Predictors of Student Failure or Poor Performance on Advanced Pharmacy Practice Experiences

Area of Science:

• Pharmacy Education
• Experiential Learning
• Student Performance Analysis

Background:

• Advanced Pharmacy Practice Experiences (APPEs) are critical for developing competent pharmacists.
• Identifying factors that predict student failure or poor performance in APPEs is essential for targeted interventions.
• Previous research has not fully elucidated the specific predictors of APPE success or failure.

Purpose of the Study:

• To identify factors predicting student failure in APPEs.
• To identify factors predicting poor performance (grade of C or F) in APPEs.
• To inform the development of early intervention strategies for at-risk pharmacy students.

Main Methods:

• Retrospective cohort study of Doctor of Pharmacy (PharmD) students from 2012-2014.
• Comparison of students who failed APPEs versus all others.
• Secondary comparison of students with poor APPE performance (C or F) versus all others.
• Analysis included didactic and experiential performance, professionalism issues from Introductory Pharmacy Practice Experiences (IPPEs), and honor code violations.
• Univariable and multivariable logistic regression analyses were performed.

Main Results:

• Of 669 students, 4.2% failed at least one APPE, and 12.1% had poor performance (C or F).
• Multivariable analysis identified professionalism issues during IPPEs (HR 4.8) and pharmacotherapy course failure (HR 4.2) as significant predictors of APPE failure.
• For poor performance, predictors included a professional GPA < 2.7 (HR 2.7), IPPE professionalism issues (HR 3.9), and pharmacotherapy course failure (HR 2.0).

Conclusions:

• Poor academic performance and unprofessional behavior during IPPEs are significant predictors of subsequent APPE failure and poor performance.
• Interventions should focus on identifying students with these risk factors before they begin APPEs.
• Addressing academic and professionalism deficits early can improve student outcomes in experiential pharmacy education.