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Evaluating Pharmacy Curriculum Outcomes Assessment and NAPLEX Performance, Phase 1

By: Zachary Piracha, PharmD Candidate c/o 2017

BACKGROUND

The pharmacy profession is constantly fortified by an ever-evolving process by which students of pharmacy become practicing healthcare providers licensed in their respective states. The National Association of Boards of Pharmacy (NABP) carefully regulates the dissemination of tests as well as the shifting forms of administration and its arcane question writing process, which has only been reported through anecdotal recollections from professors.1,2

Indisputably, the pharmacy student is often purposely shrouded in mystery regarding their ultimate licensing exam so that they may focus instead on the didactic coursework throughout schooling.3

However, student performance relevant to the North American Pharmacist Licensure Examination (NAPLEX) should be evaluated at certain crucial gap junctions in their learning, and this is accomplished with an annual exam known as the Pharmacy Curriculum Outcomes Assessment (PCOA). This serves as a benchmark for pharmacy students in their professional years of study across the country.2,4 Scores are calculated and distributed back to students as a percentile against the rest of their year (in keeping with the same standardization they would face on the NAPLEX) including performance ratings in key categories such as medicinal chemistry, public health, and biostatistics in the score report.

Still, a true correlation between the basic science nature of the PCOA and the real-life applications employed during the NAPLEX is difficult to elucidate without a full analysis of the PCOA’s 26 subcategories and the new format for the 6 hour NAPLEX examination beginning in 2017. Our goal is to assess how effective the PCOA is at evaluating preparatory material for the NAPLEX when offered to students.3

METHODS

We wanted to determine whether or not the PCOA was helpful in gauging how well students performed on the NAPLEX. We asked 100 students in their final year of pharmacy school, who took the PCOA at least one time prior to taking NAPLEX, what their opinions of the PCOA were and how confident they felt about taking the NAPLEX. We also asked if the PCOA had given these students any insight on what to expect for the NAPLEX.

We offered all participants a chance to take a free sample simulation test geared towards the new NAPLEX format and to self-report their scores to us. Original preparatory information was provided by Jakstat Tutors LLC. The primary purpose was to elucidate a correlation between the PCOA and NAPLEX content, all while enhancing student confidence for the NAPLEX. The secondary purpose was to gauge how effective the practice material was in preparing students for the NAPLEX, which will be discussed in phase II of this trial.

RESULTS

Of the 100 students, 40% of the group scored above the 60th percentile on the PCOA and the correlation coefficient was found to be 0.7. After 12 months of follow-up, the passing rate was measured and correlated through a linear regression with PCOA scores and NAPLEX simulation exam scores. This conclusion leads us to believe that the PCOA exam, coupled with supplemental study materials, is ample for preparing most students for the NAPLEX exam.

DISCUSSION

Because there was a correlation between PCOA and NAPLEX prep scores, we rejected the null hypothesis and accepted the alternative hypothesis. The secondary endpoint measured was time to study, which was self-reported number of hours per week each student claimed they studied for school. We sorted these students into heavy and low studiers and also saw a correlation based on their simulated NAPLEX exam scores. However, self-reporting could bring about recollection bias as well as reporting bias. This was not a primary endpoint of the study and further analysis should be performed.

Although this poll is subject to the several biases stated above, this study demonstrated how assessment material such as the PCOA may be correlated with student NAPLEX readiness. This wealth of information not only puts into perspective how student outcomes may appear, but may potentially shine light on areas that need fortification. The change of the NAPLEX format introduces an uncharted area in which we cannot assess new material. However, the PCOA gives students and committee members alike the opportunity to learn and self-assess while simultaneously adjusting coursework for an always-shifting board examination.

Future studies correlating NAPLEX performance and the PCOA need to be conducted with actual NAPLEX results which this study aims to do in its subsequent phase. These phase II studies we are conducting on the same cohort will evaluate which section’s proficiency best predicts a student’s pass or fail rate on the real-time exam. Future studies need to be conducted utilizing larger populations with more emphasis on illuminating the demographics behind NAPLEX performance and whether this factor could even outweigh the significance of early PCOA returns. Lending credence to the weight of PCOA scores could offer opportunities to extrapolate data that can be used to determine a causal factor in NAPLEX pass rates.

SOURCES:

  1. How the PCOA benefits pharmacy students. n.d. http://www.pharmacytimes.com/contributor/michael-berger-pharmd-bcps/2015/11/how-the-pcoa-benefits-pharmacy-students. Accessed 12/21/2016.
  2. NAPLEX | National Association of Boards of Pharmacy | NABP. National Association of Boards of Pharmacy. N.p., n.d. Web. Accessed 12/21/2016.
  3. PCOA. National Association of Boards of Pharmacy. N.p., n.d. Web. Accessed 12/21/2016.
  4. Kahaleh, A. Pharmacy curriculum outcome assessment. American Association of Colleges of Pharmacy. Accessed 02/16/2016.
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