Evaluating Pharmacy Students’ Practice Readiness: Insights from Academic and Experiential Performance at University of Waterloo

Abstract

Background: Health professional programs, including pharmacy, face challenges in aligning academic training with real-world healthcare needs, affecting graduates' transition into practice. These challenges highlight the gap between theory and practice, particularly the role of experiential education in students’ practice readiness. Competency-based education and training frameworks such as Entrustable Professional Activities (EPAs), help address this. While EPAs are widely used in medical education, their application in Canadian pharmacy programs remains underexplored. The University of Waterloo Doctor of Pharmacy (PharmD) program, with its co-operative (co-op) education model, provides a unique context for further research in this space. Objectives: This research aims to assess the practice-readiness of University of Waterloo PharmD students and evaluate the utility of EPAs in measuring entry-to-practice competencies. Methods: This thesis includes three studies. The first study examines the relationship between student grades, co-op evaluations, and success on entry-to-practice milestones, including final-year clinical rotations and the Pharmacy Examining Board of Canada (PEBC) Pharmacist Qualifying Examination (QE). The second study explores co-op and rotation preceptors' perceptions of students' practice-readiness, highlighting competencies developed through experiential education. The third study investigates students’ and preceptors’ perceptions of EPAs amongst traditional assessment tools used in the experiential education program. Results: The first study identified predictors of success on clinical rotations and the PEBC QE. The second study found that both co-op and clinical rotations enhanced students’ confidence, communication skills, and teamwork. Co-op provided interprofessional experience, supporting students’ transition to final-year rotations focused on patient care. The third study revealed that students valued the real-world relevance of EPAs but had concerns about grading clarity and applicability in some co-op settings, particularly those not involving direct patient care. Supervisors and preceptors found EPAs practical but noted the need for training and rating consistency, and many preferred a hybrid model integrating EPAs with current tools. Conclusion: This thesis provides insights into existing and novel assessment methods in experiential education in pharmacy and identifies factors influencing practice-readiness among PharmD students within a co-operative education program.