated tool to measure critical thinking in pharmacy students for institutional assessment and accreditation that is widely available, easy to use, and cost friendly.

Adapting a National Framework to Inform Curricular Redesign Focused on Enhancing Student Clinical Competency.

Doctor of Pharmacy (PharmD) programs continually engage in curricular redesign to ensure practice readiness of graduates. With ever-increasing demands on clinical competency and curricular time, it is important to be intentional when determining curricular priorities and prioritize contemporary pharmacist practice. This paper describes how to adapt a national framework for pharmacotherapy curricula to emphasize the pharmacist's role within a given topic area in order to facilitate conversations about allotting curricular time during a curricular redesign. Customized Tier descriptions based on various factors expected of student pharmacists during Advanced Pharmacy Practice Experiences (APPEs) were developed (e.g., relative autonomy of the pharmacist in managing the topic, emphasis on licensing exams, frequency with which students can expect to encounter the topic at school-specific experiential placements, and condition-specific information). Topics were also reprioritized to address regional variations in practice and ideologies. Customizing a national framework to determine program-specific considerations for prioritizing topics within the pre-APPE curriculum can help faculty and students alike maintain focus on highly critical and foundational concepts, while also making sure not to completely disregard topics of lower priority. We have proposed such a framework for programs to utilize when facilitating conversations surrounding curricular reforms and topic prioritization.

Evaluation of pharmacy students' self-efficacy and performance in applying components of the Pharmacists' Patient Care Process within a capstone course and during advanced pharmacy practice experiences.

INTRODUCTION: Capstone courses are ideal for reinforcing and assessing the Pharmacists' Patient Care Process (PPCP). The purpose of this study was to assess pharmacy students' (1) self-efficacy in applying PPCP components before and after a capstone course, (2) performance in applying PPCP components in several assignments, and (3) self-efficacy in applying the PPCP during advanced pharmacy practice experiences (APPEs). METHODS: Student evaluation included: (1) electronic surveys to assess students' self-efficacy in applying three components of the PPCP (Collect, Assess, and Plan) via a pre-/retrospective pre-/post-survey design, (2) course evaluations, and (3) an electronic survey to assess students' self-efficacy in applying the PPCP after completing five APPEs. Faculty evaluation included rubrics assessing performance in applying the PPCP model given patient cases. Descriptive statistics, paired t-tests, and mixed-effects linear modeling were conducted. RESULTS: Sixty-four students participated in the course during spring 2018. The sum mean self-efficacy scores for the PPCP components significantly improved between the beginning and end of the course (P < .05). There was a significant increase in evaluators' ratings of students' ability to apply the PPCP (P < .05). The sum mean self-efficacy scores for the PPCP components did not change significantly between the end of the course and after completion of five APPEs, except for a few specific items. CONCLUSIONS: A capstone course integrating the PPCP in patient case assignments resulted in improved student performance and self-efficacy in applying three PPCP components (Collect, Assess, and Plan). Students' self-efficacy remained consistent after the course concluded and during APPEs.

Predictors of student pharmacist success on an advanced pharmacy practice experience-readiness performance-based assessment.

INTRODUCTION: The study objective was determining the relationship of certain predictor variables with student performance on an advanced pharmacy practice experience (APPE)-readiness performance-based assessment (PBA) in the third professional year (P3). METHODS: This retrospective study aimed to identify if student predictors and/or curricular-related predictor variables correlate with student performance on a patient interview and documentation activity (PIDA), an APPE-readiness assessment. Student predictors included Pharmacy College Admission Test score, pre-pharmacy cumulative grade point average (GPA), end of first professional year (P1) GPA, end of second professional year GPA, end of fall P3 GPA, and elective Pharmacists' Patient Care Process (PPCP) score. Curricular-related predictor variables comprised specific activities with emphasis on patient care skill development in P1 through P3 years. Adjusted and unadjusted linear regression models assessed correlations between PIDA score and student predictors as well as curricular variables. RESULTS: Students from the Classes of 2018 through 2020 at Southern Illinois University Edwardsville School of Pharmacy (N = 231) were included. Two student predictors, P3 GPA and PPCP elective score, showed statistically significant correlations with PIDA performance. One curriculum-related variable, P3 activity with an emphasis on medication reconciliation, demonstrated a statistically significant correlation with student performance on the PIDA. CONCLUSIONS: Student performance on a cumulative PBA may be predictive from prior curricular learning experiences that assess similar patient care skills. The predictive impact of the elective PPCP score on a PBA needs additional research. Recent implementation of a new curriculum may lead to identification of other predictors of student success on PBAs.

Use of Capstone Experiences in Pharmacy Education to Synthesize and Apply Students' Knowledge and Skills.

Objective. To investigate capstone experiences in pharmacy education with the broad aim of better understanding how they are designed, used, and sustained.Methods. Capstones were defined as culminating experiences that required Doctor of Pharmacy (PharmD) students to apply their knowledge and skills and demonstrate their ability to integrate, extend, and apply multiple components of their academic experience. This study was conducted in two phases. Phase one was a mapping review, which provided insight into the design of pharmacy capstone experiences, including the purpose they served and their associated outcomes. Phase two consisted of conducting follow-up interviews to explore the current status and sustainability of those capstone experiences. Qualitative methods with multiple coders were used to analyze the data.Results. Five distinct purposes for capstone experiences were identified: preparation for advanced pharmacy practice experiences (APPEs), pharmacotherapy education, research, reflection on pharmacy school experiences, and immersive learning through an external organization. Wide variability was found in the design, purpose, and outcomes of capstone experiences. Study authors described the capstone experiences at their institution in terms of the viability, feasibility, desirability, and challenges faced.Conclusion. Capstones can play an important role in assessing student progress and practice readiness in pharmacy education. The findings of this study can be used to help pharmacy schools design capstone experiences that are effective and sustainable.

A Modeling Exercise to Identify Predictors of Student Readiness for Advanced Pharmacy Practice Experiences.

Objective. To model the relationship of common pharmacy education assessment data including student demographics, pre-pharmacy performance, core didactic performance, and external testing measures to identify predictors of student readiness for advanced pharmacy practice experiences (APPEs). Methods. The associations between 23 predictive covariates from 226 graduating students from 2015-2018 (5786 observations) and APPE readiness as measured by midpoint core APPE scores were modeled. Multiple linear and Poisson regression models with backward selection were used. A selection criterion of p >.10 was used for covariate elimination from the model. Three models were evaluated: average of all midpoint core APPE rotation scores; average of midpoint acute care pharmacy practice and ambulatory care APPE rotation scores; and number of midpoint core clerkship failing scores. Results. The average age of the population at admission was 25.4±4.5 years, 47% were female, and 75.2% had prior degrees. Across the three prediction models, knowledge-retention covariates were the strongest predictors. Total score on the Pharmacy Curriculum Outcomes Assessment was a modest yet consistent predictor across the models. All other significant predictors were unique to the various models. Conclusion. This four-year, population-based modeling study of the relationship of common pharmacy education assessment data to APPE midpoint scores shows a modest correlation with knowledge-based measures. There is a need for greater innovation in this area of research.

Developing a comprehensive APPE-readiness plan with a focus on skills, attitudes, and behaviors.

BACKGROUND AND PURPOSE: Pharmacy schools must have a framework to ensure students have the necessary knowledge, skills, attitudes, and behaviors to be successful during advanced pharmacy practice experiences (APPEs). EDUCATIONAL ACTIVITY AND SETTING: Ten summative assessments, called APPE-readiness assessments (ARAs), were developed based on eight competencies encompassing skills, behaviors, and attitudes that must be demonstrated prior to APPEs. All eight competencies were assessed in the course Case Studies in Pharmacotherapy IV, which is offered in the final semester of the didactic curriculum immediately prior to APPEs. A 15-question pre- and post-survey was conducted to assess student confidence in performing each APPE-readiness competency. Cohort data was evaluated by the curriculum and assessment committee to assess curriculum effectiveness and areas for improvement. FINDINGS: Upon completion of the course, the average first-attempt pass rate across all ARAs was 92.4%. All students who failed on the first attempt passed on the second attempt, thereby demonstrating APPE-readiness. Out of 62 students, 45 and 44 completed the pre- and post-survey, respectively. Prior to the ARAs, the overall average of students who felt (strongly) confident about their ability to perform each competency was 82.2 ± 2.1%. This increased to 92.6 ± 1.6% after the ARAs. SUMMARY: The development of an APPE-readiness assessment plan focusing on skills, attitudes, and behaviors provides insight into student and cohort performance and allows for continuous quality assurance of the pre-APPE curriculum.