Currents in Pharmacy Teaching and Learning 13 (2021) 255–260

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Currents in Pharmacy Teaching and Learning

journal homepage: https://www.journals.elsevier.com/currents-in-
pharmacy-teaching-and-learning

Research Note

Supporting students with academic difficulties

⁎
Javad Tafreshi , Sophia Chorbadjian, Dania Jaradat, Samantha Johannesmeyer
Marshall B. Ketchum University College of Pharmacy, 2575 Yorba Linda Blvd., Fullerton, CA 92831, United States

A R T I C L E I N F O A B S T R A C T

Keywords: Introduction: Up 15% of health professions students experience academic difficulties. We describe
Pharmacy school
an early tracking system that effectively identifies and supports students with performance defi-
Academic difficulties
ciencies. The objectives of this study were to discuss changes made in an academic success system
Professional school
Support at our new college of pharmacy, describe effectiveness of the updated program after one-year of
use, and present changes that are being discussed based on the faculty and student feedback.
Methods: We conducted in-person faculty interviews using open-ended questions to evaluate the
effectiveness of our original program for supporting students with academic difficulties called the
Early Tracking System (ETS). We then developed a new program titled the Individualized Plan
for Academic Success System (IPASS). We conducted more faculty interviews and a student survey
after the implementation of IPASS to evaluate its effectiveness.
Results: In the 2018–2019 academic year at our institution, IPASS was activated 291 times, of
which there were 27 course failures. The results of our study indicated a pass rate of 90.72%
post-IPASS for all pharmacy students.
Conclusions: The goal of this study was to revise and implement an early tracking system that all
faculty members, students, and administrators can utilize efficiently and effectively. This study
demonstrated that students with academic difficulties have the potential for progression if their de-
ficiencies are detected early. We described a unique system by which we addressed the needs of
the at-risk students. The interview of faculty and survey of students indicated satisfaction with
IPASS.
© 2020 Elsevier Inc. All rights reserved.

Introduction

Six to 15% of health professions students experience academic difficulties.1–3 In pharmacy programs, as in all other professional pro-
grams, students are expected to have proper study skills and abilities that lead to their success.4 Given the transition from undergrad-
uate to graduate or professional schools, identification of these deficits is essential in successfully progressing through the curriculum.
Many pharmacy schools predict student success early through the evaluation of admission grade point averages and Pharmacy College
Admission Test scores.5,6 There is concern that many struggling students are not identified.1,7 Students struggle during pharmacy school
for various reasons, one being that students do not know what to expect or what will be expected of them. Therefore, graduate and
professional programs have a responsibility to identify and support students who experience academic difficulties within their pro-

⁎ Corresponding author.
E-mail addresses: [email protected] (J. Tafreshi), [email protected] (S. Chorbadjian), [email protected] (D. Jaradat),
[email protected] (S. Johannesmeyer).

http://dx.doi.org/10.1016/j.cptl.2020.10.008

Available online xxx

1877-1297/© 2020 Elsevier Inc. All rights reserved.
J. Tafreshi et al. Currents in Pharmacy Teaching and Learning 13 (2021) 255–260

grams.1,5,8,9 An at-risk student can be defined as a student who is likely to receive a course failure, dropout, or be dismissed.1,3,9–13
Studies indicate that although repetition does not correlate with success, remediation does.14 Studies also show there are two ap-
proaches in assisting an at-risk student: accurate prediction and targeted prevention of failure.9
Accreditation standards for a doctor of pharmacy degree, as stipulated by the Accreditation Council for Pharmaceutical Education
Guidance for Standards 2016, states that school policies and procedures must be in place regarding academic progression and remedi-
ation (Standard 17).15 Targeted interventions are needed in order to create policies that produce the greatest learning and persistent
improvements for students. Although faculty members are committed to helping their students succeed, some feel that academic pro-
gression is the student's responsibility and that faculty members should not have to remediate students at the graduate or professional
level.2 Failure of students to recognize and reflect on their own deficiencies adds to the complexity of managing at-risk students.1,8,16–20
In order to identify the source of the deficits proactively, programs should take several procedural steps including early detection of
academic performance problems, an action plan to help students develop better strategies for academic success, or counseling and men-
torship to help facilitate student-driven learning.2,5,16
It is unclear how many institutions have detailed remediation plans that include early tracking systems initiated midway through a
course with the purpose of ensuring that students are aware of areas of improvement and establishing an action plan to improve defi-
ciencies.8,16 Areas of improvement may include addressing academic skills, course performance, and study strategies. Although litera-
ture on schools of pharmacy remediation programs and policies is sparse, some information exists for other programs such as
medical and nursing schools.1,6,19,20 Many agree that written reflections are useful in aiding self-awareness and metacognitive defi-
cits.16,21 After an at-risk student is identified, a collaborative discussion should take place to determine if a performance issue is isolated
or ongoing to establish the type of assistance the student may need.
Our new institution is a traditional four-year doctor of pharmacy program that utilizes a quarter system. Our main methods of teach-
ing include traditional lectures, case presentations, laboratory, and active learning pedagogies. Our program mostly utilizes computer-
ized and written types of testing. The curriculum consists of three years of didactic education incorporated with introductory pharmacy
practice experiences (IPPEs) before students begin their advanced pharmacy practice experiences (APPEs) during their fourth year. Fail-
ing is defined as receiving a final grade of less than 69.45% in any course. A failing grade in any course will not allow the student to
progress to the next academic year. With few exceptions, a majority of the courses assign letter grades to students.
The objectives of this study were to discuss changes made in an academic success system at our new college of pharmacy, describe
effectiveness of the updated program after one-year of use, and present changes that are being discussed based on faculty and student
feedback.

Methods

As a newly established college, we originally developed a program to identify students with academic performance deficits, called
the Early Tracking System (ETS). When a student scored less than 70% on any major assessment, the course coordinator contacted
the at-risk student and the student's faculty advisor. The student was then obligated to meet with their advisor to discuss how they
intended to improve their overall grade. An enhancement plan was formulated with inputs from the student, course coordinator, faculty
advisor, respective departmental chairs, the assistant dean for student affairs, and the associate dean for academic affairs. Following the
end of the fifth week in a quarter, all students who received less than 70% in a course were also contacted and asked to complete the
same process. After the first year of using the ETS, we surveyed all faculty members to evaluate its effectiveness. Many of the faculty
members believed the program had shortcomings. After reviewing the interview results, a program was developed and executed. The
new program consisted of modifications based on faculty feedback and was renamed the Individualized Plan for Academic Success Sys-
tem (IPASS). Both systems apply to all courses in the curriculum.
The policy for IPASS states that at any point during a course, at the discretion of the course coordinators or instructors, students may
be contacted to develop and implement a plan for academic success. Prior to meeting with the course coordinators or instructors, stu-
dents are encouraged to prepare an individualized plan for academic success using the IPASS form (Fig. 1). When approximately 50% of
the cumulative course grade has been generated or at the course midpoint, the course coordinator must identify students achieving
≤75% in the course and notify the student, the assistant dean for student affairs, and the associate dean for academic affairs. At
this stage, the student must complete the IPASS form and communicate with the course coordinator or instructor within three business
days. If a student fails to comply with this policy, the student will be required to meet with the associate dean for academic affairs.
Failure to meet with the associate dean for academic affairs may result in referring the student to the Academic Progression and Pro-
fessionalism Committee for further actions.
The students can voluntarily meet with the assistant dean for student services in order to address any non-academic issues or to ar-
range for the assignment of tutors when there is a proven need. In addition to the resources available to students within the college,
there are multiple other resources that are available through the university such as counseling and discussions on the need for accom-
modations. The Office of Academic Affairs collects IPASS data from the course coordinators. The associate dean for academic affairs
serves as a liaison for the course coordinators by sending additional notifications to appropriate individuals when a student's name ap-
pears in multiple IPASS notifications.
Some of the major changes that were made from ETS to IPASS included the involvement of course coordinators, participation of the
assistant dean for student services, and notification of the associate dean for academic affairs. We also increased the identification
threshold from <70% to ≤75% in order to identify more students who may benefit from increased communication with a course co-
ordinator, increased awareness of their areas of improvement, and assistance in verbalizing strategies in order to reach those improve-
ment goals.

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Fig 1. Individualized Plan for Academic Success System (IPASS) form.

In May 2019, after IPASS was utilized for one complete year, we conducted another round of faculty interviews to evaluate the effec-
tiveness of the program. Approval for this study was obtained by the university's institutional review board in April 2019. Face-to-face
interviews were conducted with all faculty members to evaluate perceptions of IPASS using standardized questions. The faculty inter-
views consisted of one open-ended question that was designed to obtain feedback on the previous ETS as well as the current IPASS.
The faculty interviews were conducted over a two-week period from 29 April through 13 May 2019. The interview results were ana-
lyzed, and comprehensive themes are presented as benefits and weaknesses of the ETS vs. IPASS.
In addition to faculty interviews, students were asked for their voluntary and anonymous feedback on IPASS via a survey on the
SurveyMonkey platform. The associate dean for academic affairs disseminated the five-question survey to all students enrolled in the
pharmacy program. The survey consisted of one yes/no question to gauge use of IPASS and four open-ended questions about experi-
ences with it. Students were reminded to complete the survey on three occasions. The survey was available from 1 May through 11
May 2019. Individual student responses were reviewed to ensure that those who did not have any experience with IPASS did not pro-
vide positive feedback or improvements. All individual responses to faculty interviews and the student survey were reviewed, tabulated,
and kept confidential.

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Table 1
Distribution of IPASS initiations and course failure.

First-year students Second-year students Third-year students Total

(n = 55) (n = 51) (n = 37) (N = 143)

IPASS initiations (n) 147 66 78 291

Course failures (n) 16 5 6 27
IPASS:course 10.88 7.58 7.69 9.28
failures (%)

IPASS = Individualized Plan for Academic Success System.

Results

The IPASS was initiated for students with poor academic performance as defined by the IPASS guidelines. There were 143 students
enrolled in the program during the 2018–2019 academic year: first-year students (n = 55), second-year students (n = 51), third-year
students (n = 37), and fourth-year students (n = 0). In the same academic year, there were 27 course failures throughout the three
class years. These included therapeutics and science-based courses, but no IPPEs. Sixteen students (11.2%) were responsible for the
27 course failures (Table 1). Of the 16 students, 11 students (7.7%) failed one course, three students (2.1%) failed two courses, and
two students (1.4%) failed five courses. The results of our study indicated a pass rate of 90.72% post-IPASS for all pharmacy students
at the end of the academic year.
All faculty members participated in the interviews. The most voiced improvement was that the course coordinators using IPASS pro-
vided more insight and guidance for students who were not succeeding in their courses, whereas the faculty advisors using ETS lacked
proficiency of the course content. Faculty also saw the benefit of one mandated notification at the course midpoint in IPASS rather than
after every examination in ETS. Multiple notifications in ETS resulted in “alert fatigue” and lack of timely response to the notices. Fac-
ulty also noted that IPASS was student-driven, thereby making students accountable for their own academic success. Faculty also noted
the encouraging nature of the name change from ETS to IPASS. While there were many benefits described from the change to IPASS
from ETS, faculty also shared weaknesses of the new program.
The most frequently voiced weakness of IPASS discovered during faculty interviews was that there was no specific mandate of face-
to-face meetings, thereby causing dissimilar ways in which the IPASS policy was carried out by course coordinators. Faculty indicated
that the system could be improved by having a more uniform implementation of the guidelines. Faculty also indicated that the IPASS
program could benefit from having a centralized system in place in order to more effectively monitor at-risk students.
In addition to the faculty interviews, the student survey also provided information on the IPASS. Of the 143 students in the program,
57 responded (39.8%). An analysis was performed using the data from open-ended interviews and surveys. These findings were cate-
gorized based on the most frequent responses received from faculty (Table 2) and students (Table 3). Student responses to two of
the survey questions were excluded from the results based on insufficient information provided. Faculty feedback indicated an improve-
ment between the ETS and IPASS programs. We plan to disseminate the results of the interviews and survey to faculty and modify
IPASS accordingly.

Table 2
Faculty interview responses presented in comprehensive themes.

Characteristic n %

Total number of faculty responses attained 26 100

Number of faculty involved in IPASS 23 88.46
Number of faculty involved in ETS 20 76.92
Theme 1: benefits of IPASS over ETS
Course coordinators (IPASS) are able to more effectively assist students rather than faculty advisors (ETS) 7 26.92
IPASS is triggered at midpoint, unlike ETS which is triggered after every exam 4 15.38
Name change from punitive (ETS) to positive (IPASS) 4 15.38
IPASS requires less work and notifications for faculty over ETS 4 15.38
ETS was automatic and passive, whereas IPASS is active and manual 3 11.54
Theme 2: benefits of IPASS
It is an early detection system that can identify struggling students 12 46.15
It is student-driven and holds students accountable for their own academic progression and success 11 42.31
Student and faculty communication significantly increased 10 38.46
Students who are proactively involved in their academia have shown substantial improvement over time 10 38.46
Course coordinators may initiate IPASS at any given time during the quarter (pre- or post-midpoint) 8 30.77
Course coordinators are able to offer students strategies, resources, and/or additional tutoring if needed 8 30.77
Theme 3: weaknesses of IPASS
Policies of IPASS indicate that students are not mandated to have a face-to-face meeting with faculty 11 42.31
There is no centralized system in place for administration to monitor at-risk students 6 23.08
Faculty Advisors are no longer involved in the IPASS notification for their advisees 3 11.54
Faculty exhaust lots of resources, time, and commitment into the maintenance of the IPASS system 3 11.54
Students lack guidance on how to complete IPASS paperwork and the process thereof 3 11.54

ETS = Early Tracking System; IPASS = Individualized Plan for Academic Success System.

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Table 3
Student survey items and responses.a

Item n %

Have you participated in the IPASS program?

Yes 36 66.67
No 19 33.33
If you HAVE participated in the IPASS program, please list any positive feedback.
IPASS acts as a wakeup call 9 32.14
IPASS increases efficiency when studying 7 25
More personalized feedback from the course coordinator 6 21.43
More interactions with the course coordinator 4 14.29
Access to a tutor 2 7.14
If you HAVE participated in the IPASS program, what are possible areas of improvement?
Increased communication with the course coordinators 6 25
Change the criteria to activate IPASS 6 25
Access to more tutors 4 16.67
For course coordinators to be more genuine 4 16.67
Consistency between course coordinators in carrying out IPASS 4 16.67

IPASS = Individualized Plan for Academic Success System.

a
A total of 143 students were enrolled.

Discussion

There is a clear need for early tracking policies and procedures, yet there is little published literature to guide graduate programs in
developing specific plans.1,8,17,22 Although literature on remediation programs and policies are limited in schools of pharmacy, informa-
tion exists from other institutions such as medical and nursing schools. Literature reveals that other health institutions have similar con-
cerns and struggles as pharmacy schools to find and develop effective, generalizable remediation plans for struggling students.1,6,19,20
Our study provides a unique example of an early tracking system for students with performance deficiencies. Our institution was
able to create an effective and efficient system to identify students with academic difficulties early in a course. Like the didactic curric-
ulum, our institution utilizes IPASS for the IPPEs and plans to utilize IPASS for APPEs with the same procedures. Ultimately, not all
students will be able to circumvent academic failure, even with an effective early tracking system. However, it is the responsibility
of the institution to provide a non-punitive, reliable, early detection system in order to help students successfully progress through
the curriculum. Given the limited guidance on how to deal with struggling students, institutions should work towards a structured align-
ment of pre-remediation policies and principles in higher education.
We believe that the implementation of IPASS was effective at our institution because it identified at-risk students early and advanced
student awareness. Our students became more proactive and had to complete an academic success plan prior to meeting with each
course coordinator in order to enhance their academic performance. This approach allowed the student an opportunity to improve
their performance before final grades were submitted. The system is in place to hold students accountable for their own academic pro-
gression. In addition, the course coordinators are given the opportunity to get to know the at-risk student and understand their aca-
demic difficulties. This approach provides the course coordinators an opportunity to strategize, mentor, and recommend appropriate
resources, such as study tips or private tutoring, to enhance student academic progression. One major change that was implemented
from the previous ETS to the improved IPASS was that the course coordinators, rather than the faculty advisors, were to communicate
with students who were at-risk. However, faculty advisors are still required to meet with their advisees at least once a quarter to discuss
their general progression through the program.
The faculty interviews enabled us to identify issues faculty and students faced with IPASS. In general, faculty seem to notice a more
successful progression from those students who took responsibility and showed an interest in their academic performance. We also
found that with a more unified approach, students and faculty members could have better guidance and understanding of the IPASS
process. As an example, some course coordinators communicated electronically with at-risk students and others required in-person
meetings regarding IPASS. Revising our current system will address the new concerns expressed by students and faculty members to
effectively and efficiently assist students with academic difficulties.
There is a growing need for a system-based perspective for a successful early tracking program.9,20,22,23 Few studies have been con-
ducted to verify and validate the effectiveness of their strategies for early tracking of at-risk students. Based on interview and survey
data, we plan to implement the following to improve our process: (1) an educational meeting with faculty needs to be held to discuss
the findings of this study, (2) there is a need to create more rigorous consequences for students who do not comply with IPASS, (3) fac-
ulty advisors should also be notified initially when IPASS is activated, (4) there is a need to provide more resources for faculty to assist
at-risk students, and (5) there is a need to hold training sessions in order to assist both students and faculty members on how to accu-
rately comply with IPASS. Based on these results, we suggest that professional schools apply a similar proactive approach to minimize
student academic deficiencies. In doing so, we may better contribute to the success of our students and our institutions.14,24 Although
there is a paucity of reporting remediation success rate in pharmacy literature, the mean percent of students generally passing or suc-
cessfully completing remediation in the higher education was reported to be in the 70% range.25
There are limitations to this study. There could be cases where students remained above the 75% cutoff at course midpoint, with no
IPASS initiation, but still failed the course due to poor performance post-course midpoint. Although all faculty members were
interviewed, not all had personally initiated IPASS. In addition, we did not have access to complete data for the 2017–2018 academic

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year when the college was using ETS. We only had complete data for a single quarter; therefore, we were unable to conduct any sta-
tistical analyses. Additionally, including more data from multiple years would have made our study more significant. We did not have
access to demographic information on the student population. Furthermore, being a new program, this was the first iteration of our
curriculum. Given the limitations described, future studies should be performed to monitor the effectiveness of IPASS.

Conclusions

This study demonstrated that students with academic difficulties have the potential for progression if their deficiencies are detected
early. The development of a successful early tracking system can be a challenge. Our goal was to revise and present an early tracking
system that all faculty members, students, and administrators can utilize. By providing students with proactive strategies, institutions
may contribute more to the success of their students. Our study can hold the framework for an ideal early tracking system for any pro-
fessional program. Ensuring accurate identification of struggling students through an improved early tracking system that mandates stu-
dent input and a proactive response are necessary steps to ensure academic success and progression.

Declaration of Competing Interest

None.

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