Association Between Accreditation Era, North American Pharmacist Licensure Examination Testing Changes, and First-Time Pass Rates

Evolving Standards: An Examination of NAPLEX Blueprint Changes and Implications for the Academy

OBJECTIVE

To examine changes in the North American Pharmacist Licensure Examination (NAPLEX) blueprint from 2007 to 2025 and identify trends in the blueprint competencies and their alignment with curricular standards.

METHODS

Members of the research team created a crosswalk using the 2025 NAPLEX blueprint as the reference year, to which they mapped the 2007, 2016, and 2021 blueprints. The crosswalk was distributed to several other assessment and curriculum colleagues at various institutions, public and private, for iterative review and revision until consensus was reached. The same process was used to map the 2025 blueprint to Curriculum Outcomes and Entrustable Professional Activities 2023.

RESULTS

New NAPLEX subdomains in 2025 include immunization, ethics, and mentorship/preceptorship. Notable differences in blueprints include structural changes in content moving from separately identifiable areas (ie, math and compounding) and into a collective domain with other content and reducing formulation-related content while increasing clinical content. The latter aligns with a substantial amount of content mapping to the "provider" and "problem-solver" curricular outcomes and the clinical sciences, particularly, medication use processes, area of Accreditation Council for Pharmacy Education Standards 2025 Appendix 1.

CONCLUSION

The 2025 NAPLEX blueprint resembles a shift toward clinical content in comparison to previous blueprints. Curricular outcomes related to solving problems; providing whole person care; and stewardship of medication systems for prescribing, order processing, dispensing, administration, and effects monitoring align with the new NAPLEX blueprint.

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.

Student pharmacists' perceptions of a NAPLEX preparation module in the pharmacy curriculum at one United States college of pharmacy

BACKGROUND AND PURPOSE

To investigate final-year student pharmacists' experiences of a new module for North American Pharmacist Licensure Examination® (NAPLEX®) preparation at one college of pharmacy in the United States.

EDUCATIONAL ACTIVITY AND SETTING

All student pharmacists enrolled in a new Spring 2023 module for NAPLEX preparation (n = 118) were invited to complete an electronic questionnaire and participate in a semi-structured interview. The questionnaire investigated the perceived helpfulness, grading, importance, prioritization, structure, and timing of the module in the curriculum, as well as assignment choices, confidence building, and time management using a six-point Likert scale. Semi-structured interviews investigated experiences with NAPLEX modules, time management, and course format. Questionnaire data were descriptively analyzed; interview data were thematically analyzed.

FINDINGS

Forty-one completed questionnaires and seven interviews were analyzed. Median scores for questionnaire items were six (denoting strongly agree) for three items, five (denoting agree) for seven items, and four (denoting somewhat agree) for two items. Twenty-three (56%) students desired an online self-directed (asynchronous) course structure. Seventeen (42%) students desired a mixture of short and long course assignments with a greater proportion of short course assignments while another 17 (42%) desired only short course assignments. Two themes were constructed from interviews: timing (when to study for NAPLEX) and structure (how to study for NAPLEX).

SUMMARY

Study findings indicated typically positive perceptions of a module for NAPLEX preparation among final-year student pharmacists at a college of pharmacy in the United States. Recommendations from students can be used to improve the module in future years.