Rx for Reinvigorating a PharmD Peer Tutoring Program

By: Lauren McQuaide, BS, PharmD Candidate Class of 2026, Hope Brandon, PharmD, MBA, Esther P. Black, PhD, and Arryn Blaine, PhD 

Optimizing Peer-Assisted Learning to Augment Student Success 

Over the past 6 years, average first-time pass rates for the North American Pharmacist Licensure Exam (NAPLEX) have declined by approximately 13%, indicating more pharmacy school graduates who do not demonstrate minimum competence to practice pharmacy.¹ The University of Kentucky College of Pharmacy (UK COP) has also witnessed declining NAPLEX scores since 2023² and a subjective decrease in student’s clinical competence in didactic and experiential settings. To address these observations, the UK COP enacted a 70% examination average passing standard (“the 70% rule”) in therapeutics courses. In tandem, the UK COP reinvigorated the PharmD program’s peer tutoring as additional support. We will highlight steps taken to improve the school’s tutoring program and discuss its perceived impacts to assist in supporting other institutions who may attempt similar pursuits. 

Historic Peer-Learning Perspective 

For decades, students who excelled in the classroom have educated their peers.³ This is mutually beneficial: tutees clarify concepts in a less-intimidating environment, and tutors foster teaching skills and content mastery. Over the past decade, the UK COP has attempted peer-assisted learning with variable success. 

Historically at the UK COP, students in Rho Chi were peer tutors. The Rho Chi Society is a Pharmacy Honor Society composed of the upper 20% in GPA of the second through fourth year (P2-P4) PharmD cohort. For many years, Rho Chi tutoring consisted of office-hour style sessions where students could come in-person to ask questions of volunteer Rho Chi tutors. This was considered minimally successful; attendance was often single digits with minimal engagement. Little data was collected from which to assess program impact. Additionally, reserving building space and timing of the tutoring sessions each week posed logistical challenges. 

In the 2024-25 academic year, the UK COP modified its tutoring structure to support both students and faculty. Tutoring was transformed into a more robust, supplemental instruction model with expanded accessibility for students.

“C” You at the Finish Line! 

The tutoring program structure for 2024-25 included weekly review sessions for historically difficult courses in the P1-P2 years. Sessions were virtual with two tutors assigned to the course who created weekly reviews synchronously with course content. Students could attend sessions live or watch session recordings. 

Here is a summary of the tutoring changes: 

Organizational Changes	Logistical Changes	Content Changes
Created a tutoring Standard Operating Procedure to outline the workflow and duties Expanded tutor eligibility outside Rho Chi to any student who completed a course with an “A”  Assigned tutors to courses in pairs to offset workload Compensated tutors for one hour of preparation and one hour of instruction each week	Set standing tutoring times for each course throughout semester  Instated webinar-style, recorded tutoring sessions available for repeat or asynchronous viewing (i.e. Zoom)  Required weekly communication between tutors and course directors regarding content or classroom needs  Collected qualitative and quantitative data related to perceptions of the program, student attendance, and academic performance for quality improvement	Created virtual forums for questions prior to or during sessions Implemented a teaching-based model with prepared material and practice questions in sync with weekly course content (i.e. supplemental instruction)

Assessment of Changes 

After implementation, we witnessed several positive effects. Administrative burden decreased as tutoring no longer required building space and dynamic scheduling. The standing, recorded virtual sessions allowed for direct import into the learning management system and provided data on synchronous and asynchronous viewing. Attendance was significantly improved from historic models, with peak attendance at approximately sixty students. Tutors enjoyed sharpening their classroom knowledge, and tutees felt they understood content better. Course directors valued tutors’ material. 

We noticed several areas for improvement. Similar to past models, tutee engagement was passive and minimal. Most tutees did not communicate in virtual forums before or during sessions. Although students reported a subjective improvement in  understanding of course content, we did not observe increases in examination scores linked to tutoring attendance. Tutors reported that the time needed to prepare supplemental instruction each week was greater than their compensated time. 

As we reflect on our experience, we would love to hear from others. How have you worked to promote active student engagement in a logistically feasible way? How have you been able to move the needle on objective performance such as examination grades vs. improving a student’s subjective perception of understanding? 

The Race Continues 

As the Academy continues to grapple with student success challenges, it is crucial to evaluate and develop strategies that are efficient, effective, and well received. At the UK COP, we have found value in restructuring our tutoring program. We will continue to optimize and brainstorm ways to encourage student engagement and bolster peer-to-peer support.

This leaves the question: how might we continue to strengthen resources such as peer assisted learning to build lasting knowledge, boost NAPLEX success, and enhance experiential competence? 

References: 

1. ClinCalc. Pharmacy School NAPLEX Pass Rates (2016-Present). Available at: https://clincalc.com/Pharmacy/NAPLEX.aspx. Accessed May 14, 2025. 

2. UK College of Pharmacy. Accreditation. Available at: https://pharmacy.uky.edu/accreditation. Accessed May 14, 2025. 

3. Santee J, G. L. Peer Tutoring Programs in Health Professions Schools. Am. J. Pharm. Educ. 2006;70(3):70. doi:https://doi.org/10.5688/aj700370 

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