Development of a capstone exam as pre-advanced pharmacy practice experiences domains assessment

Introduction: Accreditation Council for Pharmacy Education's (ACPE) standards require pharmacy schools to assess Advanced Pharmacy Practice Experience (APPE) readiness. This paper describes the development and implementation of a Capstone Exam for assessing APPE-readiness and exploration of potential correlations between student performance on the Exam and performance measures within the didactic curriculum. Methods: Faculty developed a Capstone examination aligned to the Pre-APPE Domains in Appendix A of the ACPE standards consisting of five stations assessing skills, which include: interviewing, counseling, prescription checking, professional communication, and inpatient order verification. Administered in the spring semester of the third professional year, students must pass all stations to progress to APPEs. Relationships between pass rates for student cohorts in the class of 2017-2023 and grade point average (GPA) and course deficiencies were explored using logistic regression. Results: Since 2016, first-attempt pass rates fluctuated between 20.3 % and 51.2 % with variability in performance observed across stations and class cohorts. Students with higher GPAs were more likely to pass all stations on the first attempt. Although history of a course deficiency did not affect overall pass rates, it was associated with lower odds of passing the interviewing and order verification stations. Conclusions: A Capstone Exam model fulfills the requirements in ACPE Standard 25.8 using a sustainable approach and has supported curricular continuous quality improvement. Findings regarding predictive value of GPA and prior course deficiencies may enable identifying students who would benefit from additional preparation.