North American Pharmacist Licensure Examination Research Articles

Correlation of P3 PCOA scores with future NAPLEX scores

ObjectiveTo determine whether a correlation exists between third-year professional (P3) Doctor of Pharmacy (PharmD) students’ Pharmacy Curriculum Outcomes Assessment (PCOA) scores and their future National Association of Boards of Pharmacy (NABP) North American Pharmacist Licensure Examination (NAPLEX) scores. MethodsIn 2009 and 2010, the PCOA was administered to P3 pharmacy students at North Dakota State University (NDSU). Students subsequently took the NAPLEX the following year and released their scores to the school. Parametric analysis of variance and Kruskal–Wallis tests were used to assess mean differences in PCOA scaled scores (total and subtopic domain) and NAPLEX scaled scores (total and by competency area). Pearson and Spearman analyses were used to assess the magnitude of the correlations between the PCOA and NAPLEX scores. ResultsPearson correlations indicated that the PCOA total and all four subtopic domain scaled scores were significantly correlated with all NAPLEX scores (total and competency areas) with one exception. The PCOA social, behavioral, and administrative subtopic domain score was not significantly correlated with NAPLEX Competency Area 2. ConclusionNDSU pharmacy students in their P3 year who scored higher on the PCOA exam were more likely to score higher on the future NAPLEX exam. Students may be able to use formative assessment data from the PCOA to correct any possible deficiencies prior to taking the NAPLEX.

Implementation of a Communication Skills Laboratory

ObjectivesTo describe a Communication Skills Laboratory and assess student performance, ability to meet North American Pharmacist Licensure Examination (NAPLEX) blueprint competency statements, and student confidence in communication-related patient care activities. DesignEssential elements of pharmacist communication, Counseling, Drug Information, and Written Documentation, were incorporated into a Communication Lab. Student performance was assessed using grading rubrics and scores. A student survey assessed how effectively the curricula met the NAPLEX blueprint objectives and perceptions of confidence in performing communication tasks. AssessmentPerformance, assessed via student grades, improved significantly in the three main activities of the lab (p < 0.001, p < 0.001, and p < 0.001). Pre- and post-laboratory surveys were completed by 89% and 87% of students, respectively. Student’s mean scores assessing the curriculum’s ability to meet NAPLEX competencies increased significantly from 3.40 to 3.80. Mean score in confidence rating increased significantly from 2.83 to 3.75. ConclusionA Communication Skills Laboratory improved student performance, met NAPLEX competencies, and increased self-rating in confidence in patient care activities involving communication.

Implementation of an Integrated Longitudinal Curricular Activity for Graduating Pharmacy Students

To evaluate whether a novel integrated longitudinal curricular activity to prepare graduating doctor of pharmacy (PharmD) students for 2 comprehensive examinations was successful, and to assess whether it engaged other pharmacy students in curricular discussion and learning. Thirty-eight of 91graduating third-year (P3) students in a PharmD program formed 11 teams to create and present pharmacotherapeutic posters to their peers. The impact of the novel activity on graduating students' performance on the North American Pharmacist Licensure Examination (NAPLEX) and a comprehensive commercial examination was assessed. All first-year (P1), second-year (P2), and P3 students reviewed and discussed the content of each poster. Participants in the integrated longitudinal curricular activity performed better than nonparticipants on the commercial examination (p=0.023) and NAPLEX (p=0.033). However, regardless of participation, commercial examination scores predicted a significant amount of variance (ie, 34%) in NAPLEX scores. The P3 participants (83%) believed the curricular activity assisted them in their NAPLEX preparation, while 75% of P1 students, 79% of P2 students, and 80% of P3 students agreed that poster review provided an effective summary of different disease states. Ninety percent of faculty poster evaluators reported that the posters were professional, and all evaluators agreed that participants effectively conveyed their message to the intended audience. The integrated longitudinal curricular activity provided a positive learning environment for all pharmacy students and may have better prepared graduating students' for the NAPLEX.

Use of Preadmission Criteria and Performance in the Doctor of Pharmacy Program to Predict Success on the North American Pharmacists Licensure Examination

To determine which student characteristics and performance criteria in the prepharmacy and doctor of pharmacy (PharmD) program predict success on the North American Pharmacist Licensure Examination (NAPLEX). Transcripts and NAPLEX scores were reviewed for 432 graduates from the Xavier University of Louisiana College of Pharmacy between 2008 and 2011. The preadmission variables that correlated with NAPLEX scores included math-science grade point average (GPA), cumulative GPA, student type (internal or transfer), and having no unsatisfactory grades (p<0.001). In the PharmD program, cumulative GPA, on-time graduation, and having no unsatisfactory grades in the prepharmacy and PharmD programs correlated with NAPLEX scores (p<0.001). Having no unsatisfactory grades in the prepharmacy program and a high cumulative GPA in the PharmD program were identified as significant predictors of success on the NAPLEX.

Revising senior pharmacy grand rounds to incorporate longitudinal board review to prepare students for licensing examination

Little is known about the content of senior grand rounds (GR) or senior seminars frequently taught as a component of the Doctor of Pharmacy curriculum. Colleges and schools of pharmacy use GR to educate senior pharmacy students, showcase role models, and promote collegiality. In the past, GR at the Arnold and Marie Schwartz College of Pharmacy and Health Sciences were designed similarly and had vague overall objectives. We redesigned our GR with a focused goal to guide and prepare our graduates for licensing examination (the North American Pharmacist Licensure Examination (NAPLEX)). To assist with reaching this goal, we incorporated disease state reviews, case-based discussions, and questions designed similarly to the NAPLEX format. During the senior year, five GR sessions were conducted with our graduating class of 182 students. Each session focused on major disease state reviews, with an active-learning discussion incorporating profile-based cases and questions that students answered using audience response systems (ARS). A cumulative examination was administered during the last GR session. A survey examining student perceptions of their learning and value of GR was also conducted. Majority of students enjoyed the new pedagogical approach used in GR, and 65% felt that GR contributed to their confidence in being prepared for pharmacy licensing examination. Conclusion: we describe a new approach to senior GR in a large College of Pharmacy with a focus on preparing students for licensing examination. Student survey revealed that the students had favorable views on this revised approach to conducting GR.

Pharmacists’ Expectations for Entry-level Practitioner Competency

Objective. To determine if defined subgroups of pharmacists' have variability in their expectations for competency of entry-level practitioners.Methods. Rating scale data collected from the 2009 National Pharmacy Practice Survey were analyzed to determine to what extent pharmacists' degree, practice setting, and experience as a preceptor were associated with the ratings they assigned to 43 competency statements for entry-level practitioners. The competency statements determine the content on the North American Pharmacist Licensure Examination (NAPLEX).Results. Pharmacists with a doctor of pharmacy (PharmD) degree rated the co mpetency statements higher in terms of criticality to entry-level practice than did those with a bachelor of science (BS) degree (p< 0.05). Pharmacists working in inpatient settings gave slightly higher ratings to the competency statements than did pharmacists working in outpatient settings, pharmacists without direct patient care responsibilities, and those in academia. However, there were no significant differences among practitioner subgroups' criticality ratings with regard to practice setting. Preceptor pharmacists' criticality ratings of the competency statements were not significantly different from those of non-preceptor practitioners. Conclusion. Pharmacists exhibited a fair amount of agreement in their expectations for the competence of entry-level practitioners independent of their practice sites and professional roles. As the pharmacy profession embraces patient-centered clinical practice, evaluating practicing pharmacists' expectations for entry-level practitioners will provide useful information to the practitioners and academicians involved in training future pharmacists. Stakeholders in pharmacy education and regulation have vested interests in the alignment of the education of future practitioners with the needs of the profession.

The Impact of Pharmacy Students’ Remediation Status on NAPLEX First-Time Pass Rates

To determine whether there is a difference in pass rates on the North American Pharmacist Licensure Examination (NAPLEX) between students who did and did not require remediation for deficient course grades. Student-specific data were collected regarding course grade deficiencies and completion of a comprehensive examination or course for remediation. Student-specific first-time NAPLEX performance data for the graduating classes of 2008, 2009, and 2011were provided by the National Association of Boards of Pharmacy (NABP). A significant difference was found in first-time NAPLEX mean pass rates between students who did not need to undergo remediation versus those who did ( 97% vs 70%). Students requiring remediation for deficient course grades had a lower pass rate on the NAPLEX compared with those who did not require remediation. The difference can be attributed to several factors and therefore further study is needed.

Assessing quality in pharmacy education in an era of rapid expansion

To describe measures used to evaluate the quality of U.S. pharmacy graduates in an era of rapid increases in the number of pharmacy colleges and schools (CS) and students and to assess if the expansion has influenced such measures. United States. Institutional research used by CS and the pharmacy accrediting organization in evaluating the knowledge, skills, and abilities of pharmacy graduates. Scores on the North American Pharmacist Licensure Examination (NAPLEX) and survey data from CS graduates, faculty, and preceptors. Mean first-time NAPLEX pass rates over time are comparable for older and newer CS and for main versus branch campuses. Graduates, faculty, and preceptor survey results affirm that faculty, preceptors, and students perceive the quality of pharmacy education to be very high. The increase in pharmacy programs and graduates has not thus far affected educational quality based on available objective and subjective measures.

CPE monitor replaces ACPE paper statements of credit in 2012

CPE monitor replaces ACPE paper statements of credit in 2012

Pharmacist Licensure: Time to Step It Up?

Pharmacist Licensure: Time to Step It Up?

Conceptual framework for pharmacists’ professional development: Implications for future planning

Evolving change in the scope of practice of pharmacists1 and the profession’s envisioned future for pharmacy practice2 should prompt serious consideration of the approach to ensuring competence and professional development of pharmacists. This notion is supported by the mission and outcomes of contemporary pharmacy education,3–5 current accreditation standards and guidelines for the Doctor of Pharmacy degree,6 new blueprint for the North American Pharmacist Licensure Examination,7 new accreditation standards for continuing pharmacy education (CPE),8 core competencies for health professionals advocated by the Institute of Medicine (IOM),9 and emerging views of an expanded role of postgraduate pharmacist training and specialist certification.10,11 Meeting the future professional development needs of pharmacists will require a transition from today’s continuing education framework to a process that effectively accomplishes continuing professional development (CPD). The authors of this viewpoint article contend that a professional credentialing framework organized across the three domains of contemporary pharmacy practice can serve as a roadmap that is in alignment with societal need for the professional development of future pharmacists. In addition, using such a framework to help articulate, document, and ensure competence is a critical step in establishing the pharmacist’s professional credibility with other health professionals.

The Addicts Among Us

A study conducted in 2001-2002 in the United States estimated the lifetime prevalence of alcohol dependence (alcoholism) and of drug dependency (addiction) to be 12.5% and 2.6%, respectively.1,2 This suggests that at least 1 in 8 individuals will have a problem with alcoholism or addiction. Knowledge of the pharmacology of addicting substances might suggest that health professionals are at reduced risk for developing addictions, yet studies investigating health professional addiction, including pharmacists and student pharmacists, suggests no such protective effect. Some even suggest a higher prevalence of addictive disease in health professionals. Although we would hope that student pharmacists are not using recreational drugs, studies that we and others have conducted between 1984 and 1999 show substantial past-year self-reports of recreational use among student pharmacists, including use of marijuana (5.9% - 28%), amphetamines (1.2% - 6.8%), cocaine (0.5% - 13%), sedatives (3% - 9%) and opioids (0.7% - 5.1%).3-6 While these are very wide ranges and report recreational use rather than dependence, they nonetheless indicate that there are probably students in each of our colleges who are abusing substances recreationally while enrolled. What are you doing at your college to prevent substance abuse, to encourage those with substance abuse and dependence problems to obtain timely and appropriate assistance, and to educate the profession to appropriately and professionally deal with addicted and recovering patients and colleagues? Patient (including medication) safety is an urgent concern to health professionals. Do you have a functional and effective substance use disorder assistance policy? Do your PharmD graduates have a sufficient understanding of the psychological and social aspects of addiction, its treatment, and recovery support to provide appropriate care to those roughly 1 in 8 patients who will have a problem with addiction or alcoholism at some time during their life? I have appointed a Substance Abuse and Pharmacy Education Special Committee chaired by Dr. Paul Jungnickel from Auburn University. The Committee met in early October to begin to address the substance abuse needs of colleges of pharmacy. Among the tasks related to substance abuse identified and currently being addressed by the Committee are: (1) documentation of the impact of substance abuse on the practice of pharmacy; (2) potential revision of the Association's guidelines for the development of psychoactive substance use disorder policies for colleges of pharmacy and encouragement of the adoption of policies based on these guidelines7; (3) core curricular content, as well as educational needs, resources, and processes related to substance abuse; (4) education of faculty members and pharmacists; (5) ways to encourage all colleges of pharmacy to annually have student pharmacists and faculty members attend the University of Utah School on Alcoholism and Other Drug Dependencies Pharmacy Section; (6) examining Center for the Advancement of Pharmaceutical Education (CAPE) public health competencies that may be related to substance abuse; and (7) examining the possibility of inclusion of substance abuse related items on the North American Pharmacist Licensure Examination (NAPLEX). I anticipate that the committee will provide your college with resources that can assist you in your prevention, assistance, and educational efforts. As you move forward with your curricular modifications, I encourage you to anticipate the inclusion of resources to adequately prepare student pharmacists and graduates to provide appropriate care to “the addicts among us.”

The NAPLEX: Evolution, Purpose, Scope, and Educational Implications

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete.

Preadmission predictors of PharmD graduates' performance on the NAPLEX.

To identify prepharmacy variables that predicted graduate performance on the North American Pharmacist Licensure Examination (NAPLEX) test. Undergraduate and pharmacy school transcripts for 424 students admitted to the Texas Tech University Health Sciences Center (TTUHSC) Doctor of Pharmacy program from the fall of 1996 to the fall of 2001 were reviewed. NAPLEX scores were provided by the Texas State Board of Pharmacy (TSBP). Statistical analyses were performed using SPSS, 11.5. Grade point average, composite Pharmacy College Admission Test (PCAT) score, and California Critical Thinking Skills Test (CCTST) score were each positively correlated with NAPLEX score (p < 0.001 for each). Type of school where organic chemistry was completed; age; advanced courses taken in chemistry, biology, and math; and attainment of a BS, BA, or MS degree were not significantly correlated with NAPLEX score (p > 0.05). When comparing students who successfully graduated and passed the NAPLEX with students who were academically suspended or who failed the NAPLEX, there were significant differences in mean PCAT scores, CCTST score, and age (p < 0.05 for all). Stepwise regression analysis applying all admission variables except PCAT subscores revealed a correlation between predictors (composite PCAT, prepharmacy GPA, and age) and NAPLEX score (p < 0.001). Composite PCAT score was the strongest predictor of success and failure on the NAPLEX. However, the combined predictive ability of PCAT and CCTST scores, prepharmacy GPA, and age was relatively low. Thus, a full review of each candidate's application is justified.

Letters

Letters

Addressing the pharmacist shortage through a cooperative internship program for foreign pharmacy graduates

ObjectiveTo describe the Latin American Pharmacist Internship Program, a pilot project to prepare foreign-trained pharmacists for pharmacy licensure in the United States. SettingTwo schools of pharmacy (located in Arequipa, Perú, and Boston, Mass.) and a chain pharmacy in the Greater Boston area. Practice descriptionDidactic/experiential pharmacy completion program. Practice innovation/interventionsThree distinct phases combining didactic courses delivered at two schools of pharmacy with supervised experiential training in a community pharmacy setting. Main outcome measureCompletion of the program requirements for licensure in the United States within 1year by 15 licensed Peruvian pharmacists who participated in a pilot project. ResultsAs of June 30, 2006, nine interns from the original group had received a pharmacy license in the United States and one was awaiting results of the North American Pharmacist Licensure Examination. Three returned to Perú, and two continued to work as pharmacy interns while working toward completion of the requirementsfor licensure. ConclusionFor the Latin American Pharmacist Internship Program to be successful, these results show that the following components should be incorporated: (1) admission criteria should include a Test of English as a Foreign Language score of 550 or more and a Test of Spoken English score of 50 or more (or the equivalent Internet-based Test scores required by National Association of Boards of Pharmacy), (2) admission should be open to all qualified candidates from around the world, (3) the program’s timeline for completion should be extended to 18months, (4) interns should receive more instruction in assertiveness and U.S. employment practices, and (5) preceptors should receive additional training in culturally sensitive supervisory techniques.

Nonpresciption Medicines and the North American Pharmacist Licensure Examination

The North American Pharmacist Licensure Examination (NAPLEX) is currently used by all 50 state boards of pharmacy to aid in determining whether a candidate for licensure possesses the minimal knowledge and skills required to safely and effectively practice pharmacy. The blueprint for this examination periodically undergoes revision so that it remains current with the demands and trends of modern-day pharmacy practice. During the most recent revision, which occurred between 2002 and 2004, several substantial content changes were incorporated. One of the most notable changes was the elimination of any distinction of importance between prescription and nonprescription medications. This change was in response to several factors, including the growing variety of conditions for which nonprescription medications are available and the recent switching of several pharmaceutical products from prescription-only to nonprescription status. The previous example is indicative of how the practice of pharmacy is continually evolving and the need for periodic changes to the examination used in the licensure process. As such, the NAPLEX blueprint is continually reviewed and revised to ensure it includes the most current knowledge and skills required of entry-level practitioners.

Development of an Instrument to Measure Professionalism

To develop and validate an instrument that measures professionalism among pharmacy students and recent graduates. A pharmacy professionalism survey instrument developed by a focus group was pretested and then administered to all first-year pharmacy students enrolled in the University of Georgia College of Pharmacy and to recent pharmacy graduates who were taking the preparation course for the Georgia Pharmacy Law Examination and North American Pharmacist Licensure Examination. Participants were asked to indicate the extent to which they agreed or disagreed with each of 32 items using a 5-point Likert scale. One hundred thirty first-year pharmacy students and 101 pharmacy graduates participated in the survey. Statistical analysis identified 6 factors (subscales), which were later named excellence, respect for others, altruism, duty, accountability, and honor/integrity, the 6 tenets of professionalism. Item to total correlations ranged from 0.25 to 0.57 on the 6 factors (subscales), and reliability estimates ranged from 0.72 to 0.85 for the 6 factors and total scale. The Pharmacy Professionalism Instrument measures the 6 tenets of professionalism and exhibits satisfactory reliability measures. Future studies using this scale in other pharmacy populations are needed.

Gastric studies in sjogren's syndrome.

<b>Objective.</b> To examine the relationship between the Pharmacy Curriculum Outcomes Assessment (PCOA) and the North American Pharmacist Licensure Examination (NAPLEX) using a large, multi-institutional sample of student scores. <b>Methods.</b> A matched dataset was obtained from the National Association of Boards of Pharmacy (NABP) consisting of examination scores for the 1,460 students who completed both the PCOA and the NAPLEX between 2012 and 2015 at six schools/colleges of pharmacy (S/COPs). Bivariate correlations were estimated for total and content area scores on both examinations. Students’ total NAPLEX scores were predicted using linear regression models containing total and content area scores on PCOA and dummy variables for S/COP and year. <b>Results.</b> Students’ PCOA total score and NAPLEX total score were significantly and moderately correlated (<i>r</i>=0.54). All correlations between PCOA and NAPLEX total and content area scores were significant. and ranged from <i>r</i>=0.22 to 0.56. Regression results showed pharmaceutical and clinical sciences PCOA content scores were significant predictors of NAPLEX total score while basic biomedical sciences and social/behavioral/administrative sciences were not. The PCOA total and content scores accounted for 30%-33% of the variance in total NAPLEX score. <b>Conclusion.</b> Student PCOA and NAPLEX total and content area scores were significantly correlated, which is consistent with the findings of previous research. The somewhat modest proportion of variance in NAPLEX scores accounted for by PCOA scores illustrates the need for use of additional performance measures when evaluating student preparedness for the NAPLEX. This study provides important baseline data that can be used by S/COPs for comparison with their own student data as well as by researchers seeking to conduct additional analyses following recent changes in the PCOA and NAPLEX blueprints.