Preadmission Predictors of PharmD Graduates' Performance on the NAPLEX

American Journal of Pharmaceutical Education, 2007 by McCall, Kenneth L, MacLaughlin, Eric J, Fike, David S, Ruiz, Beatrice

Objectives. To identify prepharmacy variables that predicted graduate performance on the North American Pharmacist Licensure Examination (NAPLEX) test.

Methods. Undergraduate and pharmacy school transcripts for 424 students admitted to the Texas Tech University Health Sciences Center (TTUHSC) Doctor of Pharmacy program from the fall of 1996 to the fall of 2001 were reviewed. NAPLEX scores were provided by the Texas State Board of Pharmacy (TSBP). Statistical analyses were performed using SPSS, 11.5.

Results. Grade point average, composite Pharmacy College Admission Test (PCAT) score, and California Critical Thinking Skills Test (CCTST) score were each positively correlated with NAPLEX score (p 0.05). When comparing students who successfully graduated and passed the NAPLEX with students who were academically suspended or who failed the NAPLEX, there were significant differences in mean PCAT scores, CCTST score, and age (p

Conclusion. Composite PCAT score was the strongest predictor of success and failure on the NAPLEX. However, the combined predictive ability of PCAT and CCTST scores, prepharmacy GPA, and age was relatively low. Thus, a full review of each candidate's application is justified.

Keywords: North American Pharmacist Licensure Examination (NAPLEX), admissions, PCAT, grade point average, performance, CCTST

INTRODUCTION

The National Association of Boards of Pharmacy Licensure Examination (NABPLEX) was first administered in 1976.1 In 1986, the NABPLEX was significantly revised to a scenario-based format that required examinees to answer patient-centered questions rather than subject-centered questions. The NABPLEX examination changed from a pencil and paper format to a computeradaptive test in 1997. In the same year, the name of the examination was altered to the North American Pharmacist Licensure Examination (NAPLEX) to reflect that the instrument was valid for both US and Canadian pharmacy practice. The most recent NAPLEX revisions, which included the addition of a specific competency addressing dietary supplements, were introduced in 2005. The blueprint for NAPLEX questions is kept current with the ''knowledge and skills necessary to safely and effectively practice entry-level pharmacy.''2 The scaled NAPLEX scores range from 0 to 150 with a minimally acceptable level of performance on the examination reflected by a score of 75.

Numerous studies have explored correlations between student preadmission characteristics and academic success during pharmacy school.3-27 Yet, only 2 studies have evaluated student admission variables with NABPLEX scores.12,14 Pharmacy College Admission Test (PCAT) scores were predictive of NABPLEX scores in both of these studies. However, these studies were conducted in the late 1970s and early 1980s; well before the patient profile-based format and the computer-adaptive test format. A likely reason why no recent studies evaluating individual licensure examination scores have been reported is that many schools and colleges of pharmacy have difficulty obtaining individual student NAPLEX results. One explanation for this difficulty is that many pharmacy graduates take board examinations in states other than where they attended pharmacy school. Another reason is that states may not have similar public records laws as Texas and many state boards will not release the NAPLEX results in a format needed to perform this type of analysis.

To our knowledge, the relationship between PCAT scores, the California Critical Thinking Skills Test (CCTST) score, admission age, advanced prepharmacy coursework, and the attainment of a BS, BA, orMS degree with success or failure on the NAPLEX have never been evaluated. Exploration of these relationships is important because theNAPLEXis a prerequisite to obtaining a license and the most recognized assessment of the minimum competency to practice pharmacy. Furthermore, NAPLEX scores reflect a standardized, external performance assessment and are required to be evaluated by schools and colleges of pharmacy for regional accreditation by the Southern Association of Colleges and Schools and by the Accreditation Council for Pharmacy Education.28,29 Thus, licensing examination scores are an important component in the assessment system of a college or school. Therefore, evaluation of preadmission variables that predict success or failure on the NAPLEX should be considered by admission committees at schools and colleges of pharmacy.

METHODS

The Texas Tech University Health Sciences Center (TTUHSC) School of Pharmacy has offered the Doctor of Pharmacy (PharmD) degree as its only professional pharmacy degree since the first class was admitted in 1996. The TTUHSC PharmD degree program requires at least 2-years of specific undergraduate college study followed by 4 academic years of professional pharmacy study. The required science and math prepharmacy courses at Texas Tech include 8-10 semester hours of general chemistry with laboratory, 8-10 semester hours of organic chemistry with laboratory, 4 semester hours of general physics with laboratory, 8 semester hours of general biology with laboratory, 4 semester hours of microbiology with laboratory, 3-4 semester hours of calculus, and 3 semester hours of statistics.