Evolution of a capstone exam for third-year doctor of pharmacy students.

BACKGROUND AND PURPOSE: Pharmacy capstone exams are an example of an assessment strategy to evaluate student competency and practice-readiness. Capstone exam processes have been discussed in the literature; however, description of format, evolution of the process, and implementation in the year prior to rotations is lacking. This manuscript discusses the development, implementation, and utilization of a third professional year pharmacy capstone exam to assess advanced pharmacy practice experience (APPE) readiness. EDUCATIONAL ACTIVITY AND SETTING: A pharmacy year three (PY3) capstone exam was initially developed prior to enrollment of the inaugural graduating class. Since the first iteration, utility has remained the same, but the overall development and implementation process has evolved due to changes in programmatic and student learning outcomes, curricular mapping, student and faculty feedback, and practice expectations. FINDINGS: The entities responsible for exam implementation perceive faculty and students have a positive perception of the exam evolution and improvements implemented. Specifically, feedback from students and faculty mentioned clear expectations, comfort with the new capstone exam process, and an appreciation for the focus on interrater reliability. As assessment is an iterative process, quality improvement strategies continue to be implemented to address feedback regarding the PY3 capstone exam. SUMMARY: Purposeful utilization of capstone exams in the third year is one method to assess APPE readiness. Sharing one college's experience with the evolution of such an exam, quality improvement methods, and experience in implementing reliability and validity measures may provide a model for institutions to implement similar assessment methods efficiently.

Evaluating the quality of multiple-choice questions in a NAPLEX preparation book.

INTRODUCTION: There is a plethora of preparatory books and guides available to help study for the North American Pharmacist Licensure Examination (NAPLEX). However, the quality of questions included has not been scrutinized. Our objective was to evaluate the quality of multiple-choice questions (MCQs) construction in a commonly used NAPLEX preparatory book. METHODS: Five students and two faculty members reviewed MCQs from the RxPrep 2018 edition course book. Item structure and utilization of case-based questions were evaluated using best practices for item construction. Frequency of item writing flaws (IWF) and utilization of cases for case-based questions was identified. RESULTS: A total of 298 questions were reviewed. Twenty-seven (9.1%) questions met all best practices for item construction. Flawed questions contained an average of 2.53 IWF per MCQ. The most commonly identified best practice violations were answer choices containing differing length and verb tense (21%) and question stems containing too little or too much information necessary to eliminate distractors (16.6%). Of the case-based questions, the majority (61.9%) did not require utilization of the provided case. CONCLUSIONS: This pilot analysis identified that a majority of MCQs in one NAPLEX preparatory source contained IWF. These results align with previous evaluations of test-banks in published books outside of pharmacy. Further evaluation of other preparatory materials, to expand on the findings from this pilot analysis, are needed to evaluate the pervasiveness of IWF in preparatory materials and the effect of flawed questions on utility of study materials.

Predicting success in pharmaceutical calculations.

INTRODUCTION: Understanding preadmission predictors of success in pharmacy calculations, an important aspect of pharmacy practice, could impact admissions selection and advising practices. The objective of this study was to determine which student specific preadmission variables best predict success in a pharmaceutical calculations course. METHODS: Preadmission data from 388 students who completed a one semester pharmaceutical calculations course between 2013 and 2016 were evaluated. This retrospective analysis was performed to determine which of the independent preadmission variables were positively correlated to the pharmaceutical calculations course grade. Fifteen preadmission variables, including demographics, grade point average (GPA), Pharmacy College Admission Test (PCAT) score, prior degrees, and number of pre-professional credit hours completed, were evaluated. Descriptive statistics were used for baseline characteristics and relative importance analysis was used to examine association between the dependent and independent variables. RESULTS: The relative importance analysis revealed eight of the fifteen preadmission variables were significantly correlated with final grades in pharmaceutical calculations. Overall, 26.1% of the variance was explained by these variables. GPA (cumulative and science specific) and PCAT (quantitative and verbal) were the strongest indicators. CONCLUSIONS: Preadmission GPA and PCAT scores were the best predictors of success in a pharmaceutical calculations course. About one quarter of the variance was explained by the identified predictive variables, therefore other factors, not evaluated in this study, likely influence the success in pharmaceutical calculations and should be investigated to determine a more dependable set of predictors.

How-to-guide for writing multiple choice questions for the pharmacy instructor.

BACKGROUND: Writing multiple choice questions (MCQ) takes a lot of practice. Often, pharmacy practitioners lack the training to write effective MCQ. Sources for instruction in effective MCQ writing can be overwhelming with numerous suggestions of what should and should not be done. PURPOSE: The following guide is prepared to serve as a succinct reference for creation and revision of MCQ by both novice and seasoned pharmacy faculty practitioners. METHODS: The literature is summarized into 12 best practices for writing effective MCQ. Pharmacy specific examples that demonstrate violations of best practices and how they can be corrected are provided. IMPLICATIONS: The guide can serve as a primer to write new MCQ, as a reference to revise previously created questions, or as a guide to peer review of MCQ.

Student perceptions of group examinations as a method of exam review in pharmacotherapeutics.

OBJECTIVE: Evaluate student perceptions of learning outcomes, group dynamics, and team-based skill development during group-retake exams in pharmacy education. DESIGN: Group-retake examinations utilizing distributed practice were implemented in a pharmacotherapeutics course to serve as a post-individual exam review. A survey was designed to assess student perceptions of these group-retake exams. ASSESSMENT: Students perceived group-retake examinations to be beneficial in respect to retention and application of content. Peer teaching was reported to be effective and occur frequently. Minimal hostility and stress were reported. Consensus answers were reached often and this improved throughout the semester. Overall, 92% of students agreed that group-retake examinations should be continued. CONCLUSION: Group-retake examinations were perceived by students to be an effective method for exam review within pharmacy education.