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

Abstract

Objective: 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 CAPE-based to EPA-based experiential assessments are also shared.

Methods: 6,679 raw student performance scores (RSPS) were collected from two Colleges of Pharmacy (COPs) across a 2-year period where both COPs used an identical CAPE-based APPE evaluation tool with traditional letter grading (TLG), and a 2-year post-EPA implementation period where one COP also implemented HPFG (COP 1) and the other (COP 2) continued TLG. The change in RSPS vs baseline was compared between the Years 1-2 timeframe to 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 were also compared across the two timeframes at both institutions.

Results: The COP transitioning to HPFG experienced a similar decline in RSPS following EPA-based evaluation implementation to the COP maintaining TLG. A multiple regression model identified a lack of significant association between RSPS and grading system, while controlling for COP, rotation category, and timeframe of evaluation.

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