(298) Advanced Pharmacy Practice Experience Exams as Predictors of First-Time Pass Rates for Pharmacist Licensure Exams

Objective : Pharmacist licensure exam pass rates have declined for several years. Predictors of licensure exam performance including the Pharmacy College Admission Test and the Pharmacy Curriculum Outcomes Assessment are no longer required or available, necessitating alternative strategies. We hypothesize that a relationship exists between advanced pharmacy practice experience (APPE) exam scores and first-time pharmacist licensure exam pass rates. Our aim is to assess the correlation between numerical scores on APPE exams and first-time pass rates for pharmacist licensure exams.

Methods: We conducted a single center retrospective observational analysis. APPE examination results between May 2020 and November 2022 were analyzed for association with licensure information from the Texas State Board of Pharmacy (TSBP). Successful first-time pass rates were measured using the TSBP intern and pharmacist license database. Correlation between exam scores and probability of successful licensure was assessed using logistic regression. A classification and regression tree analysis identified the most significant exam score threshold.

Results: Overall licensure success rates were 80.6% for the input cohorts (2021-2022, n=206). Exam scores were well correlated to the likelihood of licensing success (OR=1.04, 95% CI 10.2-1.07, p<.001) on the first attempt. The most significant threshold cutoff was 77.8%. The success rate was 82.5% vs. 16.7% for those scoring above and below the threshold (p=.001).

Conclusions: APPE exam performance was reasonable in predicting the overall first-time licensure success rates for a graduating class. Our assessment appears promising as a risk stratification tool for students who may require additional coaching to facilitate successful pharmacist licensure on the first attempt. Further research in APPE assessment is warranted.