Monitoring of Schools and Colleges of Pharmacy Based on NAPLEX Passage Rate

Introduction. We have evaluated two approaches of monitoring schools and colleges of pharmacy based on North American Pharmacist Licensure Examination (NAPLEX) passage rates. Historically, the Accreditation Council for Pharmacy Education (ACPE) has cited programs based on achieving a passage rate equal or over 2 SD standard deviations (SD) below the national average. Since the National Association of Boards of Pharmacy (NABP) no longer reports scores, this procedure is currently being reconsidered. Our supposition is that the failure rate of 2 SD below the average passage rate should be retained, but now, based on the national average passage rate. However, we further suggest this is not adequate, due to major variations in class size. Commentary. We suggest the establishment of a 'maximum acceptable failure count', likely in the range of 20-25 failing graduates per class. Analyses of data from 2017-2019 indicate that this approach would lead to monitoring approximately 15% of existing programs that graduate approximately 40% of individuals failing NAPLEX, versus monitoring approximately 5% of programs that graduate approximately 9% of individuals failing NAPLEX. Implications. The historical method of monitoring pharmacy programs with NAPLEX passage based on the 2 SD below the national average is not adequate, primarily due large variations in class size. In that accreditation standards are currently being revised ('Standards 2025'), this would be an ideal time to reconsider methods for selecting programs that warrant monitoring based on inadequate NAPLEX passage rates. We suggest the concept of 'maximum acceptable failure count' should be taken into account when identifying programs to be cited. Keywords: NAPLEX failures, quality indicator, monitoring paradigms, accountability Conflict of interest: The authors declare no conflicts of interest. Disclosures: The authors have no disclosures. Contribution to literature: First time passage rate of Doctor of Pharmacy (PharmD) graduates on the North American Pharmacist Licensure Examination (NAPLEX) is key indicator of programmatic success. Historically, schools and colleges of pharmacy would be monitored by the Accreditation Council for Pharmacy Education (ACPE) if the passage rate of the program fell two standard deviations below the national average. As presented in this Commentary, it does not appear this approach fully captures the intent or spirit of the monitoring paradigm. We present an alternative approach that seems superior when used in conjunction with the current method. This analysis is especially timely since the professional standards adjudicated by the ACPE are currently under revision. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data in the present study are in public domain.