Academic journal article American Journal of Pharmaceutical Education

Incremental Development of an Integrated Assessment Method for the Professional Curriculum

Academic journal article American Journal of Pharmaceutical Education

Incremental Development of an Integrated Assessment Method for the Professional Curriculum

Article excerpt


Ensuring that all students build and retain a core foundation of knowledge and skills is a requirement and growing concern for doctor of pharmacy (PharmD) programs. (1) Annual progress examinations (eg, milestone, mile-marker or benchmark examinations) have received increasing support from many colleges and schools of pharmacy as the tool for measuring students' retention of core knowledge and skills for future clinical application. (2-7) Despite the attention annual progress examinations have received in the academy and in accreditation standards, questions remain about what test to use and how and when to use it. After reviewing the literature (2-7) about these progress examinations and evaluating the Accreditation Council for Pharmacy Education (ACPE) (1) Standards and Guidelines for guidance, the University of Oklahoma College of Pharmacy incrementally created biannual integrated knowledge and skills examinations and embedded them into the final examinations of pharmacy practice courses (I-VI) offered in the first 3 years. The development of these examinations was based on ACPE Guideline 15.1, which calls for "periodic, psychometrically sound, comprehensive, knowledge-based, and performance-based formative and summative assessments," and Standard 13, which requires programs to integrate, apply, reinforce and advance knowledge, skills and attitudes throughout the curriculum. (1) However, the ACPE standards offer little guidance regarding which examination to use and how and when to offer the examination. This paper describes the development and implementation of the integrated examinations for the first 3 years of the classroom curriculum, embedding each integrated examination into the final examinations of the pharmacy practice course series (I-VI). To ease the stress of change in the college's assessment program, these examinations were developed and implemented incrementally over a 3-year period, minimizing the burden on faculty members' time and engaging them in the development of a process that requires a sustained effort.


The incremental development of the examination began in the summer of 2008 when the college charged an ad hoc assessment committee of faculty members and preceptors to explore the feasibility and sustainability of biannual progress examinations. The committee was presented with 4 specific questions to address that would impact how the college created its examinations: (1) Should the examinations be locally developed or nationally developed to enable benchmarking? (2-5) (2) Should colleges or schools offer the examination every year, every semester, or immediately prior to advanced pharmacy practice experiences, or would a different timetable be better? The answer to this question impacts the use and frequency of cumulative examination questions; specifically, should these questions be cumulative per year or cumulative across all years of the professional program? (6-7) (3) Which question type should be used: multiple-choice, written essay or case-based, objective structured clinical examinations (OSCEs), or other performance-based assessments? (4) Should the examination be high stakes and affect progression in the program or a course grade, or low stakes and have no impact on grades or progression? (6-7) If the examination is low stakes, students may not study and may subsequently perform poorly, impacting the ability to make interpretations about the results. In contrast, high-stakes examinations carry their own implications. (6,7) For example, what if students fail the examination but are in good academic standing?

The 4 guiding-specific questions were addressed with 8 integrated examination objectives (Table 1). The committee concluded that embedding knowledge and skills-based progress examinations into the college's existing P1-P3 pharmacy practice course series (I-VI) final examinations was possible and sustainable.

The college began its work of incrementally creating integrated examinations for use in the classroom curriculum by first focusing on committee formation. …

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