A Process for Curricular Improvement Based on Evaluation of Student Performance on Milestone Examinations.

To identify and address areas for curricular improvement by evaluating student achievement of expected learning outcomes and competencies on annual milestone examinations. Students were tested each professional year with a comprehensive milestone examination designed to evaluate student achievement of learning outcomes and professional competencies using a combination of multiple-choice questions, standardized patient assessments (SPAs), and objective structured clinical examination (OSCE) questions. Based on student performance on milestone examinations, curricular changes were instituted, including an increased emphasis on graded comprehensive cases, OSCE skills days, and use of patient simulation in lecture and laboratory courses. After making these changes, significant improvements were observed in second and third-year pharmacy students' grades for the therapeutic case and physician interaction/errors and omissions components of the milestone examinations. Results from milestone examinations can be used to identify specific areas in which curricular improvements are needed to foster student achievement of learning outcomes and professional competencies.