(94) Using continuous performance monitoring to design individual student plans optimizing EPA entrustment prior to graduation

Objective : To describe how continuous performance monitoring and early intervention and individualized in-course remediation strategies implemented during the Advanced Pharmacy Practice Experience (APPE) year can improve students’ achievement of minimum entrustment level for each Entrustable Professional Activity (EPA) decreasing the need for end of year remediation.

Methods: Students’ EPA ratings were recorded and reviewed at midpoint and endpoint of each APPE. Despite repeat opportunities to demonstrate entrustment with an EPA within a core APPE course and/or subsequent core APPEs, some students were not entrusted to perform a specific task with reactive supervision (performance level 3), which is the minimum entrustment level the program requires. Three early intervention and remediation strategies were implemented to ensure deficiencies are improved as early as they are identified: (1) proactive review of students’ past performance on EPAs with a focus on tailoring subsequent core APPEs to meet deficiencies, (2) using elective APPEs to augment activities identified as requiring remediation within core APPE(s); scheduling changes incorporated where applicable, and (3) intensive one-on-one remediation and reassessment by clinical faculty for students who do not meet EPAs through course embedded and course sequence modification approaches.

Results: In 2021 and 2022, remediation was offered by clinical faculty following the APPE course sequence; 3 students (4%) and 1 student (1.5%) required remediation respectively. In 2023 to date, 3 students (4%) will complete in-course remediation in a subsequent elective APPE with no modification to the schedule warranted.

Conclusions: Monitoring student performance on EPA entrustment systematically optimizes proactive early intervention for students at risk of not achieving the minimum expected entrustment. Early intervention with individualized remediation plans throughout the APPE course sequence has decreased the need for end of year remediation.