The Time for Competency-Based Education is Now

By:  Sara Trovinger, PharmD, MSEd

In early March of 2022 Stuart Haines, 2021-2022 President of AACP, posted a thought provoking article in the AACP Council of Faculties titled, “Optimizing Pharmacy Education Across the Lifespan” which highlights Strategic Priority 2 in AACP’s 2021-2024 Strategic Plan Priorities, Goals and Objectives.1  The article he posted focused on competency-based education (CBE), an approach to learning that allows students to advance in their educational journey based on their ability rather than the speed of the environment.2 CBE is currently seeing a renaissance in pharmacy education due, in part, to the creation of the AACP Transformation Center. It is time for pharmacy education to look at CBE as a tool in the path forward for our profession. 

History of CBE in Pharmacy Education

Pharmacy initially started as a CBE system with apprenticeships. While CBE practices have been around for hundreds of years in the form of craft guilds and technical training programs, there has been a slow uptake of this in other higher education settings. In 2014 there were only 34 colleges or universities in the United States that had CBE programs in existence.3 

Traditionally, pharmacy has taken a very regimented view of the education of future pharmacists, with stringent requirements for the amount of time a student must spend preparing for their pharmacy career.  Even parts of the pharmacy curriculum that are rooted in CBE practices, such as rotations, have minimum time parameters.  The model of educational credits being tied to time and not competency forced the movement of pharmacy education in this direction.

Why CBE?

CBE makes sense in pharmacy education. A recent article comes to the conclusion that mastery learning, i.e. competency-based learning, shows “improved learning outcomes compared to more traditional methods of learning”.4 Not only does it make sense academically, but it is also a way that our profession can be more inclusive.  If a student has been a technician in a hospital for 15 years making IVs, do we really need to make them take a class about how to perform this skill? Why does a person who has been a technician in a community pharmacy for 5 years have to complete IPPE hours in a community pharmacy? This is one way we can make pharmacy education more accessible to more people. This increase in accessibility, combined with the increased demand for pharmacists may also lead to an increase in demand for degrees in pharmacy. Everyone in pharmacy education is well aware of the decrease in applicants to pharmacy programs over the past decade. Increases in the demand will help pharmacy education, by both increasing their number of applications and increasing the quality of these applicants.

CBE in the Future

I attended the SXSW EDU conference in early March to collect ideas from other disciplines outside of pharmacy (and even outside higher education), and to see if there are ways to improve what we do for our students. Sometimes I feel we are stuck in a cycle of doing the same thing at many colleges, just to check a box.  I can’t count the number of times I have heard “Well, that is how _____ college does it”.  I wholeheartedly agree with the perspective shared by Williams and Kelley that pharmacy needs to reduce barriers to pharmacy education.5 CBE can help to accomplish this. 

The diversification of our field aids in the health of our country and our world. It allows us to reach communities that have traditionally been underserved by pharmacists because the pharmacist comes from that community. The time is now for pharmacy education to shed the traditional checklist ways of educating and embrace new programs that address the new world of healthcare.  CBE offers benefits to pharmacy education that must be explored with best practices established and shared throughout the academy. While additional research is needed for this educational technique, this research would be in vain without the concurrent relaxing of restrictions from accreditation bodies and national education standards.  We, as educators, need to start making the needs of these learners evident to policy makers. ACPE is currently accepting comments for Standards 2025, so now is the perfect time.

 References:

  1. Haines, S.  Reflections and musings: optimizing pharmacy education across the lifespan (strategic priority 2) [blogpost].  Retrieved from AACP Connect Council of Faculties Community Discussions. Updated March 10, 2022.  . www.connect.aacp.org.  
  2. Competency-based education (CBE). Competency-based Education (CBE). https://library.educause.edu/topics/teaching-and-learning/competency-based-education-cbe.
  3. Nodine TR. How did we get here? A brief history of competency-based Higher Education in the United States. The Journal of Competency-Based Education. 2016;1(1):5-11. doi:10.1002/cbe2.1004
  4. Winget M, Persky AM. A practical review of mastery learning. American Journal of Pharmaceutical Education. 2022:8906. doi:10.5688/ajpe8906
  5. Williams, VL, Kelley, KA. The time is now: Addressing access and affordability of a pharmd education through revised program requirements. Pulses. https://cptlpulses.com/2021/12/07/the-time-is-now-addressing-access-and-affordability-of-a-pharmd-education-through-revised-program-requirements/ Published December 6, 2021.

Sara Trovinger is an Associate Professor of Pharmacy Practice and the Director of the Distance Pathway at the Manchester University College of Pharmacy, Natural, and Health Sciences. Educational scholarship interests include the scholarship of teaching and learning. In his/her free time, Sara enjoys Disney World and swimming with her son.


Pulses is a scholarly blog supported by a team of pharmacy education scholars.

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