Prepharmacy Predictors of Success in Pharmacy School: Grade Point Averages, Pharmacy College Admissions Test, Communication Abilities, and Critical Thinking Skills

David D. Allen, Ph.D., Department of Pharmaceutical Sciences; and C. A. Bond, Pharm.D., FASHP, FCCP, Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center-Amarillo, Amarillo, Texas.

Pharmacotherapy. 2001;21(7) 

In This Article

Abstract and Introduction

Good admissions decisions are essential for identifying successful students and good practitioners. Various parameters have been shown to have predictive power for academic success. Previous academic performance, the Pharmacy College Admissions Test (PCAT), and specific prepharmacy courses have been suggested as academic performance indicators. However, critical thinking abilities have not been evaluated. We evaluated the connection between academic success and each of the following predictive parameters: the California Critical Thinking Skills Test (CCTST) score, PCAT score, interview score, overall academic performance prior to admission at a pharmacy school, and performance in specific prepharmacy courses. We confirmed previous reports but demonstrated intriguing results in predicting practice-based skills. Critical thinking skills predict practice-based course success. Also, the CCTST and PCAT scores (Pearson correlation [pc]=0.448, p<0.001) were closely related in our students. The strongest predictors of practice-related courses and clerkship success were PCAT (pc=0.237, p<0.001) and CCTST (pc=0.201, p<0.001). These findings and other analyses suggest that PCAT may predict critical thinking skills in pharmacy practice courses and clerkships. Further study is needed to confirm this finding and determine which PCAT components predict critical thinking abilities.

One of the most important attributes of a successful clinician is the ability to think critically in patient care situations. Despite the recognition of the value of this ability for practice, there are no published reports of pharmacy schools having systematically evaluated this ability as part of their admissions process.

To date, 16 published reports have evaluated prepharmacy admissions criteria as predictors of academic performance.[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16] Most of these studies were published in the late 1970s and early 1980s after the Pharmacy College Admissions Test (PCAT) became available in 1975. However, many of these studies occurred before the development of modern pharmacotherapy courses, problem-based learning courses, and clerkships. In addition, these studies primarily focused on academic success early in the pharmacy curriculum, as opposed to professional practice courses and clerkships, which more accurately imitate pharmacy practice.[1,2,3,4,5,6,7,8,11,13,14,16]

Prospective students are evaluated using various criteria for admission to pharmacy programs. There are differing prepharmacy requirements among pharmacy schools. These requirements focus mainly on biological and physical sciences, mathematics, and general education courses, such as writing, speech, and courses in the humanities and social sciences. Performance in these prepharmacy courses, as well as a student's overall grade point average (GPA), are important components of the admissions process at most schools. In addition, approximately one-half of pharmacy programs require applicants to take the PCAT. It is assumed that most, if not all, of these institutions use the PCAT as an admissions criteria; however, this has not been evaluated.

The PCAT was developed to assist admissions processes by providing more insight into the abilities of prospective students.[13] This test was altered in 1993 and currently is undergoing further revision. Performance on the test as a predictor of success was studied after its introduction in the 1970s and again in the mid-1990s. Most evaluations compared PCAT performance with academic performance in the first year of the pharmacy curriculum. There are conflicting reports about the predictive capabilities of this instrument.[3,6,12] A detailed review of earlier studies evaluating the PCAT and its utility as a success predictor, alone and in comparison with GPA, was published in 1995.[16] The authors of the review also evaluated the post-1993 version of the PCAT. While earlier studies demonstrated that the PCAT is a better predictor than GPA,[5,12] other reports found the opposite result.[4,9] The PCAT subsections were evaluated for predictive value as well.[3,6,9,12]

In addition to PCAT and prepharmacy GPA scores, common prerequisite undergraduate courses have been assessed for predictive power. Math and science grades may be significant predictors of pharmacy school academic success; this suggests that performance in specific courses may be relevant to admission decisions.[7,9] Certain demographic data may be important parameters as well.[15]

None of these studies focused on critical thinking skills or drug problem-solving skills, even though these skills are critical to the ability of today's graduates to provide pharmaceutical care for their patients. This study focuses on several new prepharmacy assessment measures -- the California Critical Thinking Skills Test (CCTST), the on-campus interview, and problem assessment scores -- as predictors of academic success in a modern curriculum. In addition, this study looks at various components within the professional curriculum, including grades for group- and problem-based learning courses and performance in nine categories of clerkships. This is the first study to focus on predictors of success for all components of the modern pharmacy curriculum.

Clearly, evaluation of predictors for success in a school of pharmacy (SOP) is needed to identify students who will matriculate these programs and achieve professional success. Newly established pharmacy programs have a significant disadvantage in predicting success due to lack of prior performance history in their curricula. The Texas Tech University Health Sciences Center SOP is a new school that graduated its first class in May 2000. Therefore, with a new curriculum, we evaluated predictors for academic success in our program. This work represents 4 years of data and will be continued as further data become available. It includes prepharmacy data, tests, assessments, and grades for all coursework in the SOP program, scored on a 0-100% basis.

Although limited to 4 years, the data show statistically significant factors for predicting success in our program. We found variables expected to predict for certain aspects of success in the program based on previous studies. In addition, we found new, unexpected results of a variable that predicts performance on clerkship rotations and in pharmacy practice courses. Though preliminary, this finding is very important, as it has not been previously demonstrated that a parameter can predict aspects of a curriculum most closely related to practice.

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