Oral Assessment of Clinical Reasoning in Student Pharmacists: A Scoping Review

This scoping review aimed to identify, collate, and map the existing literature on oral assessment of clinical reasoning in student pharmacists, focusing on assessment methods and rubric types.

A comprehensive scoping review was conducted utilizing Arksey and O'Malley's 5-stage framework and Joanna Briggs Institute (JBI) methodological guidance. A comprehensive search across 10 electronic databases and gray literature sources yielded 356 potentially relevant articles, of which 16 full-text articles met the inclusion criteria. All oral assessments were case-based, in hospital, ambulatory, or community settings. Students were evaluated through problem-based learning, Socratic questioning, virtual or standardized patient interactions, or a think-aloud approach. Students used frameworks such as Subjective, Objective, Assessment, Plan (SOAP); Pharmacists' Patient Care Process (PPCP); and Situation, Background, Assessment, Recommendation (SBAR), with safety and efficacy being the most commonly addressed drug-related problems. Rubrics were mostly analytic, supported by checklists and global scores. Presentation skills were assessed in some studies, and most rubrics aligned with intellectual standards. Assessor training and feedback varied, and inter-rater reliability was inconsistently reported.

Oral assessments offer an authentic way to evaluate clinical reasoning in student pharmacists and reduce risks associated with artificial intelligence in written assessments. Future assessments should incorporate real-world scenarios, a hybrid of analytic and global rubrics aligned with intellectual standards, and structured assessor training. Further research is needed to identify optimal rubrics and assessment formats. Findings from this review can guide the development of oral assessments in pharmacy curricula, ensuring that pharmacy graduates meet the competency standards for entry into the pharmacist scope of practice.