Student pharmacists' perceptions of a NAPLEX preparation module in the pharmacy curriculum at one United States college of pharmacy.

BACKGROUND AND PURPOSE: To investigate final-year student pharmacists' experiences of a new module for North American Pharmacist Licensure Examination® (NAPLEX®) preparation at one college of pharmacy in the United States. EDUCATIONAL ACTIVITY AND SETTING: All student pharmacists enrolled in a new Spring 2023 module for NAPLEX preparation (n = 118) were invited to complete an electronic questionnaire and participate in a semi-structured interview. The questionnaire investigated the perceived helpfulness, grading, importance, prioritization, structure, and timing of the module in the curriculum, as well as assignment choices, confidence building, and time management using a six-point Likert scale. Semi-structured interviews investigated experiences with NAPLEX modules, time management, and course format. Questionnaire data were descriptively analyzed; interview data were thematically analyzed. FINDINGS: Forty-one completed questionnaires and seven interviews were analyzed. Median scores for questionnaire items were six (denoting strongly agree) for three items, five (denoting agree) for seven items, and four (denoting somewhat agree) for two items. Twenty-three (56%) students desired an online self-directed (asynchronous) course structure. Seventeen (42%) students desired a mixture of short and long course assignments with a greater proportion of short course assignments while another 17 (42%) desired only short course assignments. Two themes were constructed from interviews: timing (when to study for NAPLEX) and structure (how to study for NAPLEX). SUMMARY: Study findings indicated typically positive perceptions of a module for NAPLEX preparation among final-year student pharmacists at a college of pharmacy in the United States. Recommendations from students can be used to improve the module in future years.

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

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

An Exploratory Analysis of PharmD Program Value Using the Tuition: Licensure Index.

Objective. To assess the value of a Doctor of Pharmacy (PharmD) program using the Tuition: Licensure Index (TLI), a de novo metric combining tuition and licensure pass rates. Methods. The TLI is a ratio of program tuition and licensure pass rates, where separate indices are derived for the North American Pharmacist Licensure Examination or NAPLEX (ie, TLI-N) and the Multistate Pharmacy Jurisprudence Examination (ie, TLI-M). The TLI can be further nuanced depending on use of in-state (ie, TLI-Ni and TLI-Mi) or out-of-state (ie, TLI-No and TLI-Mo) tuition. The TLI-N for the 2018 cohort was used in this analysis. Total program tuition and NAPLEX pass rates were obtained from publicly available sources. Differences in traditional vs accelerated and public vs private programs were examined using the TLI-N categories "one or less" and "greater than one." Results. While differences in TLI-Ni category (ie, "one or less" and "greater than one") for traditional vs accelerated PharmD programs were not significant, a major difference was found in the TLI-Ni category for public vs private programs. No differences in the TLI-No category for public vs private or for traditional vs accelerated programs were found. Conclusion. In-state public (vs private) PharmD programs may be preferable for optimizing value. Prospective students are encouraged to consider a school's tuition and licensure pass rates when selecting a PharmD program.

Length of advanced pharmacy practice experience and first-time NAPLEX pass rate of US pharmacy programs.

INTRODUCTION: The objectives of this study were to (1) report the length in weeks of advanced pharmacy practice experiences (APPEs) of US pharmacy programs in 2016 and (2) compare first-time North American Pharmacy Licensure Examination (NAPLEX) pass rates according to the length in weeks of the programs' APPEs. METHODS: First-time NAPLEX pass rate was obtained from the National Association of Boards of Pharmacy public web page. The length in weeks of programs' individual APPEs (iAPPEs) and program characteristics were obtained from the individual pharmacy programs' web pages. Analysis of variance was used to compare iAPPE length and first-time NAPLEX pass rate and multiple regression was used to quantify the independent influence of iAPPE length on first-time NAPLEX pass rate. RESULTS: The length in weeks was evenly distributed among four-, five- and six-week iAPPEs for NAPLEX testing years 2013 to 2015, although six-week iAPPEs have been preferred recently. The first-time NAPLEX pass rate was not associated with the total APPE length or whether the program used four-, five- or six-week iAPPEs for all three years and for the three-year aggregate pass rate. CONCLUSION: Six-week iAPPEs were the most common, but not the majority among pharmacy programs. Longer total or individual APPEs did not translate into higher first-time NAPLEX pass rates. Length of iAPPE rotations can be chosen without concern that student pharmacists' performances on first-time NAPLEX pass rates will be significantly impacted.

Predictors of performance on the North Carolina Multistate Pharmacy Jurisprudence Examination.

INTRODUCTION: To evaluate an expanded set of variables and determine their association with Wingate University School of Pharmacy (WUSOP) graduates' scores on the North Carolina (NC) Multistate Pharmacy Jurisprudence Examination (MPJE). METHODS: Demographic, pre-admission, pharmacy school, and licensing preparation variables were collected for WUSOP graduates who attempted the NC MPJE for the first time in 2017. Bivariate correlations between student-pharmacist characteristics and the MPJE score were performed. RESULTS: Several variables were found to have a statistically significant association with the NC MPJE score, including prerequisite grade point average, pharmacy coursework, Pharmacy Curriculum Outcomes Assessment performance, and completion of MPJE practice questions. There were no significant associations between NC MPJE scores and demographic characteristics, previous paid pharmacy employment, receipt of undergraduate degree, or Pharmacy College Admission Test scores. CONCLUSION: This exploratory analysis identified characteristics of WUSOP graduates that were associated with performance on the NC MPJE. The results of this study will be communicated with future graduates to enhance their success on the jurisprudence examination.

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.

Impact of Pharmacy School Characteristics on NAPLEX First-time Pass Rates.

Objective. To assess the impact of pharmacy school characteristics on the pass rates of students taking the North American Pharmacist Licensure Examination (NAPLEX) for the first time. Methods. A retrospective review of NAPLEX first-time pass rates, pharmacy school characteristics and percent of total graduating class who matched for a first postgraduate year (PGY1) residency was performed for 2014, 2015, and 2016. All US colleges of pharmacy accredited as of July 2017 were included. Independent samples t tests, paired samples t tests, correlational analysis, and multiple linear regression were conducted. Results. The first-time pass rates on the NAPLEX were significantly higher for the following: schools located within an academic health center; schools established before 2000, and public schools. The 2016 NAPLEX first-time pass rate was significantly higher for schools with a traditional four-year program structure versus an accelerated three-year structure. Also, a school's first-time pass rate on the NAPLEX was positively, significantly correlated with percentage of fourth-year students who matched for a PGY1 residency and being located within an academic health center. The NAPLEX first-time pass rate for the previous year and percent of the total graduating class that matched for a PGY1 residency were significant predictors in the final regression models for 2015 and 2016 NAPLEX first-time pass rates. Conclusion. While differences in certain program characteristics was coorelated with NAPLEX pass rate, many of these factors are not modifiable. Programs can proactively and critically evaluate their educational programs and the readiness of their students to sit for the NAPLEX.

Impact of a low-cost simulated electronic medical record on perceptions of APPE readiness.

BACKGROUND: Meaningful use of electronic medical records (EMRs) is critical for providing high-quality, patient-centered care. However, many pharmacy students are not exposed to EMRs until the experiential components of the curriculum. EDUCATIONAL ACTIVITY AND SETTING: We created a low-cost simulated EMR (SEMR) using Microsoft PowerPoint software (Microsoft, Redmond, WA, Version 16.16) to use in a case-based application course for second-year pharmacy students for two consecutive years. FINDINGS: Pre- and post-assessment surveys of 162 students indicated that perceived confidence and efficiency navigating EMRs improved after the activity. Students agreed that the activity enhanced learning, improved understanding of how to extract meaningful data from EMRs, benefited their preparation for the fourth professional year, and demonstrated the role of informatics in patient care. SUMMARY: Incorporation of a SEMR using Microsoft PowerPoint enhances student perceptions of proficiency in navigating the patient medical record. Adoption of similar activities into pharmacy curricula may be an attractive option when adequate financial resources for simulation are unavailable.

An analysis of the use of Pharmacy Curriculum Outcomes Assessment (PCOA) scores within one professional program.

OBJECTIVE: The Pharmacy Curriculum Outcomes Assessment (PCOA) is a recent assessment requirement for US pharmacy professional programs. This study analyses PCOA scores for uses described in the 2016 Standards with data from one professional program. METHODS: PCOA data were analyzed for two consecutive classes (n=215) of pharmacy students at the end of their didactic curriculum to explore relationships among PCOA scores, grade point average (GPA), and North American Pharmacist Licensure Examination (NAPLEX) scores utilizing regression analyses. RESULTS: Decisions about student learning based on PCOA scores and GPA indicated remediation would have been prescribed for approximately 7% of students. In comparison, NAPLEX scores revealed a 1% failure rate among the study sample. Relationships between PCOA scores and GPA (r=0.47) and NAPLEX (r=0.51) were moderate to large, respectively. GPA explained a larger portion of unique variance (14%) than PCOA (8%) in NAPLEX scores. CONCLUSIONS: In this sample of students, academic decisions would have varied depending upon the learning assessment, which is consistent with a moderate correlation between GPA and PCOA scores. Although PCOA scores correlate with GPA and NAPLEX, PCOA scores explained a smaller portion of unique variance in NAPLEX scores than GPA. The ongoing establishment of validity evidence of PCOA scores is important for meaningful interpretation of scores for the intended uses.

Global education implications of the foreign pharmacy graduate equivalency examination.

Although the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) is not intended to measure educational outcomes or institutional effectiveness, it may be a reliable and valid criterion to assess the quality or success of international pharmacy programs. This comprehensive review describes the evolution and historical milestones of the FPGEE, along with trends in structure, administration, and passing rates, and the impact of country of origin on participant performance. Similarities between the FPGEE and the Pharmacy Curriculum Outcomes Assessment (PCOA) are also explored. This paper aims to provide a global prospective and insight for foreign academic institutions into parameters for evaluating their students' educational capabilities.

Are regulations more consumer-friendly when boards of nursing are the sole regulators of nurse practitioners?

The widely varied regulations in the 50 states often limit consumer access to nurse practitioners (NPs). In 22 states, the Board of Nursing (BON) must share NP regulatory authority with another profession, usually physicians. This study examines the relationship between the BON as the sole authority regulating NPs or sharing that authority with another profession and the NP regulatory environment. Independent t tests compared the NP regulatory environments for consumer access and choice in states with sole BON regulation with those in states with involvement of another profession. The states' NP regulatory environments were quantified with an 11-measure tool assessing domains of consumer access to NPs, NP patients' access to service, and NP patients' access to prescription medications. BON-regulated states were less restrictive (P < .01, effect size 1.02) and supported NP professional autonomy. Entry into practice regulations did not differ in the two groups of states. Having another profession involved in regulation correlates with more restrictions on consumer access to NPs and more restrictions to the full deployment of NPs.

[An analysis of the pharmaceuticals market in Vietnam]. / Une analyse du marché pharmaceutique vietnamien.

This article sheds a light on the Vietnamese pharmaceutical market. The progress that has been made in the recent years following the opening of the Vietnamese regime to the western world, although not easy, brought a certain number of opportunities for domestic firms and foreign investors. The pharmaceutical Vietnamese industry started to emerge at the beginning of the 1990s. Although, the consumption of drugs is low, it does reach the sum of $ 5.5 per capita. As the majority of these products are imported, foreign companies tend to dominate the market both in volume and in diversity. The state has always played an important role with the implementation of a strict price control strategy and most national drug companies remain state-owned. The production and consumption of drugs were also largely influenced by state policies as the latter also control hospitals. In the second half of the eighties, the progressive liberalisation of the country allowed private drug pharmacies to appear and advertisement campaigns became legal. Because the lack of specific products like antibiotics was clear, the government increased the flow of imports, including private imports by citizens. Sources of imports have become more diverse, although France remains an important source of supply. Fournier, Lipha and Pierre Fabre are among the French drug manufacturers located in Vietnam. Other foreign companies include from India, South Korea, Thailand and Germany. Joint ventures were also created with French and Japanese companies. The import of medical materials is subjected to authorisations from the Ministry of Health and the Ministry of Foreign Trade as it is necessary to obtain a licence to do so. Licences are issued on the basis of the production of drugs that do not currently exist on the local market. But Vietnam also exports pharmaceutical products to Laos, Cambodia, and Cuba. Local resources constitute an important source of new products and have stirred a strong interest among pharmaceutical researchers. A strong decentralisation process characterises the pharmaceutical sector, with pharmacies in the provinces and districts while wholesalers remain located in Hanoi and Saigon. The presence of many middlemen has contributed to an increase in prices. Today, a concentration of pharmacies is still noted in inner cities while the suburbs and the villages still have difficulties supplying drugs for inhabitants. Solutions have been implemented such as the opening of new pharmacies and additional professional training for pharmacists. Prices were lowered while the quality of the supply chain was improved. Local production is encouraged as hospitals are prompted to prescribe Vietnamese products. The modernisation of the Vietnamese pharmaceutical industry is also visible through the importation of medical materials and an increase in the number of private hospitals financed with both the help of local and foreign investors, mainly through joint-ventures, most often in Saigon and Hanoi. The renovation of local hospitals was also possible with the help of France and Japan. Columbia Gia Dinh International, located in Saigon, is one of the very few US/Vietnamese medical institutions created with a local partner, the Gia Dinh hospital. The recovery of the economy will accelerate the creation of new projects designed to improve local medical infrastructures. Other private companies, some of which are based in Singapore, have been specifically designed to deliver care to expatriates working in Vietnam. Insurance coverage has been provided in Vietnam since in 1992. Other improvements concern the implementation of "Good Manufacturing Practices" (GMP) and "Good Laboratory Practices" and "Good Storage Practices". Most norms were implemented at the end of the 90s in joint companies linking foreign investors and local partners or in independent foreign drug manufacturers based in Vietnam. Special areas were created to receive high tech investments in the medical and pharmaceutical field. Prices should diminish as competition on the market increases and new products are placed on the market to achieve economies of scale. But investment in medical research is still strongly needed.

Real world pharmacy: assessing the quality of private pharmacy practice in the Lao People's Democratic Republic.

The private sector is a dominant actor in the provision of pharmaceuticals, particularly in developing countries. Private provision of drugs has been associated with risks regarding availability, affordability, rational use and drug quality. Ensuring an effective regulatory framework is therefore a major challenge for governments, yet the capacity of regulatory authorities is often outstripped by private sector growth. In the Lao People's Democratic Republic (Lao P.D.R.), a poor, landlocked country in South East Asia, the private provision of drugs has increased dramatically since the liberalisation of the economy in the late 1980s. This paper aims to describe the quality of the private pharmacy services in the Savannakhet province of Lao P.D.R. In order to do this, a monitoring instrument which serves to make the concept of Good Pharmacy Practice (GPP) operational was developed and applied to a sample of pharmacies. Service quality, as measured by three facility-specific indicators, showed a tendency to be lower in the most distant districts. Poor dispensing practices were manifest by a lack of information about drugs sold in 59% of cases, drugs not being labelled in 47% and different drugs being mixed in the same package in 26% of cases. The prices of four sample drugs were slightly higher in the remote districts. A 10-fold price difference for the same drug was recorded in one district. After reporting the findings, the paper discusses the possible influence of district and pharmacy variables on the quality of services, and goes on to discuss the price differences. It is concluded that further government interventions are needed in order to improve the quality of services and to focus regulatory action on a limited number of aspects, to ensure that drugs can be traced before trying to establish a comprehensive regulatory system.