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 for passage rate >= 2 SD below the national average. Since the National Association of Boards of Pharmacy (NABP) no longer reports scores, this procedure is being reconsidered. Our supposition is that the failure rate of >= 2 SD below the average should be retained, but now be based on the national average passage rate rather than score. Yet, we further suggest this is not sufficient due to major variations in class size. Commentary: We suggest the establishment of a "maximum acceptable failure count," likely in the range of 20 to 25 failing graduates per class. Analyses of data from 2017 to 2019 indicate that this approach would lead to monitoring approximately 15% of existing programs that graduate approximately 40% of individuals failing NAPLEX vs. monitoring only 5% of programs that graduate approximately 9% of individuals failing NAPLEX. Implications: The historical method of monitoring pharmacy programs with NAPLEX passage rates >= 2 SD below the national average is not sufficient, primarily due large variations in class size. Since accreditation standards are currently being revised ("Standards 2025"), this would be an ideal time to update methods for selecting programs that warrant monitoring based on inadequate NAPLEX passage rates. We suggest the concept of "maximum acceptable failure count" should be considered when identifying programs to be cited.