EXPERIENCE WITH USING PERFORMANCE BASED EXAMS IN PHARMACY SCHOOL TO PREDICT FUTURE PERFORMANCE ON PRACTICAL EXAMS

Objective:
To determine if student’s performance on performance based exams during the first semester of pharmacy school is predictive of performance in their forth semester.

Background:
At the University of Colorado School of Pharmacy, the professional skills sequence is intended to develop a broad range of skills necessary for pharmacy practice. It is designed to parallel the didactic portion of the curriculum, integrating and applying essential knowledge, skills and attitudes. Students are expected to practice and refine a variety of skills through collaborative and individual activities. This course is designed based on the assumptions that students will actively participate in learning activities, be self-directed, independent and take responsibility for their learning and work to achieve their potential. Assessment-as-learning incorporates the notion that feedback provided to students regarding their performance helps them to determine their strengths and weaknesses, so that they can improve performance when reassessed. The assessment techniques used in this course include feedback that is used for the purpose of improving one’s performance. This is a mastery-learning course and, accordingly, is graded pass/fail.

Methods:
Performance based examinations are administered in the professional skills sequence to evaluate students retention of knowledge, ability to apply knowledge and communication. For each evaluation, students are assessed on their ability to effectively communicate and accurately deliver clinical content. Students pass the performance based exams by obtaining a cumulative score of > = 75%. Students who obtain a cumulative score < 75% receive a failing grade. We tracked the performance of student’s grades on performance based exams during their first semester of pharmacy school in 2007 to their performance on performance based exams during their forth semester. A grade cut-off of less than 85% was used to separate students at risk for performing poorly in the second year.

Results:
142 students were enrolled in the first year professional skills course. 25% of the students obtained a score of <85% on their performance based exam. 17% of the 25% students failed the exam. 67% of the 25% students passed the class, but their overall grades were mediocre (75-79%). 11% students that did not perform well in the first semester did not matriculate to their forth semester. Only 17% of the students that obtained a score of <85% passed their first semester with a grade of 80-85%. 58% of the students that scored <85% on the performance based exam in the first semester did poorly and scored <75% on the performance based exam in their forth semester.

Conclusion:
The professional skills course is designed to use the knowledge learned during didactic lectures and to develop the skills necessary to problem solve, critically think and make clinical decisions. Student performance on the performance based exams is a predictor of future performance on practical exams in the second year. It is necessary to identify and improve each student’s weak areas in the performance based exams in order to improve their performance in the future.