Grading trends and evaluation of student performance across advanced pharmacy practice experiences (APPE) in the Big Ten Academic Alliance (The GRAPPES study)

With over a third of the doctor of pharmacy curriculum relying on experiential education (EE), it is critical that students are assessed and graded in accordance with their actual performance. The objective of this paper is to review advanced pharmacy practice experience (APPE) grading across the Big Ten Academic Alliance to describe how APPE grading occurs at these institutions and highlight differences in approach and outcomes.Experiential directors/deans were asked to import de-identified data (e.g., APPE curriculum, midpoint and final evaluation score and grade, number of preceptors, number of students, number of years of pharmacy school, total hours of APPEs offered, number and duration of APPEs per year, grading scale information). A chi-square test including pairwise comparisons with a Bonferroni p-value adjustment for multiple comparisons was performed.Seven college/schools submitted data from over 3600 students between 2012-2015. The distribution of letter grades differed significantly across all colleges/schools in 2012-2013, 2013-2014 and 2014-2015 (p 0.0001). Similarly, the distribution of letter grades by rotation type varied significantly for all colleges/schools (p 0.0001). Students in acute care, ambulatory care, and other patient care rotation types were less likely to obtain an "A" and more likely to obtain a "B" compared to students in other rotation types.When letter grades are used for APPEs, the trend suggests over 95% of students receive an "A" or "B" grade. Final grades varied by rotation type with more "B" grades observed in patient care rotations than "A" grades over the three-year period.