This study retrospectively analyzed how transitioning from traditional letter grading (TLG) to an honors/pass/fail (HPFG) system affected pharmacy students’ performance during Advanced Pharmacy Practice Experience (APPE) rotations, using evaluations based on entrustable professional activities (EPAs). Additionally, the research explores insights gained from shifting assessment methods from CAPE-based frameworks to EPA-focused experiential evaluations. A total of 6,679 student performance records were analyzed from two pharmacy colleges over a four-year span. In the first two years, both institutions assessed students using a CAPE-based APPE evaluation paired with traditional letter grades. During the subsequent two years, following the transition to EPA-based assessments, one college adopted an honors/pass/fail grading system, while the other continued with letter grading. Changes in performance scores between the pre- and post-implementation periods were examined to evaluate the effect of the grading change. Additionally, multiple linear regression was employed to investigate the influence of factors such as college, evaluation period, assessment type, rotation category, and grading system on student scores. The study also compared grade distributions across the two periods at both colleges.
The college that adopted the honors/pass/fail grading system showed a comparable decrease in student performance scores after the shift to EPA-based evaluations as the college that continued using traditional letter grades. Analysis using multiple linear regression revealed no statistically significant relationship between the grading system and performance scores, after accounting for institution, rotation type, and evaluation period. The adoption of HPFG did not seem to negatively affect student performance on APPE rotations at the college using EPA-based evaluations.
