RESEARCH ARTICLE: Relationships between academic performance of pharmacy students and their postgraduate competence during internship
Keywords:Academic Performance, Competence, New Zealand, Pharmacy Internship, Workplace
Background: The pharmacy internship provides opportunity for first year graduates to demonstrate competence following undergraduate success in a Bachelor of Pharmacy (B.Pharm.) programme of study
Aim: To determine the extent to which undergraduate academic performances, including academic risk, were predictive of postgraduate competence appraised by workplace preceptors.
Method: A longitudinal, multi-cohort study was undertaken of 563 interns who graduated from a pharmacy undergraduate programme in New Zealand (NZ). Demographic variables, undergraduate performances, examination resits and delayed progression, were predictively modelled against intern competence.
Results: Full model predictions for successful intern competence were most influenced by delayed progression as an undergraduate (OR 0.18, CI 0.05 – 0.72, p=0.015) and achievement across combined professional pharmacy courses (OR 1.12, CI 1.01 – 1.24, p=0.037) with 22.4% of variance explained.
Conclusions: Undergraduate assessment measures and academic deficit occurrences show a useful, but limited, contribution to the prediction of gaining competence for a pharmacy intern.
Alston, G.L., Lane, D. & Wright, N.J. (2014). The methodology for the early identification of students at risk for failure in a professional degree program. Currents in Pharmacy Teaching and Learning, 6(6), 798-806. doi: 10.1016/j.cptl.2014.07.006
Bargagliotti, L.A. & Davenport, D. (2017). Entrustables and Entrustment: Through the Looking Glass at the Clinical Making of a Nurse Practitioner. The Journal for Nurse Practitioners, 13(8), e367-e374. doi:10.1016/j.nurpra. 2017.05.018
Brown, A.N., Gilbert, B.J. & Bruno, A.F. (2012). Validated Competency Framework for Delivery of Pharmacy Services in Pacific-Island Countries. Journal of Pharmacy Practice and Research, 42(4), 268-272. doi:10.1002/j. 2055-2335.2012.tb00186.x
Bruno, A., Bates, I., Brock, T. & Anderson, C. (2010). Towards a global competency framework. American Journal of Pharmaceutical Education, 74(3), Art.56
Carr, S.E., Celenza, A., Puddey, I.B. & Lake, F. (2014). Relationships between academic performance of medical students and their workplace performance as junior doctors. BMC Medical Education, 14(1), 157. doi: 10.1186/1472-6920-14-157
Chen, H.C., van den Broek, W.S. & ten Cate, O. (2015). The case for use of entrustable professional activities in undergraduate medical education. Academic Medicine, 90(4), 431-436. doi:10.1097/ACM.0000000000000586
Chesbro, S.B., Jensen, G.M. & Boissonnault, W.G. (2017). Entrustable Professional Activities as a Framework for Continued Professional Competence: Is Now the Time? Physical therapy, 98(1), 3-7. doi:10.1093/ptj/pzx100
Crampton, P., Weaver, N. & Howard, A. (2018). Holding a mirror to society? Progression towards achieving better sociodemographic representation among the University of Otago's health professional students. New Zealand Medical Journal, 131(1476), 59-69
Epstein, R.M. & Hundert, E.M. (2002). Defining and assessing professional competence. JAMA, 287(2), 226-235
EVOLVE. (2019). Pharmaceutical Society of New Zealand EVOLVE programme overview (online). Available at: https://www.psnz.org.nz/Category?Action=View& Category_id=255 . Accessed 24th June, 2019
Feemster, A., Calabrese, M., Gaitonde, P. & Shaya, F. (2017). Characteristics of Pharmacy Students Associated with a Successful PGY1 Residency Match. Medical Science Educator, 27(4), 607-611
Field, A. (2013). Discovering statistics using IBM SPSS statistics: Sage Publications Ltd.
Frank, J.R., Snell, L., Englander, R., Holmboe, E.S. & Collaborators, I. (2017). Implementing competency-based medical education: Moving forward. Medical Teacher, 39(6), 568-573. doi:10.1080/0142159X.2017.1315069
Gallagher, H.C. (2010). New fitness-to-practice requirements for pharmacists in Ireland: Implications for undergraduate pharmacy education. Medical Teacher, 32(2), e71-e77. doi:10.3109/01421590903199635
Garavan, T.N. & McGuire, D. (2001). Competencies and workplace learning: some reflections on the rhetoric and the reality. Journal of Workplace Learning, 13(4), 144-164. doi: 10.1108/13665620110391097
Green, J.A. (2015). The effect of English proficiency and ethnicity on academic performance and progress. Advances in Health Sciences Education, 20(1), 219-228. doi:10.1007/ s10459-014-9523-7
Hester, E.K., McBane, S.E., Bottorff, M.B., Carnes, T.A., Dell, K., Gonyeau, M.J. & Trujillo. (2014). Educational outcomes necessary to enter pharmacy residency training. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 34(4), e22-e25. doi:10.1002/phar.1411
Hirsh, D.A., Holmboe, E.S. & ten Cate, O. (2014). Time to trust: longitudinal integrated clerkships and entrustable professional activities. Academic Medicine, 89(2), 201-204. doi:10.1097/ACM.0000000000000111
Hojat, M., Gonnella, J.S., Erdmann, J.B. & Veloski, J.J. (1996). The fate of medical students with different levels of knowledge: Are the basic medical sciences relevant to physician competence? Advances in Health Sciences Education, 1(3), 179-196
Hojat, M. & Xu, G. (2004). A visitor's guide to effect sizes– statistical significance versus practical (clinical) importance of research findings. Advances in Health Sciences Education, 9(3), 241-249
Houglum, J.E., Aparasu, R.R. & Delfinis, T.M. (2005). Predictors of academic success and failure in a pharmacy professional program. American Journal of Pharmaceutical Education, 69(3), Art.43.
Jarrett, J.B., Berenbrok, L.A., Goliak, K.L., Meyer, S.M. & Shaughnessy, A.F. (2017). Entrustable Professional Activities: A Novel Framework for Pharmacy Education. American Journal of Pharmaceutical Education, 82(5), Art. 6256. doi:10.5688/ajpe6256
Kairuz, T., Noble, C. & Shaw, J. (2010). Preceptors, interns, and newly registered pharmacists' perceptions of new zealand pharmacy graduates' preparedness to practice. American Journal of Pharmaceutical Education, 74(6), Art. 108.
Kane, M.T. (1992). The assessment of professional competence. Evaluation & the health professions, 15(2), 163-182
Kenny, S., McInnes, M. & Singh, V. (2013). Associations between residency selection strategies and doctor performance: a meta-analysis. Medical Education, 47(8), 790-800. doi:10.1111/medu.12234
Kinder, D.H. & Knecht, K.T. (2011). Impact of non-passing grades and academic retention on subsequent academic performance in a cohort of pharmacy students. Currents in Pharmacy Teaching and Learning, 3(2), 92-100. doi: 10.1016/j.cptl.2011.01.003
McGill, D., Van der Vleuten, C. & Clarke, M. (2011). Supervisor assessment of clinical and professional competence of medical trainees: a reliability study using workplace data and a focused analytical literature review. Advances in Health Sciences Education, 16(3), 405-425. doi:10.1007/s10459-011-9296-1
Nash, R.E., Chalmers, L., Brown, N., Jackson, S. & Peterson, G. (2015). An international review of the use of competency standards in undergraduate pharmacy education. Pharmacy Education, 15(1), 131-141
Nash, R.E., Chalmers, L., Stupans, I. & Brown, N. (2016). Knowledge, use and perceived relevance of a profession's Competency Standards; implications for Pharmacy Education. International Journal of Pharmacy Practice, 24(6), 390-402. doi:10.1111/ijpp.12267
Nisbett, R.E. & Wilson, T.D. (1977). The halo effect: Evidence for unconscious alteration of judgments. Journal of Personality and Social Psychology, 35(4), 250-256. doi: 10.1037/0022-35220.127.116.11
Noble, C., Coombes, I., Nissen, L., Shaw, P.N. & Clavarino, A. (2015). Making the transition from pharmacy student to pharmacist: Australian interns' perceptions of professional identity formation. International Journal of Pharmacy Practice, 23(4), 292-304. doi:10.1111/ijpp.12155
Pijl-Zieber, E.M., Barton, S., Konkin, J., Awosoga, O. & Caine, V. (2014). Competence and competency-based nursing education: finding our way through the issues. Nurse Education Today, 34(5), 676-678. doi:10.1016/j.nedt. 2013.09.007
Pittenger, A.L., Chapman, S.A., Frail, C.K., Moon, J.Y., Undeberg, M.R. & Orzoff, J.H. (2016). Entrustable professional activities for pharmacy practice. American Journal of Pharmaceutical Education, 80(4), Art.57. doi: 10.5688/ajpe80457
PCNZ [Pharmacy Council of New Zealand]. (2015). Competence Standards for the Pharmacy Profession. Available at: http://www.pharmacycouncil.org.nz/Portals/12/ Documents/standardsguidelines/CompStds2015Web. pdf? ver=2017-02-20-104344-177. Accessed 11th November, 2017
Rhodes, L.A., Marciniak, M.W., McLaughlin, J., Melendez, C.R., Leadon, K.I. & Pinelli, N.R. (2019). Exploratory Analysis of Entrustable Professional Activities as a Performance Measure During Early Practice Experiences. American Journal of Pharmaceutical Education, 83(2), Art. 6517. doi: 10.5688/ajpe6517
Robinson, D. & Speedie, M. (2015). Is Post-Graduate Training Essential for Practice Readiness? Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 35(12), 1096-1099. doi:10.1002/phar.1654
Salvatori, P. (2001). Reliability and validity of admissions tools used to select students for the health professions. Advances in Health Sciences Education, 6(2), 159-175
Schlesselman, L.S. & Coleman, C.I. (2011). Predictors of poor student performance at a single, Accreditation Council for Pharmacy Education–accredited school of pharmacy. Currents in Pharmacy Teaching and Learning, 3(2), 101-105. doi:10.1016/j.cptl.2011.01.002
Shaw, J., Kennedy, J., Jensen, M. & Sheridan, J. (2015). An international perspective on pharmacy student selection policies and processes. American Journal of Pharmaceutical Education, 79(8), Art.115. doi:10.5688/ ajpe798115
Stupans, I. (2012). Qualitative interviews of pharmacy interns: Determining curricular preparedness for work life. Pharmacy Practice, 10(1), 52-56
ten Cate, O., Chen, H.C., Hoff, R.G., Peters, H., Bok, H. & van der Schaaf, M. (2015). Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99. Medical Teacher, 37(11), 983-1002. doi:10.3109/0142159X.2015.1060308
Terry, R., Hing, W., Orr, R. & Milne, N. (2017). Do coursework summative assessments predict clinical performance? A systematic review. BMC Medical Education, 17(1), 40. doi:10.1186/s12909-017-0878-3
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
Wilkinson, T.J. & Frampton, C.M. (2004). Comprehensive undergraduate medical assessments improve prediction of clinical performance. Medical Education, 38(10), 1111-1116
Windle, J.M., Spronken-Smith, R.A., Smith, J.K. & Tucker, I.G. (2018). Preadmission predictors of academic performance in a pharmacy program: A longitudinal, multi-cohort study. Currents in Pharmacy Teaching and Learning, 10(7), 842-853. doi:10.1016/j.cptl.2018.04.018