Examining the relationship between prerequisite grades and types of academic performance in pharmacy school

The Association between Academic Performance and Entry-to-Practice Milestones within a Co-Operative Education PharmD Program

Research on associations between student performance in pharmacy programs and entry-to-practice milestones has been limited in Canada and in programs using a co-operative (co-op) education model. Co-op exposes students to a variety of opportunities both within direct patient care roles and in non-traditional roles for pharmacists, such as policy, advocacy, insurance, research, and the pharmaceutical industry. The purpose of this research is to analyze associations between student grades and evaluations achieved in the University of Waterloo (UW) Doctor of Pharmacy (PharmD) co-op program and success rates on entry-to-practice milestones, including the Pharmacy Examining Board of Canada (PEBC) Pharmacist Qualifying Examination and performance on final-year clinical rotations. Grades and evaluations from courses, co-op work terms, clinical rotations, and PEBC exam data from three graduating cohorts were obtained. A multiple regression analysis was performed to explore associations between student evaluations and PEBC Pharmacist Qualifying Examination and clinical rotation performance. Holding all other variables constant, grades in anatomy/physiology were negatively correlated with scores on the PEBC Pharmacist Qualifying Examination, while grades in one of the professional practice courses showed a positive relationship with the same examination. Students with higher grades in a problem-based learning capstone therapeutics course, in their first co-op work term, and in the direct patient care co-op work term tended to score higher on clinical rotations. Co-op performance was not significant in predicting PEBC performance. However, complimentary descriptive analysis underscored that students with a co-op rating of good or below were more likely to fail courses, midpoint evaluations, Objective Structured Clinical Examinations (OSCEs), and PEBC measures. Multiple predictors of performance on final-year clinical rotations and the PEBC Pharmacist Qualifying Examination were identified. This predictive model may be utilized to identify students at risk of underperforming and to facilitate early intervention and remediation programs, while also informing curricular revision.

Design and Evaluation of an APPE Readiness Dashboard Tool

OBJECTIVE

To describe the design and evaluation of a dashboard tool to assess the readiness for advanced pharmacy practice experiences (APPEs).

METHODS

The investigators developed a dashboard tool for the appraisal of APPE readiness consisting of indicators of pharmacy student knowledge, skills, and noncognitive attributes. For the 2018-2019 and 2019-2020 rotation years, a panel of stakeholders used the dashboard to evaluate APPE readiness. Students deemed not ready (5 or more dashboard indicators) had a remediation experience before the APPEs. The investigators monitored the students who were deemed ready but at risk for substandard performance (3 or 4 indicators or completion of remediation experience) and tracked the incidence of substandard performance for all APPE students. The outcomes were presented using descriptive statistics. Performance of the tool between years was compared using the χ2 test.

RESULTS

For 2 APPE rotation cycles, the investigators evaluated readiness in 499 students. A total of 3 students were deemed not ready, and 78 students were considered at risk for substandard performance. The tool predicted 52.1% of students who experienced a substandard performance. It had a negative predictive value of 93.6% and a positive predictive value of 38.5% for substandard performance. The predictive value was similar across the risk categories of knowledge, skills, and noncognitive attributes.

CONCLUSION

A dashboard tool facilitating holistic evaluation of APPE readiness was helpful in identifying students who were not ready for APPEs or at risk for substandard performance. The next steps include refinement of the tool through the evaluation of characteristics of students who experienced substandard performance and were not identified by the tool.

Pharmacy undergraduate programs: Development of an adaptive curriculum for student success

Objectives

Applicants for graduate work in Pharmacy on paper appear competitive, but upon entering a Doctor of Pharmacy (PharmD) program many students struggle with course work, course load, and pharmacologic topics in their first-year studies. In addition to math and science, undergraduate candidates need to have skills that enable them to be adaptable and creative learners. The Pharmacy Undergraduate Program (PUP) at the University of Southern California (USC) has been attentive to these educational needs. In this manuscript we will show how our program has been successful in generating well-prepared and successful candidates for graduate programs (pharmaceutical, clinical, medical, and other) and employment in pharmaceutical fields.

Methods

A review of current student enrollments (N = 121), graduated student annual survey data (N = 50), student research data (N = 68), and ongoing course surveys have been used to detail information related to PUP.

Results

Students who have graduated from PUP have been successful post-graduation. Graduates of PUP have gone on to PharmD programs 44% (22/50); medical school 16% (8/50); PhD programs 24% (12/50); full-time employment 6% (3/50); internship/volunteer positions 10% (5/50); taken a gap year 4% (2/50); and MS/MA program 2% (1/50).

Conclusions

PUP has been successful in helping the admission of our students into graduate degree programs related to pharmaceutical sciences and medicine. This success can be attributed to the dynamic nature of the course offerings and the creativity of the teaching faculty, which leads to students being well-prepared to tackle the rigors of their graduate studies after leaving the program.

Content, costs, and characteristics of United States prepharmacy curricula

INTRODUCTION

The objective of this study was to examine pharmacy prerequisites and estimate the costs prospective students may incur to complete those requirements.

METHODS

Prepharmacy requirements for doctor of pharmacy (PharmD) degree programs in the United States (US) (n = 137) were sourced from school websites in 2018. Credit hour costs for community colleges, public four-year institutions, and private four-year institutions were collected. Chi-square and independent t-tests compared group differences.

RESULTS

Schools required 66.12 ± 8.15 prerequisite credit hours (range 41 to 91  hours). All schools required one course in general chemistry and organic chemistry. A higher proportion of schools in 2018 required anatomy/physiology and statistics when compared to 2009. Estimated costs to complete prerequisites ranged from US $16,359 at a community college to US $187,800 for a bachelor's degree at a private institution.

CONCLUSIONS

Trends in healthcare and education make it timely for schools to reconsider prerequisites. Renewed consideration should be given to identifying what is core to the profession and the minimum competencies students must demonstrate for entry into PharmD programs.

Developing a Framework of Relationships Among Noncognitive Factors in Doctor of Pharmacy Students' Academic Performance

Objective. To develop a framework of the effects of select noncognitive factors (grit, perceived stress, internal locus of control, and select Big Five personality traits) on pharmacy students' academic performance.Methods. A survey measuring select noncognitive factors was administered to two cohorts of first professional year (P1) pharmacy students (entering classes of 2019 and 2020, n=374) during fall orientation. Demographics, pre-pharmacy GPA, and P1 fall semester GPA were collected from student records. Structural equation modeling was conducted to assess the proposed framework.Results. Academic performance was directly influenced by students' (n=367; 98.1%) perceived stress and neuroticism and indirectly influenced by internal locus of control and neuroticism (via perceived stress as mediator). Neuroticism has a complex relationship in the models as it was directly and positively associated with academic performance, and indirectly contributed to decreased academic performance via a positive association with perceived stress. Squared multiple correlations indicated 13% and 9% of the variance in academic performance in the first final model (academic performance measured by pre-pharmacy GPA and P1 fall GPA) and second final model (academic performance measured by P1 fall GPA), respectively, were explained by the predictor variables.Conclusion. Evidence provided by structural equation modeling supports the conclusion that select noncognitive factors, namely perceived stress, neuroticism, and internal locus of control, have direct and indirect effects on the academic success of P1 students. The model variances of 9% and 13% represent 36% to 52% of the predictive value of the most accepted cognitive measures used to determine students' potential for academic success.

Resilience and First-Year Pharmacy Students' Academic Performance in a Pharmacy Math Course

Objective. The purpose of this study was to examine the relationship between academic resilience and academic success in Doctor of Pharmacy (PharmD) students.Methods. A cross-sectional survey using the Academic Pharmacy Resilience Scale (APRS-16) was conducted in two cohorts of first year pharmacy (P1) students (n = 374) during fall orientation in 2019 and 2020. The following data were also collected from student records: demographics, pre-pharmacy grade point average (GPA), Pharmacy Math outcome (passing or failing the course), and Pharmacy Math final numerical grade. Academic success was defined as achieving a passing grade in a Pharmacy Math course. Correlational, multiple logistic regression, and multiple linear regression analysis were conducted.Results. The survey response rate was 98.1%, and approximately 95% of participants passed Pharmacy Math. No significant correlations were found between Pharmacy Math final pass/fail outcome or Pharmacy Math final numerical grade and APRS-16 overall and subscale scores. In multiple logistic regression, neither pre-pharmacy GPA nor APRS overall scale or subscale scores were significantly associated with final Pharmacy Math outcome (passing/failing). In multiple linear regression, pre-pharmacy GPA was significantly associated with Pharmacy Math final numerical grade, but APRS-16 overall score and subscale scores were not.Conclusion. First-year pharmacy students' performance in Pharmacy Math was not influenced by academic resilience. Studies like this one examining the relationship between pharmacy students' resilience and academic performance are lacking. Future studies should assess whether academic resilience may affect performance in other courses as well as performance in the PharmD curriculum.

Online interviews for the selection of applicants for admission into an entry to practice program in pharmacy: Relationship to performance and student perspectives

INTRODUCTION

Admissions processes for entry-to-practice pharmacy programs across North America vary in the types of information used to decide which students to admit. The use of online interviews emerged at our program as an option to assess basic communication skills and personal traits to supplement traditional achievement measures such as prerequisite course grade point average (GPA) and admissions letters.

METHODS

Student cumulative grade, year-by-year grade, and some grades from selected classes were correlated with the interview score for three years of consecutive cohorts. Linear regression was used to explore relationships. A survey was completed by students to understand their views on the use of the online interview process.

RESULTS

There was no relationship seen between the compiled GPA and the interview score. The survey data revealed a strong preference for online compared to face-to-face interviews, with high student agreement that the interviews provide a good opportunity to demonstrate general communication skills. An assessment of the strength of the relationships of interview scores with a set of program GPA outcomes showed limited predictive utility. Scores weakly correlated with performance in communications and skills courses.

CONCLUSIONS

Online interviews were preferred over in-person interviews by most students. The lack of strong significant correlations between interview scores and grades suggests that use be judiciously applied in the overall admissions decision-making process.

Examination of the Relationship between Health-related Quality of Life and Academic Performance Among Student Pharmacists

INTRODUCTION

First-year student pharmacists (P1s) may experience a number of stressors that may affect academic performance due to the transition into a professional program. Study objectives were to evaluate student demographic and pre-pharmacy factors associated with perceived stress among P1s, analyze relative change in perceived stress over the P1 year, and assess associations between perceived stress and academic performance.

METHODS

The Perceived Stress Scale (PSS-10) was administered three times to P1s: during orientation, midpoint of fall semester, and midpoint of spring semester. Data were also collected using school records, including demographics, P1 fall grade point average (GPA), P1 spring GPA, and P1 year GPA. Paired-sample t-tests, independent samples t-tests, Analysis of Variance, correlational analysis, and multiple linear regression were conducted.

RESULTS

Of 202 P1s, 201 (99.5%) completed the orientation survey administration and 110 (54.5%) completed all three administrations. PSS-10 score significantly increased across survey administrations. Differences in PSS-10 scores at orientation were noted based on gender and race/ethnicity (P < .05), with female and minority students experiencing greater levels of stress. PSS-10 score (spring administration) was significantly, inversely correlated to P1 fall GPA, spring GPA, and year GPA (P < .05). Undergraduate science GPA, PSS-10 score (orientation administration), and age were included in the final version of the regression model as significant predictors of P1 year GPA.

CONCLUSIONS

Perceived stress increased over the P1 year, and higher perceived stress was associated with lower P1 academic performance. Future studies should examine strategies to assist P1s in managing stress.

Factors Associated with Student Pharmacists' Academic Progression and Performance on the National Licensure Examination

Objective. To examine predictors of Doctor of Pharmacy (PharmD) students' on-time graduation, dismissal from pharmacy school, and scores on their first attempt at taking the North American Pharmacist Licensure Examination (NAPLEX). Methods. A retrospective review of student records for the graduating classes of 2015-2018 at a college of pharmacy was performed. Data on the following were collected: student demographics/characteristics (age, gender, race/ethnicity, financial need), having an undergraduate degree, undergraduate science grade point average (GPA), Pharmacy College Admission Test composite score percentile, pharmacy school GPAs for the didactic portion of the curriculum, Pre-NAPLEX score, on-time graduation from pharmacy school, dismissal from pharmacy school, and outcome (pass/fail) of first-attempt at taking the NAPLEX. Binary logistic regression analysis was conducted. Results. Of the 657 students whose records were included in the study, the majority were female (60%) and non-Hispanic white (70%). Higher first-year GPA was associated with increased likelihood of on-time graduation, while increased age and having an undergraduate degree were associated with a decreased likelihood of on-time graduation. A higher first-year GPA was associated with decreased likelihood of being dismissed from pharmacy school. Appearing before the Academic Standing and Promotion Review Committee for unsatisfactory academic performance was associated with decreased likelihood of passing the NAPLEX. Conclusion. First-year pharmacy school GPA is a critical predictor for student pharmacists in terms of on-time graduation and dismissal, and may have consequences for later NAPLEX outcome. Pharmacy schools should closely monitor students' performance during the first year and provide support to students experiencing academic difficulties.