Impact of Honors Pass/Pass/Fail vs Traditional Letter Grading on EPA-Based Assessment of Student APPE Performance

This retrospective, observational study evaluated the impact of honors/pass/fail grading (HPFG) implementation compared to traditional letter grading (TLG) on student performance assessed using entrustable professional activity (EPA)-based Advanced Pharmacy Practice Experience (APPE) rotation evaluations. Insights gleaned from a transition from Center for the Advancement of Pharmacy Education (CAPE)-based to EPA-based experiential assessments are also shared.

A total of 6679 raw student performance scores (RSPS) were collected from 2 colleges of pharmacy (COPs) across a 2-year period during which both COPs used an identical CAPE-based APPE evaluation tool with traditional letter grading (TLG), and a 2-year post-EPA implementation period during which one COP also implemented HPFG (COP 1), while the other (COP 2) continued using TLG. The change in RSPS from baseline was compared between the years 1-2 timeframe and years 3-4 at both institutions to assess for significant differences following HPFG implementation. A multiple linear regression model also evaluated associations between RSPS and several independent variables, including COP, time frame of evaluation, evaluation type (EPA vs CAPE-based), rotation category, and grading system (TLG vs HPFG). The distribution of grade prevalences was also compared across the 2 timeframes at both institutions.

The COP transitioning to HPFG experienced a similar decline in RSPS following EPA-based evaluation implementation as the COP maintaining TLG. A multiple regression model identified no significant association between RSPS and the grading system, while controlling for COP, rotation category, and the timeframe of evaluation.

Implementation of HPFG did not appear to have a detrimental impact on student rotation performance at a COP implementing EPA-based APPE evaluations.