Pharmacy graduates are required to complete a year of internship before they can be registered as pharmacists with the South African Pharmacy Council (henceforth ‘SAPC’ or ‘Council’). The aim of the internship is to ensure that graduates are provided with an opportunity to gain practical experience and knowledge in a practice setting. To achieve this, various assessments are conducted to ensure that pharmacists entering the profession are competent.
One of the assessments conducted is the Pre-registration examination. The examination is conducted as an open book examination. There were various changes in the examination format with the implementation of the first online examination on 01 April 2017. The current pre-registration examination is based on the 2018 Competency standards for pharmacists with questions set according to the specific domains and competencies. The examination is one paper comprising of the general practice and calculation type questions and a minimum of 120 single-best answer multiple choice questions (MCQs). The questions are contextualised across the manufacturing, institutional and community sectors, challenging the interns to apply themselves and solve the scenarios presented. The SAPC follows a thorough process (Figure 1) in setting, moderating, verifying and approving the examination and results to ensure the assessment is valid and reliable.
Figure 1: Outline of the process in setting examination questions and release of examination results
Remote pre-registrations examinations
The pre-registration examinations were scheduled for 18 July and 22 October 2020. Due to the COVID-19 pandemic, Council experienced challenges in securing examination venues. In addition, Council was concerned that conducting examinations at venues would be a risk to both interns and invigilators. Thus, in July 2020 Council resolved that the pre-registrations examination be conducted remotely in October and November 2020.
To ensure the integrity and security of the examination, Council undertook various measures in developing the remote online examination platform – as outlined in Figure 2. The security measures focused on the code of conduct and declaration; verification of the interns writing the examination as well as the format for displaying examination questions. The interns were able to communicate with the SAPC via a dedicated WhatsApp number during the examination. The examination was remotely invigilated by the SAPC staff, where the primary role of invigilators was to verify interns writing the examination and monitor their progress.
Figure 2: Security measures implemented for the remote online examinations
Preparation of interns for the remote online examination
Council conducted pre-registration examination workshops and practice examinations to prepare interns for the pre-registration examination. Workshop presentations were available on the SAPC website for interns to review prior to the workshops. These focused on the structure and content of the examination. There were six virtual workshops held in August 2020 which were attended by eight hundred and fifty-one interns (851). During the workshops interns were informed of the change in the examination format and were introduced to the remote examination format. Interns had the opportunity to ask questions and engage with the SAPC workshop facilitator. Practice examinations were conducted on 12 September and 28 October 2020, mimicking the remote online examination environment to prepare interns.
2020 Pre-registration examinations results
The online pre-registration examinations were conducted remotely for the first time on 09/10 October and 12/13 November 2020. In total, nine-hundred and seventy-six (976) interns wrote the examinations remotely (Figure 3). The pass rates for the examinations were (87% (average percentage: 77.17%) on 09/10 October 2020 and 86.78% (average percentage: 68.93%) on 12/13 November 2020. These results were consistent with previous examinations. Council wishes to congratulate all interns that sat for the remote pre-registration examination and would like to encourage interns unsuccessful in the examination not to give up.
Figure 3: Number of interns who wrote the examination remotely at various places
The overall outcomes for the examinations are depicted in Figure 4. A combined total of eight hundred and fifty interns passed the examinations held in October (n=699) and November 2020 (n=151). There were one hundred and three (103) interns who were unsuccessful in the October 2020 examination. These interns had the opportunity to rewrite the examination in November 2020. There were twenty-three (23) interns who were unsuccessful in the November 2020 examination.
Of the interns who were unsuccessful, the majority failed the calculations section (October n=103; November n=21) where a subminimum of 60% is required. Far fewer interns failed the general section (October n=2; November n=2) where the subminimum is 50%. As the examination is one paper comprising of the calculation and general sections, interns unsuccessful in any of the sections have to rewrite both sections of the paper.
Figure 4: Percentage of interns who passed and/or failed the Pre-registration examination in 2019 and 2020
The overall results obtained in October and November 2020 were comparable to July 2019 (n=602) and October 2019 (n=189) examinations (Figure 4). The July and October examinations were held at designated venues across South Africa. There was a nominal difference (2,41%) in the pass rates between these four examinations. Likewise, most of the unsuccessful interns failed the calculations sections (July 2019: 11,88%; October 2019: 14,29%; October 2020: 12,84%; November 2020: 12,07%).
As resolved by Council, condonation was applied on the results based on the marks, where interns who obtained one (1) mark less than the pass mark for the calculation questions and/or the general questions were condoned.
Interns who are unsuccessful in the pre-registration examinations in 2020 will be able to either write the supplementary examination in February 2021 (specific criteria apply) or rewrite both sections of the examination in March 2021.
Over the past few years, it has become evident that interns struggle most with the calculation section of the examination. Examination reports are provided to the universities to focus on their identified areas of concern as part of the undergraduate curriculum.
Pre-registration examination in 2021
The COVID-19 pandemic accelerated the Council’s plan to conduct the online pre-registration examinations remotely. The October and November 2020 examinations were both successfully conducted remotely. The challenges experienced during the examinations are being addressed to improve the examination platform. There are added advantages to conducting examinations remotely such as reduced cost and time for interns in terms of traveling to specific venues as well as the convenience of writing the examination in an environment of the intern’s choice. There were a few interns who experienced challenges in connectivity, however, they were given the opportunity to write and/or rewrite the examination at the SAPC offices. The SAPC is planning on strengthening the remote online examination platform and improving the examination experience for interns into 2021 and beyond.