A Description of NAPLEX and MPJE Preparation Strategies Among US Colleges and Schools of Pharmacy

Exploring Tools to Manage Curricular Content and Overload Within the Professional PharmD Program

OBJECTIVE

Given recent discussions in the literature and across the Academy about curricular overload and calls for tools that aid in reducing content, it is important to determine what tools and resources programs are using to evaluate curricular content and how these resources are used to inform curricular change. Thus, the objective of this research project is to describe tools and resources pharmacy programs use for curricular content and change.

METHODS

A 17-item instrument was created, pilot-tested, and then distributed electronically to assessment leads at accredited pharmacy programs with multiple reminders to improve response rates. The instrument covered various tools for pharmacotherapy, foundational sciences, social and administrative sciences (SAS), and top 200/300 medications. Respondents provided information related to the study objectives, and data were analyzed descriptively.

RESULTS

With a 51% response rate, programs commonly used, and rated most helpful, the American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkit to inform curricular prioritization. Programs indicated they did not have comparable resources commonly used for determining curricular content related to foundational sciences, SAS, and top 200/300 medications.

CONCLUSIONS

Established tools, such as the ACCP Pharmacotherapy Didactic Curriculum Toolkit, are helpful in selecting curricular topics, but additional guidance is needed to optimize its usefulness in managing curricular overload. Developing toolkits for foundational sciences, SAS, and top 200/300 medications is necessary to provide similar guidance for the Academy.

Qualitative analysis of preparation and planning habits of students with low-performance on high-stakes practice examinations (pre-NAPLEX®)

OBJECTIVE

The purpose of this analysis was to identify, analyze, and report patterns (or themes) of planning and preparation considerations of students that scored less than the historic average score on the Pre-NAPLEX® exam.

METHODS

This qualitative study was a retrospective, inductive thematic analysis of de-identified semi-structured interview field notes collected from student interviews for those students that scored less than the historic average score on the Pre-NAPLEX® exam.

RESULTS

Ninety-one students were initially contacted based on their score on the Pre-NAPLEX® exam to participate in one-on-one virtual discussions (i.e., interviews) with faculty members. Fifty-two responded and participated with their responses analyzed and included in thematic categorization. Four major themes were identified during the analysis. These include 1) Organization and Messaging of NAPLEX® Preparation Efforts, 2) Time Management during Competing Obligations, 3) Test Taking Experience, and 4) Curricular Disconnect.

CONCLUSION

Student performance on the NAPLEX licensing exam is of great concern to many colleges of pharmacy. As a result, many institutions are looking at root-causes for poor performance and working to implement structural changes at their institution to address these concerns. This investigation identified four major themes surrounding the preparation and planning for the Pre-NAPLEX® for students that scored less than the historic average score on the Pre-NAPLEX®. These include 1) Organization and Messaging of NAPLEX® Preparation Efforts, 2) Time Management during Competing Obligations, 3) Test Taking Experience, and 4) Curricular Disconnect. Each of these themes provides potentially actionable items to improve how students prepare and plan for the Pre-NAPLEX®, which may be translatable to informing actions to improve results on the actual NAPLEX exam itself.

Correlating Advanced Pharmacy Practice Experience Exam Scores and Pharmacist Licensure Status in a Single Program

OBJECTIVE

Pharmacist licensure exam first-time pass rates have declined for several years. Predictors of licensure exam performance, including the Pharmacy College Admission Test, are no longer required, necessitating alternative strategies. Our aim is to assess the relationship between numerical scores on advanced pharmacy practice experience (APPE) exams and pharmacist licensure exams first-time pass rates.

METHODS

We conducted a single-center, retrospective, observational analysis. APPE examination results between May 2020 and November 2023 were analyzed for association with licensure information from the Texas State Board of Pharmacy. Exam scores were collected for student cohorts graduating from 2021 to 2022 as study cohort data. Correlation between exam scores and probability of successful licensure was assessed using logistic regression. A classification and regression tree analysis identified the most significant threshold. Predictive ability of the best-fit model was prospectively validated using the 2023 graduate cohort.

RESULTS

The overall licensure success rate was 80.6% for the study cohort (2021-2022, n = 206). Exam scores were well correlated to the likelihood of licensing success. The most significant threshold was 77.8%. The success rate was 82.5% vs 16.7% for those scoring above and below the threshold, respectively. The observed and predicted licensure success rates were 91.0% and 88.8%, respectively, in the validation cohort (2023, n = 89). The positive and negative prediction values were 94.9% and 40.0%, respectively.

CONCLUSION

The performances on APPE exams were reasonable in predicting the first-time licensure success rate for a graduating class. Our assessment appears promising as a risk-stratification tool for students in gaining successful pharmacist licensure.

A Description of Required NAPLEX Preparation Courses Among US Pharmacy Programs

OBJECTIVE

One of the final tasks for pharmacy graduates to enter practice is passing the North American Pharmacist Licensure Examination (NAPLEX). Given the recent national declines in pass rates, programs are making significant investments of time and money in NAPLEX preparation. The objective is to characterize the structure and content of required NAPLEX preparation courses.

METHODS

A survey on NAPLEX preparation practices was developed and distributed to all Accreditation Council for Pharmacy Education-accredited pharmacy schools. NAPLEX preparation course syllabi were also collected as part of this survey. Syllabus information was summarized into 4 elements: course structure, content, resources, and assessment strategies.

RESULTS

Of 144 colleges/schools of pharmacy, 100 responded to the survey, 87 reported having a NAPLEX preparation program, and 47 reported having a NAPLEX preparation course. Twenty syllabi were collected. Most courses (14) were longitudinal through the Advanced Pharmacy Practice Experiences year, 16 were credit-bearing, and 19 included a vendor NAPLEX preparatory product. Fourteen courses were hybrid delivery, and 12 focused on licensure preparation and included test-taking strategies, calculations practice, case-based discussions, etc. All 20 courses reported using unproctored timed quizzes and practice examinations, half conducted proctored timed assessments, and 11 included written reflections and/or continuous professional development activities. Most courses were pass/fail (15), and high stakes (16) were defined by delayed or withheld graduation as a consequence for failure. Only 3 of 20 NAPLEX preparation courses were mapped to NAPLEX competencies.

CONCLUSION

Although required NAPLEX preparation courses focus on assessments, the content is infrequently mapped to NAPLEX competencies. This project provides some information on how schools might create their own NAPLEX preparatory courses.