High Total Failures of the North American Pharmacist Licensure Examination (NAPLEX) Warrant Monitoring of Professional Pharmacy Programs.

From 2021 to 2023, 7978 graduates of pharmacy programs failed the North American Pharmacist Licensure Examination on the first attempt. Presently, the Accreditation Council for Pharmacy Education monitors programs with a passage rate of ≥ 2 SDs below the national mean pass rate. In 2023, this should lead to monitoring 7 programs that produced 140 failures out of the total of 2472 failures (5.7 %). In our view, this is neither equitable nor demonstrative of sufficient accountability. Analysis of failure counts among the 144 programs reported by the National Association of Boards of Pharmacy demonstrates a distribution curve highly skewed to the right. The evaluation of average failure counts across all programs suggests that schools with absolute failures ≥ 2 SDs higher than the average number of failures should be identified for monitoring, in addition to those falling ≥ 2 SDs below the national mean pass rate. Based on the 2023 data, this additional criterion corresponds to ≥ 35 failures/program. This threshold would prompt monitoring of 18 programs and 36.5 % of the total failures. Of the 7 programs that will be monitored based on the current Accreditation Council for Pharmacy Education criteria, only 1 would be captured by the ≥ 35 failure method of selection; the remaining 6 contribute 85 total failures to the pool. Thus, if both criteria were to be applied, ie, ≥ 35 failures and ≥ 2 SDs below the national mean pass rate, a total of 24 programs would be monitored (16.6 % of the 144 programs) that contribute 987 of the total failures (39.9 %).

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.

The North American Pharmacist Licensure Examination (NAPLEX) Pass Rate Conundrum.

As first-time pass rates on the North American Pharmacy Licensure Examination (NAPLEX) continue to decrease, pharmacy educators are left questioning the dynamics causing the decline and how to respond. Institutional and student factors both influence first-time NAPLEX pass rates. Pharmacy schools established before 2000, those housed within an academic medical center, and public rather than private schools have been associated with tendencies toward higher first-time NAPLEX pass rates. However, these factors alone do not sufficiently explain the issues surrounding first-time pass rates. Changes to the NAPLEX blueprint may also have influenced first-time pass rates. The number of existing pharmacy schools combined with decreasing numbers of applicants and influences from the COVID-19 pandemic should also be considered as potential causes of decreased first-time pass rates. In this commentary, factors associated with first-time NAPLEX pass rates are discussed along with some possible responses for the Academy to consider.

A Systematic Review of APPE Readiness Assessments Utilized by US Schools of Pharmacy.

OBJECTIVE: The 2016 Accreditation Council for Pharmacy Education standard 25.8 requires schools of pharmacy to assess student readiness for Advanced Pharmacy Practice Experiences (APPEs). We performed a systematic review to identify how schools of pharmacy in the United States assess student readiness for APPE rotations in accordance with Accreditation Council for Pharmacy Education accreditation guidelines. FINDINGS: From a search of 6 databases, we identified 1053 unique studies, of which 11 were eligible for inclusion in our review. The most commonly reported assessment method was the use of a capstone course; however, these courses varied significantly from school to school in duration, resources used, and content. Regardless of the specific approach used, first-time and overall pass rates were high. SUMMARY: We found that while most studies reported using some type of capstone course for APPE readiness assessment, there was variability in how these courses were structured and the assessment methods used within the courses. The future 2025 standards may dictate a more uniform structure for readiness assessments; however, further research is needed to identify best practices regarding the assessment of APPE readiness.

Joint Statement on Pediatric Education at Schools of Pharmacy.

Providing health care for children is a unique specialty, and pediatric patients represent approximately 25% of the population. Education of pharmacy students on patients across the lifespan is required by current Accreditation Council for Pharmacy Education standards and outcomes; thus, it is essential that pharmacy students gain a proficiency in caring for children. A collaborative panel of pediatric faculty members from schools and colleges of pharmacy was established to review the current literature regarding pediatric education in Doctor of Pharmacy curricula and establish updated recommendations for the provision of pediatric pharmacy education. This statement outlines five recommendations supporting inclusion of pediatric content and skills in Doctor of Pharmacy curricula.

Let External Stakeholders Be Your Guide to Curricular Revision.

Schools and colleges of pharmacy undertake curriculum revisions for a variety of reasons ranging from the reactionary (eg, responding to changes in practice patterns, accreditation standards) to the proactive (eg, striving for innovation and excellence). Continuous quality improvement processes and published curriculum models, both described in this commentary, should be used to guide revision processes. Equally important is engaging the expertise of external stakeholders. While there may be challenges to incorporating external stakeholders in a curriculum revision process, their perspectives and knowledge can contribute to a more robust result, often in unexpectedly positive ways. Logic modeling is one mechanism to structure this approach, maximize the utility of external stakeholders, and strengthen the overall curriculum revision process. Regardless of the size of the revision, a good rule of thumb is to engage external stakeholders at the outset and to let their expertise be your guide.

Challenges to Pharmacy School Enrollment Management Caused by a Global Pandemic.

Academic institutions work diligently each year to recruit, retain, and graduate Doctor of Pharmacy (PharmD) students who will be positive contributors to our healthcare system. The immergence of a novel coronavirus in 2019 (COVID-19) has threatened these systems. This commentary is a discussion of the effects of the COVID-19 pandemic on the enrollment management processes of PharmD degree programs, including recruitment, admissions, orientation, retention, and graduation. The authors highlight enrollment management processes that may forever be changed by the COVID-19 pandemic. This commentary is intended to assist pharmacy administrators as they reflect on the impact of the COVID-19 pandemic on their own programs and develop strategies to minimize the negative effects.

An initial environmental scan of APPE readiness assessment.

INTRODUCTION: Standards 2016 require schools/colleges of pharmacy (s/cop) to assess students' readiness to enter advanced pharmacy practice experiences (APPEs). However, literature describing how schools are meeting this standard is limited. The purpose of this study was to conduct an environmental scan to describe how s/cop assess student readiness to enter APPEs. METHODS: A web-based survey was distributed to assessment leads at United States s/cop, regardless of accreditation status. Respondents answered questions related to their current approach to assessing student APPE readiness, existence of intentional assessment plans, competencies used, assessment methods, benchmarks, and remediation strategies. Aggregate data were analyzed using descriptive statistics. RESULTS: Fifty-two S/COP (36.1%) responded. The majority (90.1%) were fully accredited schools. Most respondents have an intentional APPE readiness plan (73.5%), although the duration since implementation varied. There was no consensus among schools on which competencies informed APPE readiness with 67.3% listing Center for the Advancement of Pharmacy Education (CAPE) 2013 outcomes, 61.2% Guidance for Standards 2016 Appendix A, 53.1% pre-APPE domains (Standards 2007), and 30.6% Entrustable Professional Activities. Twenty-eight S/COP (57.1%) reported having individual student-level data to assess student APPE readiness. The most common methods for validating student APPE readiness were preceptor (48.9%) and student (44.9%) surveys. CONCLUSIONS: This environmental scan begins to identify trends in how S/COP is approaching the assessment of student readiness to begin APPEs. Further research is needed to identify best practices and practical methods to ensure compliance with current accreditation standards.

An assessment of interprofessional education in schools/colleges of pharmacy in the United States.

INTRODUCTION: Pharmacy educational standards provide requirements for interprofessional education (IPE). However, there has not been a comparison of IPE structure between doctor of pharmacy programs in the United States (US). The purpose of this study was to gather information regarding current IPE programs and curricula in schools/colleges of pharmacy (S/COP) across the US. METHODS: A survey was developed and emailed to at least one faculty member or administrator from each S/COP responsible for IPE or experiential education. The survey gathered information on IPE status, structure, and oversight. It also explored mechanisms promoting IPE success, pieces of advice for starting or expanding IPE, and hurdles for IPE implementation. RESULTS: Eighty-five S/COP representing 59.9% of programs in the US responded to the survey. All respondents felt IPE was either very important or important to pharmacy education. Mechanisms that promoted IPE success included partnerships, faculty interest in IPE, having an IPE center, being located on an academic medical center, administrative support, and integrating IPE during curricular development. IPE hurdles included logistics, faculty buy-in, sustainability, distance from other programs, and differing accreditation standards across programs. Themes of advice for others were to be innovative/patient/flexible, collaborative, identify key initial partners, develop a director or coordinator of IPE position, and receive administrative support. CONCLUSIONS: IPE is a vital component to training the next generation of health professionals, but the process for can be daunting. Building on the successes of others and predicting barriers can assist S/COP in developing effective IPE.

The individual's role in maintaining a positive climate.

INTRODUCTION: This commentary adds to the discussion about academic workload challenges raised in the Mothers in Academic Pharmacy article. Outlined here are strategies for individual faculty members to proactively engage in developing a positive climate for all faculty. PERSPECTIVE: Faculty play an important role in building and maintaining a positive culture. This article provides suggestions for individuals to consider their role and impact at their institution. These suggestions focus on communication, building communities, embracing flexibility, and recognizing burnout. IMPLICATIONS: Faculty retention is important for student support and financial efficiency. Faculty who are able to openly discuss their struggles in a positive climate are more likely to identify opportunities to be productive. This helps faculty meet their overall needs and maintain success in teaching, scholarship, and service.

Could recruiting former college athletes be the answer to less pharmacy student burnout?

INTRODUCTION: Student pharmacists are in a notable wellness deficit. Pharmacy organizations are issuing statements and providing resources addressing efforts to increase student wellness. This commentary suggests that institutions refocus recruiting efforts on students with experience balancing the demands of school, wellness, and mental health. PERSPECTIVE: The purpose of this commentary is to start the conversation on increasing efforts to recruit candidates who already possess the resilience needed to perform in pharmacy school, with a focus on former college athletes. This piece in no way suggests decreased attention on wellness programs or efforts to reduce burnout. Former student athletes, through their training, have increased experience in resilience and may be less at risk for burnout. These candidates will likely have an increased team mentality and acceptance of constructive criticism. Additionally, this is an untapped resource for candidates as only 2% of collegiate athletes pursuing professional athletic careers. Of the 140 accredited pharmacy schools, 82.9% have an undergraduate program that offers at least one National Collegiate Athletic Association sport. IMPLICATIONS: Schools of pharmacy should consider additional recruitment efforts and admissions criteria weight for former student athletes who meet the same standards as other candidates. As many pharmacy faculty direct significant effort toward the prevention of student burnout, perhaps an additional approach is to recruit students who are already capable of the expected demands. The athletic community may answer both the need for additional pharmacy recruits and provide a cohort with advanced abilities in stress management, wellness, and teamwork.

Assessment of contraceptive curricula in US pharmacy programs.

INTRODUCTION: Pharmacists prescribe contraception in some states following expansions in scope of practice. Adequate education on contraception in pharmacy curricula is crucial to effectively deliver these services. METHODS: A 26-item survey assessing contraception curricula regarding was administered by email to instructors and administrators at 139 pharmacy schools in the United States. The survey assessed teaching methods, hours taught, topic content, and opinion of adequacy of contraceptive education provided by the program. RESULTS: The survey achieved a response rate of 40% (n = 56). All programs that responded offer emergency contraception and hormonal contraception content, 96% offer non-hormonal over-the-counter contraception content, and 91% offer long-acting reversible hormonal contraception content. Average number of hours taught were as follows: non-hormonal over-the-counter contraception 2.0 hours, emergency contraception 0.9 hours, hormonal contraception 3.0 hours, long-acting reversible hormonal contraception 0.8 hours, and non-reversible hormonal contraception 0.5 hours. Patient cases were most used to supplement didactic content in all topics. Standardized patient interviews were used less frequently for both hormonal contraception (25%) and emergency contraception (7%). About 68% of programs agreed or strongly agreed that the contraceptive education provided by the program was adequate. A majority (70%) indicated interest in a standardized contraceptive curriculum. CONCLUSIONS: Contraceptive education is broadly covered in didactic curricula within pharmacy education. Further assessment and development of curricula standards may be warranted to assess quality and adequacy of contraceptive education in pharmacy.

Impact of Curricular Integration Between Patient Care Laboratory and Introductory Pharmacy Practice Experience on Documentation.

Objective. To assess the impact of curricular changes made through vertical integration between Patient Care Laboratory and Introductory Pharmacy Practice Experience (IPPE) courses on documentation outcomes. Methods. Curricular changes to address student pharmacist documentation deficiencies were developed by laboratory and experiential faculty members. A documentation activity using subjective, objective, assessment, plan (SOAP) notes completed in one IPPE rotation block, pre-intervention, were graded and compared to SOAP notes from the same IPPE rotation block in the subsequent year, post-intervention, using a standard checklist. Chi square test (or Fisher exact test when appropriate) was used to evaluate the relationship between each question's score and different timepoints. Wilcoxon rank sum test was used to compare total scores between the two groups of students. Results. Significant improvement among student pharmacists' SOAP note scores were observed in the post-intervention cohort (n=52) compared to pre-intervention cohort (n=52) following curricular changes. Specific SOAP note components that revealed significant improvements between years were drug therapy problem identified, proposed drug therapy problem resolution, follow-up plan identified, overall impression, and addressing a pharmacist-specific intervention. Conclusion. Collaboration between laboratory and experiential education faculty members are integral to the identification of gaps in student pharmacists' application of simulated activities into actual experiences and in the achievement of educational outcomes. Curricular quality improvements can be implemented and assessed quickly through vertically integrated courses.

Comparison of NAPLEX pass rates for non-modifiable determinants of pharmacy programs in the United States.

INTRODUCTION: Students consider numerous variables before applying to a doctor of pharmacy program. Some key non-modifiable variables may include program length, institution type, graduating class size, and pharmacy school grading system. The purpose of this study was to determine if there exists a difference in North American Pharmacists Licensure Examination (NAPLEX) performance based upon these variables. METHODS: This was a retrospective cohort study using observational data. NAPLEX pass rates from 2015 to 2017 were obtained from the National Association of Boards of Pharmacy (NABP) website. Data for pharmacy programs were extracted from the program, Pharmacy College Application Service, American Association of Colleges of Pharmacy, and NABP websites. RESULTS: Based on each pharmacy program's performance on NAPLEX, variables with significantly higher pass rates were public institutions and those with graduating class sizes of 100 or more students. CONCLUSIONS: The results of this study suggest that graduating class size of 100 or more students and public institutions were significant predictors of success on the NAPLEX. Lower pass rates in 2016 may be due to the examination changes implemented by NABP that year. It is possible that programs and students were not being adequately prepared for the changes made to the NAPLEX format. Although not statistically significant, there was a rise in pass rates between the years 2016 and 2017. Therefore, future studies such as this one should be performed to compare NAPLEX pass rates from 2017 forward.

Focus group describing simulation-based learning for cardiovascular topics in US colleges and schools of pharmacy.

INTRODUCTION: This qualitative focus group study sought to describe how colleges of pharmacy use simulation-based learning (SBL) to teach cardiovascular topics and to identify challenges and benefits. MATERIAL AND METHODS: Participants were recruited from a screening survey disseminated via e-mail to select American College of Clinical Pharmacy Practice and Research networks. Subjects were selected based on diversity in institution and simulation types. Two 1-hour focus group sessions were conducted by the primary investigator following a script designed by the research team. Each recorded session was independently reviewed by all investigators and coded into final themes. Results are reported in a qualitative fashion. RESULTS: Five individuals provided consent and participated. Themes identified include topics, formats, interprofessional education, challenges, strategies for success, and benefits. Frequent topics included advanced cardiac life support, heart failure, hypertension, and transitions of care. Multiple formats were used including standardized patients or providers, task trainers, and high-fidelity mannequins. Multiple institutions reported simulating interprofessional teams by involving students from other health professions. Scheduling, pharmacy program size, faculty availability, and logistics around planning and/or conducting an event were identified challenges. Institutions reported success when clear expectations were provided to students and skill development progressed from low-stakes to high-stakes events. Benefits reported included real world applicability with participants noting that students do not realize the importance of SBL until they have reached rotations. CONCLUSIONS: Various topics and simulation methods were employed to teach cardiovascular topics. While challenges exist, institutions have identified strategies for success and report students recognized the benefits to their learning.

Inclusion of Socioeconomic Status as an Additional Criterion in Holistic Pharmacy School Admission Processes.

Objective. To investigate the impact of socioeconomic status as an admissions criterion for pharmacy school admissions. Methods. Using de-identified data from two PharmCAS application cycles (2012-2013 and 2015-2016), a new socio-economic status indicator was crafted based on complex parental education and occupation information provided by applicants. The indicator was calibrated on federal standards to ensure uniform composition regardless of the applicant's location. The indicator was then used to describe acceptance patterns within each pharmacy application cycle, explore correlations with other demographic and academic indicators, and develop a regression model to understand the impact of this indicator on applicants' acceptance into pharmacy school. Results. The new education and occupation (EO) indicator for an applicant's parent(s) provided new insight into complex applicant demographic information. The number of academically qualified applicants that could have received further admission consideration based on identification of a low socioeconomic status for parent one were 2016; n=435, 13%, 2103; n=767, 14%. The EO indicator by itself had limited value for predicting acceptance rates and became less predictive when academic performance variables were incorporated, demonstrating socioeconomic status was not accounted for in admissions. Conclusion. Based on the Accreditation Council of Pharmacy Education Standards 2016, schools are required to admit a diverse group of students. The addition of the EO indicator will be valuable in identifying diverse and promising future pharmacists during each pharmacy school's holistic review process.

Characterization of Use of the Pharmacy Curriculum Outcomes Assessment Across Accredited Colleges of Pharmacy.

Objective. To characterize use of the Pharmacy Curriculum Outcomes Assessment (PCOA) in terms of timing, manner of delivery, and application of the results by accredited colleges of pharmacy. Methods. Accredited pharmacy programs were surveyed regarding PCOA administration, perceived benefits, and practical application of score reports. Survey items were comprised of new items developed from a literature review and items from prior studies. The survey addressed five domains: program demographics, administration, student preparation, use of results, and recommendations to improve the utility of the PCOA. Results. Responses were received from 126 of 139 (91%) surveyed programs. The majority of respondent programs administered PCOA in one session on a single campus. Most indicated PCOA results had limited use for individual student assessment. Almost half reported that results were or could be useful in curriculum review and benchmarking. Considerable variability existed in the preparation and incentives for PCOA performance. Differences in some results were found based on prior PCOA experience and between new vs older programs. Open-ended responses provided suggestions to enhance the application and utility of PCOA. Conclusion. The intended uses of PCOA results, such as for student assessment, curricular review, and programmatic benchmarking, are not being implemented across the academy. Streamlining examination logistics, providing additional examination-related data, and clarifying the purpose of the examination to faculty members and students may increase the utility of PCOA results.

Pharmacy Education Needs to Address Diagnostic Safety.

The American Association of Colleges of Pharmacy, the Accreditation Council for Pharmacy Education, and the Center for the Advancement of Pharmacy Education frame patient safety from the perspective of medication management, which is also the current focus of pharmacy education and training. With the growing appreciation that diagnostic errors represent an urgent and actionable patient safety concern, the National Academy of Medicine has recommended diagnostic safety training for all health care professions. The Society to Improve Diagnosis in Medicine has worked with an interprofessional consensus group to identify a set of 12 key competencies necessary to achieve diagnostic quality and safety that focuses on individual, team-based, and system-related competencies. Much of this already exists in pharmacy education, but pharmacy training programs need to give graduates more guidance on how they contribute to the diagnostic process and the prevention and detection of diagnostic errors. We describe the current state of progress in this regard, and what steps are needed by training programs to provide content and assessment so that graduates achieve the requisite competencies. Governing and advisory bodies need to expand the expectations around patient safety to include diagnostic safety.