Monday, October 5, 2020

Standardized Testing and Predictions for Success in Pharmacy Education

Marisa Rinehart, PharmD
PGY-1/PGY-2 Pharmacotherapy Resident
University of Maryland School of Pharmacy

Standardized testing is an overwhelmingly large part of the American education system. The first form of standardized testing dates back to 1845 as a part of the educational reform that occurred during this time period. Utilization of standardized testing took off in the era of war, as a way to categorize the US military members in World War I. Around the same time, the approval of standardized testing by the National Education Association led to a rapid increase in the development of these assessments. Later in 1935, the invention of scoring machines drastically improved efficiency and decreased costs of tests, further increasing their popularity. Under the Reagan administration, the need for educational reform became a political topic, leading to the passing of many “reforms” that we have today, i.e. No Child Left Behind and Race to the Top. The one common factor that can be seen in all of these education reforms, is the focus on assessing math and reading through standardized testing. It is through these test scores that students are able to be compared.1

On the basis of comparing students, standardized testing is the simplest and easiest formula to use, however it’s not a perfect system. The limitations stem from the lack of evidence supporting standardized tests as an effective measure of learning, as well as the inequality when looking at differences in resources. On the reverse side, these scores allow schools to compare their student bodies and in theory help to motivate students to perform better.2 The standardized tests that come to mind when relating this concept to pharmacy school are the Pharmacy College Admission Test (PCAT), the Pharmacy Curricular Outcomes Assessment (PCOA) and the North American Pharmacist Licensure Examination (NAPLEX). The PCAT exists to determine an individual's likelihood of success in the science based curriculum of pharmacy school. There is no “passing score” for this exam, rather colleges have the flexibility to set their own minimum score for admission applications.3 The PCOA is used to assess students’ knowledge obtained in pharmacy curriculum, and is used in accreditation.4 The NAPLEX was created to determine if pharmacy school graduates are competent enough in the profession to gain a license and practice as a licensed pharmacist.3

The three of these exams have been included in many studies assessing outside factors that can help to predict scores, ultimately attempting to predict passing of the NAPLEX.3-6

Firstly, when looking at the PCOA and PCAT, an article published in the American Journal of Pharmaceutical Education showed that higher PCAT scores, higher undergraduate science GPA and higher cumulative pharmacy GPA correlated to higher PCOA scores. Interestingly, when looking at those who struggled academically, there was a negative correlation (lower PCOA scores) for those students who had academic issues that required them to appear before the college’s progression committee but were not required to repeat course content when compared to those with no academic issues. For the student who repeated course content, their scores did not significantly differ from students with no academic issues.4 

Next let’s take a look at NAPLEX pass predictors. Both higher GPAs and PCOA scores are associated with passing NAPLEX scores. Appearing before the academic review committee, as well as repeating didactic courses is associated with decreased likelihood of passing the NAPLEX. There are also demographic factors that play into NAPLEX pass rates. First-time pass rates are higher in universities within academic health centers, universities established before 2000, public universities, and universities utilizing traditional (4 year) structures.4-6 One of the most significant results from this literature I found was that the success of students who match for PGY1 residency is a strong predictor of first-time NAPLEX pass rates.5 As all of this literature is fairly recent (published in or after 2019), I am interested to see what further studies surface in this area, and if and how pharmacy curriculum changes as a result.

This information can be used in many ways by pharmacy school educators. Overall, our goal is always the success of our students. With these shown correlations, modifications to curriculum can be made to better prepare students for success. Secondly, knowing that those who struggle academically have poorer chances of success can prompt intervention at an earlier time for these students. By having these trends, it allows us as educators to identify those students who may be struggling, intervene, and possibly change the outcomes. By knowing what factors have a negative impact on pass rates, universities as a whole can then modify curriculum to address these factors.

References:
1. Maranto, J. H. (2015). The effect of standardized testing on historical literacy and educational reform in the U.S. academic leadership. Journal in Student Research, (3).
https://files.eric.ed.gov/fulltext/EJ1062724.pdf

2. Kamenetz, A. (2015). The test: Why our schools are obsessed with standardized testing— but you don't have to be. New York, NY, US: Public Affairs Books.

3. Laurenzo, A. (2009). PCAT and NAPLEX: An Overview. US Pharm, (34), 9-11. https://www.uspharmacist.com/article/pcat-and-naplex-an-overview.

4. McDonough, S., Spivey, C., & Chrisholm-Burns, M. (2019, March). Examination of Factors Relating to Student Performance on the Pharmacy Curriculum Outcomes Assessment. American Journal of Pharmaceutical Education, 83(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448514/

5. Williams, J., Spivey, C., & Hagemann, T. (2019, August). Impact of Pharmacy School Characteristics on NAPLEX First-time Pass Rates. American Journal of Pharmaceutical Education, 83(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718508/

6. Spivey, C., Chrisholm-Burns, M., & Johnson, J. (2020, February). Factors Associated with Student Pharmacists’ Academic Progression and Performance on the National Licensure Examination. American Journal of Pharmaceutical Education, 84(2). https://www.ajpe.org/content/84/2/7561

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