A mixed methods study of a competency-driven approach in a pharmacy course
DOI:
https://doi.org/10.46542/pe.2025.251.283292Keywords:
Competency, Competency-based education, Feedback, Pass-or-fail gradingAbstract
Background: There is a call to transition from traditional grades towards Competency-Based Education (CBE) for health professionals, however, evidence is needed to describe the challenges and opportunities unique to pharmacy education. Students’ understanding and faculty perceptions of a CBE approach would help foster acceptance.
Objective: to assess student opinions, understanding, and attitudes towards implementing a Competency-Driven (CD) approach into a pharmacy course. A secondary objective was to assess faculty perceptions of the CD approach.
Methods: A CD approach was implemented in Foundations of Pharmacy Practice, a two-semester course. Using mixed methods, 61 students enrolled in the course participated in a pre- and post-survey and focus group.
Results: Sixty-two per cent of students provided informed consent, and five participated in a focus group. Findings demonstrate that students believe individualised feedback fosters professional growth. Students consistently valued feedback on non-graded assessments and were less likely to agree that graded assignments assisted their learning/professional development. Over half of the students prioritised graded courses over pass-or-fail coursework. Five qualitative themes included professional growth, motivation, sufficient time frame, supportive environment, and career success.
Conclusion: While students perceive that a CD approach creates a supportive learning environment and promotes professional development, most prioritised traditionally graded coursework.
References
Burrows, J., Kirkpatrick, C., Coombes, I., Cardiff L., & Lum, E. (2013). The impact on clinical practice of a Postgraduate Clinical Pharmacy Programme, incorporating competency-based performance evaluation. Pharmacy Education, 13(1), 177‒182. https://pharmacyeducation.fip.org/pharmacyeducation/article/view/210
Cain, J., Medina, M., Romanelli, F., & Persky, A. (2022). Deficiencies of traditional grading systems and recommendations for the future. American Journal of Pharmaceutical Education, 86(7), 8850. http://doi.org/10.5688/ajpe8850
Daugherty, K., Chen, A., Churchwell, M., Jarrett, J. B., Kleppinger, E.L., Meyer, S., Nawarskas, J., Sibicky, S. L., Stowe, C. D., & Rhoney, D. H. (2024). Competency-based pharmacy education definition: What components need to be defined to implement it? American Journal of Pharmaceutical Education, 88(1), 100624. http://doi.org/10.1016/j.ajpe.2023.100624
de Heer, M. H., Driessen, E. W., Teunissen, P. W., & Scheele, F. (2024). Lessons learned spanning 17 years of experience with three consecutive nationwide competency-based medical education training plans. Frontiers in Medicine, 11, 1339857. https://doi.org/10.3389/fmed.2024.1339857
Engle, J. P., Burke, J. M., Ashjian, E. J., Avery, L., Borchert, J. S., Faro, S. J. E., Harris, C. S., Herink, M. C., Jain, B., MacLaughlin, E. J., Martello, J. L., Moore, K., Rogers, E., Smith, W. J., & Stranges, P. M. (2020). ACCP clinical pharmacist competencies: Advocating alignment between student, resident, and practitioner competencies. The Journal of the American College of Clinical Pharmacy, 3, 123‒132. https://doi.org/10.1002/jac5.1200
Frank, J. (2005). The CanMEDS 2005 physician competency framework. Better standards. Better physicians. Better care. Ottawa: The Royal College of Physicians and Surgeons of Canada. https://www.ciperj.org/imagens/canmed2005.pdf
Frank, J. R., Snell, L. S., Ten Cate, O., Holmboe, E. S., Carraccio, C., Swing, S. R., Harris, P., Glasgow, N. J., Campbell, C., Dath, D., Harden, R. M., Iobst, W., Long, D. M., Mungroo, R., Richardson, D. L., Sherbino, J., Silver, I., Taber, S., Talbot, M., & Harris, K. A. (2010). Competency-based medical education: Theory to practice. Medical Teacher, 32(8), 638‒645. https://doi.org/10.3109/0142159X.2010.501190
Glazzard, J., & Stones, S. (2019). Student perceptions of feedback in higher education. International Journal of Learning, Teaching and Educational Research, 18(11), 38‒52. https://doi.org/10.26803/ijlter.18.11.3
Hanson, J. L., Rosenberg, A. A., & Lane, J. L. (2013). Narrative descriptions should replace grades and numerical ratings for clinical performance in medical education in the United States. Frontiers in Psychology, 4, 668. https://doi.org/10.3389/fpsyg.2013.00668
Holmboe, E., Sherbino, J., Englander, R., Snell, L., & Frank, J. (2017). A call to action: The controversy of and rationale for competency-based medical education. Medical Teacher, 39(6), 574-581. https://doi.org/10.1080/0142159X.2017.1315067
Jarrett, J. B., Elmes, A. T., Keller, E., Stowe, C. D., & Daugherty, K. K. (2024). Evaluating the strengths and barriers of competency-based education in the health professions. American Journal of Pharmaceutical Education, 88(6), 100709. http://doi.org/10.1016/j.ajpe.2024.100709
Katoue, M. G., & Schwinghammer, T. L. (2020). Competency-based education in pharmacy: A review of its development, applications, and challenges. Journal of Evaluation in Clinical Practice, 26, 1114-1123. https://doi.org/10.1111/jep.13362
Kelley, K. A., Stanke, L. D., Rabi, S. M., Kuba, S. E., & Janke, K. K. (2011). Cross-validation of an instrument for measuring professionalism behaviours. American Journal of Pharmaceutical Education, 75(9), 179. http://doi.org/10.5688/ajpe759179
Lipnevich, A. A., & Smith, J. K. (2009). Effects of differential feedback on students’ examination performance. Journal of Experimental Psychology: Applied, 15(4), 319‒333. https://doi.org/10.1037/a0017841
Lucey, C. (2018). Achieving competency-based, time-variable health professions education. Proceedings of a conference sponsored by Josiah Macy Jr. Foundation in June 2017. New York, Josiah Macy Jr. Foundation. https://macyfoundation.org/assets/reports/publications/macy_monograph_2017_final.pdf
Marie, J. (2016). Student views on the value of feedback. Journal of Education and Training Studies, 4(6), 207‒213. https://files.eric.ed.gov/fulltext/EJ1100358.pdf
McRobbie, D., Webb, D. G., Bates, I., Wright, J., & Davies, J. G. (2001). Assessment of clinical competence: Designing a competence grid for junior pharmacists. Pharmacy Education, 1(2), 67‒76. https://pharmacyeducation.fip.org/pharmacyeducation/article/view/10
Medina, M., Plaza, C., Stowe, C., Robinson, E. T., DeLander, G., Beck, D. E., Melchert, R. B., Supernaw, R. B., Roche, V. F., Gleason, B.L., Strong, M. N., Bain, A., Meyer, G. E., Dong, B. J., Rochon, J., & Johnston, P. (2013). Centre for the advancement of pharmacy education 2013 educational outcomes. American Journal of Pharmaceutical Education, 77(8), 162. http://doi.org/10.5688/ajpe778162
Payne, B., Monk-Turner, E., Smith, D., & Sumter, M. (2006). Improving group work: Voices of students. Sociology & Criminal Justice Faculty Publications. https://digitalcommons.odu.edu/sociology_criminaljustice_fac_pubs/22
Poulos, A., & Mahony, M. (2008). Effectiveness of feedback: The students' perspective. Assessment & Evaluation in Higher Education, 33(2), 143‒154. https://doi.org/10.1080/02602930601127869
Rhoney, D. H., Chen, A. M., Churchwell, M. D., Daugherty, K. K., Jarrett, J. B., Kleppinger, E. L., Nawarskas, J. J., Sibicky, S. L., Stowe, C. D., & Meyer, S. M. (2023). Recommendations and next steps for competency-based pharmacy education. American Journal of Pharmaceutical Education, 87(10), 100549. http://doi.org/10.1016/j.ajpe.2023.100549
Ryan, R. M., & Deci, E. L. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 25(1), 54‒67. https://doi.org/10.1006/ceps.1999.1020
Wang, A., Karunungan, K. L., Story, J. D., Shlobin, N. A., Woo, J., Ha, E. L., Hauer, K. E., & Braddock, C. H. (2023). Reimagining a pass-or-fail clinical core clerkship: A US residency program director survey and meta-analysis. BMC Medical Education, 23, 788. https://doi.org/10.1186/s12909-023-04770-8
Waterfield, J. (2017). How is the term ‘competence’ defined by the pharmacy educator? A qualitative study of science-based and practice-based pharmacy educators. Pharmacy Education, 17(1), 350‒356. https://pharmacyeducation.fip.org/pharmacyeducation/article/view/495
Westein, M., de Vries, H., Floor, A., Koster, A., & Buurma, H. (2019). Development of a postgraduate community pharmacist specialization program using CanMEDS competencies and entrustable professional activities. American Journal of Pharmaceutical Education, 83(6), 6863. http://doi.org/10.5688/ajpe6863
