Predictors of Student Failure or Poor Performance on Advanced Pharmacy Practice Experiences

Abstract

Objective. To determine factors predictive of student failure or poor performance on advanced pharmacy practice experiences (APPEs) at a single pharmacy program. Methods. This retrospective cohort evaluated students entering the Doctor of Pharmacy (PharmD) program from 2012-2014 at St. Louis College of Pharmacy. Students who received a grade of F for one or more APPEs (failure group) were compared to all other students (non-failure group). A secondary evaluation compared students with a C or F on one or more APPEs (poor performers) to all other students (non-poor performers). Data were collected on didactic and experiential performance, identifiable professionalism issues from introductory pharmacy practice experiences (IPPEs), and academic honor code violations. Univariable and multivariable logistic regressions were performed to determine factors associated with APPE failure and poor performance. Results. A total of 669 students were analyzed. Twenty-eight students (4.2%) failed one or more APPEs and 81 students (12.1%) were identified as poor performers (grade of C or F). For the primary outcome, professional grade point average (GPA) of less than 2.7, practicum failure, IPPE professionalism issue(s), and pharmacotherapy course failure were identified for inclusion in the multivariable analysis. The IPPE professionalism issue(s) (HR 4.8 [95% CI 1.9-12.4]) and pharmacotherapy course failure (HR 4.2 [95% CI, 1.6-11.1]) were associated with APPE failure on multivariable regression. On the secondary analysis, the same variables were identified for multivariable regression, with professional GPA of less than 2.7 (HR 2.7 [95% CI 1.5-5]), IPPE professionalism issue(s) (HR 3.9 [95% CI 2.2-6.9]), and pharmacotherapy course failure (HR 2.0 [95% CI 1.1-3.7]) associated with poor performance. Conclusion.Poor academic performance and/or identified unprofessional behavior while completing IPPEs are associated with APPE failure and poor performance. Interventions should be aimed at identifying at-risk students and addressing risk factors prior to APPEs.

A Programmatic Approach to Peer-Led Tutoring to Assist Students in Academic Difficulty

“…Beyond course failures, this tutoring program could be used as an intervention to provide academic support and minimize the need for course remediation which may have an impact in the experiential curriculum as poor academic performance, including failures and lower grade point averages, is a risk factor associated with failure or poor performance on advanced pharmacy practice experiences. 26 Currently, existing studies on PAL in the pharmacy literature evaluated students' perceptions, skills gained, and attitudes. 7,[10][11][12][13]18,19,21,22 Rodis and colleagues conducted a survey and reported that a majority of students agreed that the student-peer mentoring o n a drug information question improved the likelihood of tutees receiving a higher grade.…”

Deficiencies of Traditional Grading Systems and Recommendations for the Future

“…First, investigators have raised the issue of whether performance within the didactic curriculum (as measured by grades) correlates to performance in clinical settings. [14][15][16] Second, some have questioned whether in clinical settings if Pass/Fail grading systems might be more logical as compared to traditional A-F grading scales. [17][18][19][20] Call and colleagues aimed to determine factors predictive of student failure or poor performance on APPEs by conducting a retrospective cohort study comparing students who failed any APPE to students who did not between 2012-2014.…”

“…[17][18][19][20] Call and colleagues aimed to determine factors predictive of student failure or poor performance on APPEs by conducting a retrospective cohort study comparing students who failed any APPE to students who did not between 2012-2014. 14 A total of 669 students at a single pharmacy school were included in the analysis with 28 students (4.2%) failing…”

Associating Student Performance in Pharmacy Practice Didactic and Skills-Based Courses With Advanced Pharmacy Practice Experiences

“…Call et al examined a range of factors, including GPA; course grades; performance-based assessment and exam scores; professionalism issues on IPPEs; and academic honor code violations. 4 Nyman et al analyzed the predictive value of student demographics, along with admission and didactic performance measures. 5 Both of these studies found that two factors correlate to APPE readiness more than others: aggregate pharmacy education knowledge-based variables and entering age of students (more than skills-based variables, admission measures, or other student demographics).…”

“…5 Both of these studies found that two factors correlate to APPE readiness more than others: aggregate pharmacy education knowledge-based variables and entering age of students (more than skills-based variables, admission measures, or other student demographics). 4,5 Medical educators have also examined indicators that are predictive of medical student performance. Efforts have focused on 4 general categories, including demographics (e.g., gender), other background factors (e.g., college major), performance/aptitude (e.g., medical college admission test scores), and noncognitive factors (e.g.…”