The Pharmaceutical Journal
Vol 274 No 7354 p774-775
18 June 2005

Society summary

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From pharmacy graduate to pharmacist:

The role of the registration examination and the board of examiners

This article, written in the Royal Pharmaceutical Society’s education and registration directorate on behalf of the board of examiners, explains the role of the registration examination and of the board in assuring the Society’s Council, and the public, that newly registered pharmacists have attained and demonstrated the knowledge, skills, attributes and attitudes needed for practice, and specifically to safeguard the well-being of the public

Interest in the registration examination has been expressed in letters to The Pharmaceutical Journal in the past few months. With the next examination due on 24 June and a new cohort of potential pharmacists about to enter the system, it is worth repeating that the purpose of the examination is to safeguard the well-being of the public by complementing the testing of trainees’ skills in practice by tutors during the preregistration year. The examination also tests:

· Knowledge
· The application of knowledge
· Calculation
· Time management
· Managing stress
· Comprehension
· Recall
· Interpretation
· Evaluation

It does this by using scenarios drawing on a broad range of topics — some of which may not have been encountered by the candidate during the preregistration year.

A range of assessments

The examination (and its syllabus) must not, however, be seen in isolation.

At undergraduate level the schools of pharmacy, working to the Society’s “indicative syllabus”, carry out their own assessments from admission to final examinations. These assessments concentrate on academic skills, knowledge and attributes, using a wide range of tools, some not repeated at any later stage.

In the preregistration year the pharmacy employers (as preregistration tutors) assess the preregistration graduates’ achievement of the performance standards with a focus on demonstrating competence in the work place and professionalism, with suitable evidence collated into a portfolio. The tutors also determine the suitability of their trainees to go forward to sit the examination. (Employers, of course, assess again later at the recruitment stage.)

The Society then tests the application of knowledge using the examination syllabus and a scenario-based multiple choice question format, as described above.

All these assessments operate in concert to build up a portfolio of evidence that provides quality assurance of a person’s performance over the five years from admission to a school of pharmacy to the first professional post. Universities, employers and the Society each assess what falls within their own proper remit and use the best tools for that job.

The board of examiners

The Society appoints examiners and holds examinations under powers granted by the Pharmacy Act 1954. In 1992 the Council decided that progression to the Register should not be an automatic time-serving process but should be marked by a demonstration of competence and activated these powers. The preregistration trainees then undertook the first examination at the time in July 1993.

The Council works through the board, which it appoints after a consultative process. The board consists of up to 12 examiners. One of these must be a lay (ie, non-pharmacist) expert. Technically there are separate boards for England and Wales and for Scotland, but they meet together and are conterminous, operating with two chairmen. There must also be at least one examiner resident in Wales and the Society’s Registrar is on the board ex-officio. All this gives an appropriate spread of expertise and national representation. The roles and discretion of the chairmen and of the other examiners are laid down in detail in the examination regulations, which can be found on the preregistration training section of the Society’s website.

The main work of the examiners is to implement the policy framework set by the Council. They then keep under review the syllabus, regulations, conduct, marking and follow-up from the examination. The examiners are also involved in review of the examination questions.

The examiners carry out all these duties to a strict annual cycle to ensure that question papers are ready at the due dates, and examination results are published on time.

Examiners must not be approached directly or lobbied about examination questions or individual candidates. Examiners only ever see anonymised data and never know the identity of candidates.

Examination questions

Questions used in the examination are taken from a bank written specifically for this purpose. There are currently over 40 question writers, all of whom are pharmacists. Before questions are added to the bank they are assessed by the question writing co-ordinator and two other experienced reviewers to check that they are fit for their purpose.

When examination papers are put together, questions are selected from the bank to ensure that the syllabus coverage, ratio of question types and word counts are consistent with previous years. The examiners review papers at different stages leading up to the sitting, with questions amended if necessary to ensure accuracy and clarity. A subgroup of the examiners meets approximately eight weeks before the examination date to ensure that the questions still match up to current legislation, research and good practice.

Marking

Following each sitting of the examination, all completed answer sheets are sent to the Society’s independent marking contractor. The marking contractor prepares statistical information for a subgroup of the examiners to review the performance of the questions. The examiners look at the facility of the questions (the fraction of candidates who get each question right) and also how well each question has discriminated between candidates (by looking at how closely performance in an individual question is related to the candidates’ total test scores). They also look for any other anomalies related to question performance.

There are from time to time a very few questions which, for all the rigour of the processes, are still found in practice to have arguably more than one correct answer when the marking contractor looks at the papers. To complete the assurance of the examination such questions are withdrawn from the examination before candidates’ marks are calculated for the results awarding process. The results are then rechecked to ensure that no candidates have been moved from pass to fail for this reason alone.

Special arrangements

A major new policy area for 2005 is to consider requests from candidates for special arrangements at the examination, eg, in the case of disability, within the terms of the examination regulations and Part 2 of the Disability Discrimination Act 1995.

Secretariat

The examinations officer provides the secretariat for the boards and liaises with candidates, examination centres and invigilators to ensure that the day of the examination runs smoothly. The examinations officer works alongside the examination question-writing team and oversees the production of papers. Following each examination sitting, the examinations officer and the Society’s marking contractor prepare for awarding the results. The examinations officer is responsible for the accurate and timely release of candidates’ results, and the processing of subsequent appeals and re-markings.

The future

The examiners and the Society’s staff can demonstrate the care and attention they pay to ensure a fair and robust system. For the future, all of the above will be reviewed and consulted on in the context of the imminent Order to be made under Section 60 of the Health Act 1999. Until then, though, the registration examination will remain — as currently constituted — as an essential element of public protection.