Summative assessment in a doctor of pharmacy program: a critical insight

BACKGROUND The Canadian-accredited post-baccalaureate Doctor of Pharmacy program at Qatar University trains pharmacists to deliver advanced patient care. Emphasis on acquisition and development of the necessary knowledge, skills, and attitudes lies in the curriculum's extensive experiential component. A campus-based oral comprehensive examination (OCE) was devised to emulate a clinical viva voce and complement the extensive formative assessments conducted at experiential practice sites throughout the curriculum. We describe an evaluation of the final exit summative assessment for this graduate program. METHODS OCE results since the inception of the graduate program (3 years ago) were retrieved and recorded into a blinded database. Examination scores among each paired faculty examiner team were analyzed for inter-rater reliability and linearity of agreement using intraclass correlation and Spearman's correlation coefficient measurements, respectively. Graduate student ranking from individual examiner OCE scores was compared with that of other relative ranked student performance. RESULTS Sixty-one OCEs were administered to 30 graduate students over 3 years by a composite of eleven different pairs of faculty examiners. Intraclass correlation measures demonstrated that examiner team reliability was low and linearity of agreements was inconsistent. Only one examiner team in each respective academic year was found to have statistically significant inter-rater reliability, and linearity of agreements was inconsistent in all years. No association was found between examination performance rankings and other academic parameters. CONCLUSION Critical review of our final summative assessment implies it is lacking robustness and defensibility. Measures are in place to continue the quality improvement process and develop and implement an alternative means of evaluation within a more authentic context.