(6) Comparison of NAPLEX first-time pass rates before and after the COVID-19 pandemic

Objective : To describe the change in first-time pass rates of ACPE-accredited schools of pharmacy before and after the COVID-19 pandemic.

Methods: A retrospective, observational cohort study using publicly published data of passing rates for the North American Pharmacist Licensure Examination (NAPLEX). Programs with first-time pass rates from 2019 to 2022 graduates were included in the analysis.

Results: The analysis included 136 programs. No significant difference in first-time pass rates was found when 2019 graduates were compared to 2020 graduates (p = 0.966). However, a significant decrease in pass rates was found when comparing 2019 graduates to 2021 graduates (p < 0.001) and 2022 graduates (p < 0.001). These decreases were consistent across all programs regardless of when the program was accredited and whether the duration of the program is accelerated or traditional. When comparing first-time pass rates pre- (2019) and post- (2022) pandemic, 82% of schools had a decline of 1% or more with 38% having a decline of 10% or more. Nineteen percent of schools had no change (n=5) or an increase (n=21) in first-time pass rates. On average, the decline in first time pass rate was 7%.

Conclusions: There are a multitude of factors that could explain the decline in first-time pass rates including the stresses of learning during a global pandemic, virtual learning being less effective than in person learning, remote exam administration which increased opportunities for cheating, an update to the NAPLEX blueprint in 2021, and declining applicant pools which may increase the proportion of students who struggle in the PharmD curriculum. Schools should devise plans to ensure student success.