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

Academic performance among pharmacy students using virtual vs. face-to-face team-based learning

INTRODUCTION

This study compares pharmacy students' performance using face-to-face (FTF) team-based learning (TBL) vs. virtual TBL across multiple courses and different academic levels while accounting for student demographic and academic factors.

METHODS

The study included pharmacy students from different academic levels (P1-P3) who were enrolled in three didactic courses taught using FTF TBL and virtual TBL. Multiple generalized linear models (GLMs) were performed to compare students' performance on individual readiness assurance tests (iRATs), team readiness assurance tests (tRATs), team application exercises (tAPPs), summative exams, and total course scores using FTF TBL vs. virtual TBL, adjusting for students' age, sex, race, and cumulative grade point average (cGPA).

RESULTS

The study involved a total of 356 pharmacy students distributed across different academic levels and learning modalities: P1 students [FTF TBL (n = 26), virtual TBL (n = 42)], P2 students [FTF TBL (n = 77), virtual TBL (n = 71)], and P3 students [FTF TBL (n = 65), virtual TBL (n = 75)]. In the P1 cohort, the virtual group had higher iRAT and tRAT scores but lower tAPP scores than the FTF TBL group, with no significant differences in summative exams or total course scores. For P2 students, the virtual TBL group had higher iRAT and tRAT scores but lower summative exam scores and total course scores than the FTF TBL group, with no significant differences in tAPP scores. In the P3 student group, the virtual TBL group had higher iRAT, tRAT, tAPP, summative exam, and total course scores than the FTF TBL group.

CONCLUSIONS

Students' performance in virtual TBL vs. FTF TBL in the pharmacy didactic curriculum varies depending on the course content, academic year, and type of assessment.

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.

The Influence of Academic Affairs on PIF

Referencing literature and professional experiences of multiple academic affairs deans in Doctor of Pharmacy degree granting programs, this commentary examines the ways offices of academic affairs (OAAs) play an integral part in the professional identity formation (PIF) of students, faculty, preceptors, and staff. The overlapping roles of academic affairs and other program and university offices are examined with a focus on approaches that impact student PIF. Although size, organizational structure, and roles or responsibilities can vary among OAAs within pharmacy education, 5 focus areas are identified as opportunities where most, if not all, OAAs can positively impact PIF for students. These 5 areas include curriculum design, delivery, and operations; leadership; professional development; student support and progression; and accreditation. OAAs can help to shape PIF within pharmacy education in a variety of ways. Identifying and reflecting upon the 5 focus areas described in this paper may help individuals within OAA units to recognize where PIF efforts may be developed, refined, or assessed within their program. By intentionally layering PIF strategies across these 5 focus areas, OAA personnel and those from other units within and outside of the university system may thoughtfully work together to develop graduates who have increased self-awareness, confidence, and the ability to lead within the profession of pharmacy.

Perceptions of Remediation Policies and Procedures in Pharmacy Education

OBJECTIVE

This study aimed to (1) explore the perceptions of current remediation processes among pharmacy program administrators and faculty, and (2) identify factors surrounding successful or unsuccessful remediation in a pharmacy program.

METHODS

This qualitative study used the following 3 stakeholder focus groups with distinct perspectives: didactic faculty, experiential faculty, and administrators. A screening survey was used to identify eligible participants, and quota sampling was used to represent various institution types and stakeholder experience. Focus groups were conducted using structured interview questions by an expert interviewer who was not part of the research team. Data were coded using the constant comparison method until consensus was achieved on the identified themes.

RESULTS

Three themes associated with remediation were identified with 12 coded categories. The codes discussed by all 3 stakeholder groups included methods to identify students who need remediation, types of remediation, remediation challenges, consequences of remediation, remediation effectiveness, and necessary improvements to the remediation process. The didactic and experiential faculty groups discussed the management of remediation plans, methods of remediation prevention, and lessons learned from remediation. The timing of remediation was discussed by didactic faculty. The experiential faculty noted the need for preceptor development to provide timely feedback and ensure successful remediation. All 3 groups mentioned having clear policies and procedures for successful remediation.

CONCLUSION

Overall, faculty and administrators had similar perceptions regarding remediation practices. The differences in concerns about remediation were most notable between the experiential and didactic faculty. While all 3 groups believed that remediation may be useful and necessary, challenges remain and monitoring is needed to determine the most effective practices, particularly in experiential education.

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.

NAPLEX Preparatory Perceptions from Recent Graduates at One College of Pharmacy

OBJECTIVES

The current study assessed how students prepared for the North American Pharmacist Licensure Examination (NAPLEX), and examined factors associated with first-time pass rates. In addition, updated information on student perceptions of several currently available NAPLEX preparation resources was collected.

METHODS

A survey was administered to 2022 graduates from 1 school, which collected data on student demographics, and NAPLEX-related items regarding when the exam was taken and how students prepared, including resources used. The association between first-time success (pass, no pass) and grade point average (GPA), timing of test date after graduation, effort toward exam, and number of hours studied was examined. In addition, student ratings of NAPLEX preparation resources in terms of usefulness, representativeness to actual examination, and monetary value were reported.

RESULTS

A total of 52 individuals completed the survey. Pharmacy GPA over 3.5, taking the NAPLEX within 60 days of graduation, and exerting moderate to extensive effort to pass the NAPLEX were all associated with higher first-time pass rates. All students reported using at least 1 RxPrep resource, which students rated highly and suggested the school provide as a resource for NAPLEX preparation.

CONCLUSION

This study found that taking the NAPLEX examination within 60 days of graduation, contributing moderate to extensive effort to pass the examination, as well as a cumulative GPA of 3.5 (out of 4) or above were related to success on the NAPLEX. Additionally, students reported high satisfaction with RxPrep resources.

Factors associated with pharmacotherapy course learning achievements in Thai pharmacy students

INTRODUCTION

The doctor of pharmacy (PharmD) program is designed for direct patient care experiences. To prepare pharmacy students to have adequate clinical knowledge and skills, pharmacotherapy is a vital course. Due to the difficulties of courses, several students had unsuccessful learning achievements and insufficient clinical skills. The objective was to explore factors associated with pharmacotherapy course learning achievements in pharmacy students.

METHODS

A cross sectional survey was designed and undertaken in 2020. Pharmacy students who enrolled at least one pharmacotherapy course were included. A 39-item questionnaire was developed and distributed electronically. Content validity and reliability tests (Cronbach's α = 0.928) were performed. Descriptive statistics and univariate and logistic regression were used in this study.

RESULTS

The results indicated that four factors were found to be associated with higher grade point average: participation in a study group (adjusted odds ratio [OR] 0.47, 95% CI 0.23-0.97) for Pharmacotherapy I; self-assessed success for Pharmacotherapy II and Advanced Pharmacotherapy (adjusted OR 2.67, 95% CI 1.19-6.01 and adjusted OR 3.45, 95% CI 1.03-11.59, respectively); using social media in the classroom (adjusted OR 12.16, 95% CI 2.03-72.72); and motivation by advisors (adjusted OR 640.74, 95% CI 2.03-201,675.55) for Pharmacotherapy III. Moreover, reviewing material after class (adjusted OR 0.27, 95% CI 0.10-0.71) and using social media in the classroom (adjusted OR 2.03, 95% CI 1.01-4.07) revealed the association with cumulative grade point average.

CONCLUSIONS

There were various factors associated with pharmacotherapy learning achievements. These included factors from learners, instructors, and environment.

Envisioning the Future of Student Success: Report of the 2022-2023 AACP Student Affairs Standing Committee

Over the past several years, traditional metrics have indicated declining student success within colleges and schools of pharmacy. Though students may be less well-prepared for professional school than in years past, once candidates are admitted to our institutions, we have a responsibility to effectively support their progression through the program. The 2022-2023 Student Affairs Committee was convened to evaluate and advance the construct of student success within Doctor of Pharmacy programs. The Student Affairs Committee was charged with identifying environmental factors affecting the ability of pharmacy students to be successful; determining how colleges and schools of pharmacy are currently meeting needs related to student progress; conducting a literature review to determine what academic support measures minimize attrition; and developing innovative suggestions and recommendations that better support student success. To accomplish this work, we conducted an extensive literature review and synthesis of evidence, engaged in professional networking across the Academy, and administered a wide-ranging student success survey to all colleges and schools of pharmacy. In this report, we explore the complex and interacting systems that affect learning behavior and academic success and offer a novel, comprehensive description of how the Academy is currently responding to challenges of academic and student success. Additionally, we envision the future of student success, offering 7 recommendations to the American Association of Colleges of Pharmacy and 5 suggestions to members of the Academy to advance this vision.

Mining for Retention Gems and Unearthing Identity and Belonging

OBJECTIVE

To determine the relationship between first-year retention and variables related to professional engagement and professional, academic, and personal identities.

METHODS

This study evaluated data from 3 cohorts of students at a private 0-6 college of pharmacy. A theoretical and conceptual framework linking professional identity and retention informed the study. Professional engagement scores from the first semester of pharmacy school served as a surrogate of professional identity. Grade point average (GPA) and traditional demographic variables (eg, gender, race/ethnicity, in-state resident) served as surrogates of academic and personal identities, respectively. Logistic regression models were used to determine the relationship between first-year retention and identity variables.

RESULTS

Belonging, a domain of professional engagement, was positively related to first-year retention. In multivariable models, belonging and cumulative GPA were associated with increased odds of retention, while in-state status was associated with decreased odds. In separate models for those with GPA ≥3.00, and<3.00, belonging was associated with first-year retention in both. Belonging was also associated with first-semester retention, but not second-semester retention.

CONCLUSION

A decision to leave a Doctor of Pharmacy program is complex, but the vast majority of the literature in pharmacy education appears to focus most intently on academic variables, including GPA. This study demonstrates that belonging, an important element in professional identity formation, remains related to first-year retention, even after controlling for grades and other personal variables. This finding unearths several theory-informed gems and strategies that educators may employ to enhance retention.

Drug Information Quizzes as Predictors of Student Success in Integrated Pharmacotherapy Courses

OBJECTIVE

To determine if drug quizzes (DQs) can serve as predictors of student success in pharmacy coursework.

METHODS

De-identified student exam and DQ data from 2 courses of the pharmacy curriculum were evaluated over 3 years. One-way analysis of variance, Spearman's rank correlation analysis, and Mann-Whitney U test were utilized to determine significant changes in student performance on exams and DQs over 3 years.

RESULTS

Over 3 years, significant changes in exam performance were accompanied by significant changes in student performance on the respective DQ. A significant positive correlation was observed between student performance on DQ and their scores on respective major examinations in 22 of 24 datasets. Finally, students failing an exam had significantly lower DQ scores compared to students passing an exam in most analyzed datasets across 3 years.

CONCLUSION

Drug quizzes can serve as a predictor of student success or failure in pharmacy courses.

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

OBJECTIVE

The purpose of this study was to describe the different strategies used to supplement North American Pharmacist Licensure Examination (NAPLEX) and Multistate Pharmacy Jurisprudence Examination (MPJE) preparation in the US pharmacy programs.

METHODS

An online survey was developed to gather information from 141 accredited schools/colleges of pharmacy about the preparation methods used during the 2021-22 academic year. The questionnaire contained 19 NAPLEX- and 10 MPJE-specific questions related to timing, content, use of commercial products and programs, faculty involvement, and whether these activities were required or recommended. Characteristics of schools/colleges were compared based on the presence or absence of preparation programs; preparation programs were descriptively reported.

RESULTS

The response rate was 71%. Most schools (87/100 respondents) provided NAPLEX preparation programs starting in the advanced pharmacy practice experiential year, required students to participate, and focused on reviewing the content instead of assessing students' examination readiness. Similar elements were reported among 61 schools providing MPJE preparation programs. Schools used a variety of resources including access to vendor-based question banks or review materials, and completing live, proctored, NAPLEX-like examinations. Characteristics of schools or colleges did not differ significantly based on presence or absence of a preparation program.

CONCLUSION

Schools/colleges of pharmacy use a variety of strategies to prepare students for licensing examinations. Many require student participation in vendor-based preparation programs for NAPLEX, and homegrown programs for MPJE preparation. The next step will be to determine the effectiveness of various approaches used by the schools/colleges on first-time licensure examination attempts.

Increasing access to the profession: Admissions lessons learned from the pandemic

INTRODUCTION

The disruptions induced by the COVID-19 pandemic have forced quick and significant changes to recruitment and admissions practices in colleges of pharmacy. This process has helped to identify barriers and challenges for prospective students. At the University of North Carolina Eshelman School of Pharmacy, some changes were already under consideration prior to the pandemic, such as moving to test-optional admissions and allowing remote interviews, while new considerations included offering the entire recruitment and admissions process remotely.

METHODS

In 2020-2021, the decision was made to move to test-optional admissions. A separate decision was made to conduct interviews remotely. Data from the admission cycle were collected from the Pharmacy College Application Service as part of the standard admissions process and exported for analysis. Descriptive statistics (mean ± SD) were used.

RESULTS

Completed applications increased by 59.1% in 2020-2021 from the previous year. Applications increased by 9.8% from underrepresented students, by 6.2% from those with a bachelor's degree, and by 8.4% by out of state students. Other admissions metrics, such as the mean grade point average (3.50) and mean Pharmacy College Admissions Test composite percentile (88%), did not change.

CONCLUSIONS

The COVID-19 pandemic experience validated our perspective that we must continue to embrace change and seize opportunities to reduce barriers for prospective students to improve access to the profession. The changes that this pandemic has necessitated may help to close the gaps in accessing health professions education.

Considerations for remediation policy and procedures in pharmacy education

INTRODUCTION

Despite the heterogeneous nature of remediation definitions, processes, and impact on learning, it is commonly understood as a process for identifying student deficiencies in knowledge, skills, and attitudes that need to be corrected prior to student progression in the program.

COMMENTARY

Current issues related to remediation in pharmacy education include inconsistencies in practices and types within and among institutions, a lack of correlation to student academic success, effects on attrition both positive (student staying on-time for graduation) and negative (students sitting back one year), increase in faculty workload, and negativity or stigma associated with the student.

IMPLICATIONS

Key considerations in developing and implementing remediation policies and procedures include being student-focused, providing a positive frame for remediation, implementing a clear process, and early identification of students who need help.

Multi-institutional Analysis of Student and Program Variables as Predictors of Performance on the NAPLEX

Objective. Understanding student characteristics and risk factors for performance on the North American Pharmacist Licensure Examination (NAPLEX) may help schools and colleges of pharmacy target limited resources. This study aimed to evaluate two sets of Doctor of Pharmacy (PharmD) student variables for their effect on NAPLEX performance.Methods. Data were collected from five schools and colleges of pharmacy over three years (2016-2018). Relationships between variables were first examined with bivariate correlations, and then by a series of multiple regressions using a structural equation modeling approach. Two sets of analyses were conducted using the outcome variable of NAPLEX scaled score. The first set examined variables at admission to the program while the second set examined performance variables during the PharmD program.Results. Students' score on the Pharmacy Curriculum Outcomes Assessment (PCOA) had the highest bivariate correlation with their NAPLEX score, with area 4 and area 2 having the strongest correlations. The correlations of Pharmacy College Admission Test (PCAT) subtest scores with NAPLEX scores were significant but smaller. Admissions variables of incoming science grade point average (GPA) and PCAT area scores were significant predictors of performance on the NAPLEX, but these variables were entered in separate models as they explained the same variance (each approximately 15%). The PCOA area scores and GPA before starting advanced pharmacy practice experiences (pre-APPE GPA) were significant predictors and explained about 25% of the variance in NAPLEX scores.Conclusion Pharmacy students' PCOA area scores and pre-APPE GPA were significant predictors of their NAPLEX scores. Information in this study can be used by pharmacy schools to efficiently target support services to students for enhanced NAPLEX performance.

A classroom-based patient case activity as a potential formative indicator of pre-advanced pharmacy practice experience readiness

BACKGROUND AND PURPOSE

Pharmacy programs must assess student readiness for advanced pharmacy practice experiences (APPEs). This study evaluated: (1) if a relationship exists between student performance on a classroom-based patient case activity (Rx Review) and (2) performance on direct patient care and perceptions of the transferability of Rx Reviews to the APPE setting.

EDUCATIONAL ACTIVITY AND SETTING

Rx Reviews are timed, independent, prospective reviews of a patient's medical record intended to simulate pre-rounding activities common in acute and ambulatory care settings. Students complete 12 Rx Reviews across a skills laboratory course sequence. Rx Review scores were compared to performance on acute care and ambulatory care APPEs for students in the Class of 2019 using descriptive statistics for student scores and bivariate logistic regression for the association between Rx Review scores and performance outcomes on patient care APPEs. Student perceptions of the Rx Reviews were assessed through a survey. Descriptive statistics and qualitative responses were used to analyze responses to the multiple-choice survey questions and open-ended question, respectively.

FINDINGS

One hundred twenty-two students participated in the study. A relationship was found between students' Rx Review scores and performance in certain direct patient care APPEs, with students performing in the bottom 50% on Rx Reviews being more likely to perform poorly on those APPEs. Over 93% of students identified Rx Reviews as at least somewhat helpful in preparing them for APPEs.

SUMMARY

This study indicated that a classroom-based patient case activity could be used as a formative measure of APPE readiness.

Performance on advanced pharmacy practice experiences after implementation of mock acute care patient simulations

INTRODUCTION

We sought to compare student performance on acute care advanced pharmacy practice experiences (APPEs) pre- and post-incorporation of mock acute care patient simulations into the curriculum.

METHODS

A series of mock acute care APPE simulations (MACAS) were developed and incorporated into Touro University California College of Pharmacy curriculum for first- and second-year pharmacy students. Results for student performance on Acute Care I and Acute Care II APPEs were collected for students who received none, one year, or two years of the MACAS. Student admission characteristics and didactic academic performance (grade point average [GPA]) were also gathered. Student characteristics and APPE performance were compared across cohorts of students who received none, one year, and two years of MACAS. Multivariate models were created to measure the impact of the MACAS while controlling for student characteristics.

RESULTS

The final cohort included 394 students. In unadjusted analyses, students with one or two years of MACAS received significantly higher preceptor acute care APPE evaluations for communication, professionalism, and patient scores vs. students who received no MACAS. In multivariate models controlling for age, gender, and undergraduate GPA, one year of MACAS increased student acute care APPE communication, professionalism, and patient care scores, relative to no MACAS. Similar increases in acute care APPE scores were seen for students who received two years of MACAS.

CONCLUSIONS

MACAs significantly improved acute care APPE scores relative to students with no MACAS. This improvement in acute care APPEs occurred after students received a single year of MACAS.

Systematic Review of Predictors of Success for the North American Pharmacist Licensure Examination

Objective. Studies have examined possible predictors of success on the North American Pharmacist Licensure Examination (NAPLEX). This systematic review investigated the literature on potential predictors of success on the NAPLEX.Findings. Articles were included in the review if they studied student characteristics and academic performance as independent variables and NAPLEX scores and/or pass rates as an outcome. Data were extracted from each article for students' demographics or variables, sample size, methods of statistical analyses, and results reporting correlation or predictability. From 40 articles retrieved from the initial search and sorting, 20 studies were included in the final review per inclusion criteria. Three studies included all the pharmacy programs, 15 were single-institution studies, two were multi-institution studies, and four had been published as posters. Among 30 different variables identified as potential predictors of success on the NAPLEX, the most examined variables were student age at matriculation, having a prior degree, Pharmacy College Admission Test (PCAT) scores, cumulative pharmacy school grade point average (GPA), overall Pharmacy Curriculum Outcomes Assessment (PCOA) scores, and PCOA content areas scores. Positively correlated factors included PCAT scores, not having a prior degree, prepharmacy and pharmacy school GPA, institutional characteristics, and PCOA scores. Negatively correlated factors included older age at admission.Summary. Cumulative pharmacy school GPA and PCOA scores were predictors of NAPLEX success consistently in the studies. The effects of preadmission student characteristics on NAPLEX success varied and were not consistently correlated or predictive.

Intervention and remediation: A descriptive study of practices in pharmacy education

INTRODUCTION

This descriptive survey study was designed to collect specific data about intervention and remediation approaches used by schools and colleges of pharmacy (S/COPs) to meet the requirements of the Accreditation Council for Pharmacy Education Standard 17.

METHODS

An electronic survey was developed and sent to all members of the American Association of Colleges of Pharmacy Curriculum and Student Services Personnel Special Interest Groups. The survey gathered details about institutional criteria and practices used in identification of students at risk of failure, steps of early intervention, and approaches to academic remediation. Descriptive data are presented.

RESULTS

About 70% of accredited S/COPs responded with a complete survey. There was no statistically significant difference between public or private institutional practices. All respondents reported remediation approaches, but only 85% had structured intervention practices. There was marked variability in reports of specific details for both intervention and remediation.

CONCLUSIONS

There is great diversity in approaches to both intervention and remediation. This study provides baseline data on which to build future research that might determine best practices to optimize student outcomes. A theoretical framework is provided.

Impact of Intersession Course Remediation on NAPLEX/PCOA Scores in an Accelerated Doctor of Pharmacy Program

Objective. To compare Pharmacy Curriculum Outcomes Assessment (PCOA) scaled scores and North American Pharmacist Licensure Examination (NAPLEX) pass rates in students who completed a two-week intersession remediation or repeated a course with the scaled scores and pass rates of students who did not require any form of didactic remediation and did not have to repeat a course. Methods. Data examined for this study included NAPLEX/PCOA scores, NAPLEX pass/fail status, and remediation history for students at one college of pharmacy. Students from the graduating classes of 2016, 2017, and 2018 were organized into four groups: non-remediation, one course remediation and no repeats, more than one course remediation and no repeats, and one or more course repeats. Differences were analyzed using linear regression, logistic regression, and Pearson correlations. Results. The PCOA scores for students in the remediation groups were significantly lower than scores for students in the non-remediation groups, with a reduction of 37.8 to 50.9 points from the expected non-remediators' score. The NAPLEX scores for students who remediated more than one course or repeated one or more courses were 16-20 points lower compared to students who did not remediate. The likelihood of a student failing the NAPLEX was also not significantly lower for students who remediated one course but was significantly lower for other remediation groups. Conclusion. Although single course remediation in this curricular model appears to have minimal impact on NAPLEX outcomes and may be an acceptable intervention for many students, additional support and interventions may be warranted for students who qualify for remediation in multiple courses and/or for repeating a course.