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INTEGRATED ORAL ASSESSMENTS�2026�Overview and Lessons for Preceptors

Sarah M. Westberg, PharmD, FCCP, BCPS

Heather Blue, PharmD, BCPS FMSHP BCEMP

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Learning Objectives

  • Describe the framework for oral exams for 2nd and 3rd year pharmacy students.
  • Identify methods for applying similar conversations with students on IPPEs & APPEs to assess clinical knowledge

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Student Learning Goals for the Oral Exam

  • Effectively integrate and apply knowledge from multiple modules to the development of an assessment and care plan for a complex patient case.
  • Assess a patient case with clinical conditions from WTL content thus far.
  • Develop a care plan for a complex patient case and be able to verbally rationalize and defend the care plan.

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General Content Rubric

  • Part 1: Skill in assessing a patient case, identifying MTP’s, and developing a plan of care:
    • Identification of patient medication related problems
    • Be able to list therapeutic options
    • Identify appropriate drug dose/route/rate
    • Recognition of therapeutic targets/goals
    • Identify appropriate follow-up plan
  • Part 2: Skill in applying evidence-based medicine to patient case:
    • Be able to identify major trial and/or appropriate guidelines for clinical decision making
    • Be able to apply the findings of landmark trials to a patient case

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Content Covered

  • Each exam has 2 cases
  • For P2 students (Spring)
    • 1 case focuses on Fall content and 1 on spring content
    • Both cases are ambulatory care
  • For P3 students (Fall)
    • Both cases focuses on acute care topics from the fall

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Assessment

  • Each case is worth 20 points of content + 10 points for communication
  • Content: students should be able to identify medication therapy problems, be able to discuss therapeutic options and their pros/cons to resolve the MTPs, and formulate a recommended plan with justification for course of action
  • Students will receive a individualized written feedback report general feedback at some point after the exam (typically in 2-3 weeks).
  • Evaluators may provide some general constructive feedback on style as student exits

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Framework for the Oral Exams

Prep Room 1

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Breakout

Facilitators will help move students at appropriate times

Case 1 Eval

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Each evaluator will have individual breakout rooms (named by station)

Debrief

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1 Breakout with facilitated discussion within one cohort of students

Case 2 Eval

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Each evaluator will have individual breakout rooms (named by station)

Prep Room 2

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1 Breakout

Facilitators will help move students at appropriate times

MAIN ZOOM ROOM

Instructions will be provided to students before they go to Prep Room 1.

They will go to the Breakout Rooms listed below at the appropriate times.

Enter Main �Zoom Room

Prep 1

15 min

Case 1 Exam

10-12 min

Prep 2

15 min

Case 2 Exam

10-12 min

Debrief

15 min

3 minutes to complete eval

3 minutes to complete eval

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Sample Schedule

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Tips & Advice for Evaluators

  • Please ask the specific questions on the Qualtrics evaluation survey
    • If comfortable, you can ask student to prioritize which problem they want to discuss first.  But, this may mean that you’re going to have to scroll up & down in the survey during the Q&A
  • If a student is struggling or “freezes”, please give them a chance to skip the question and come back to it if there’s time.
  • It’s OK to rephrase a question if a student needs a prompt/clarification
  • It’s OK to repeat back the student answer…especially if their answer was unclear

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More Tips and Advice

  • Students are advised to clearly state when they don’t know something vs. guessing
    • It’s OK to prompt them to offer their initial thoughts and where they would look it up to confirm.
  • Evaluations have a free text box for “significant concerns”.  Please use this for the following types of scenarios:
    • Overt unprofessional behavior
    • Complete lack of effort or caring
    • Clinical recommendations that are significantly dangerous
    • Anything else that makes you uncomfortable as an evaluator

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Exceptional 

Competent 

Developing 

Needs Improvement 

Verbal (3)

3

Demonstrates clear, confident verbal communication: appropriate pacing, tone, and volume

2

Verbal communication is generally clear but may include minor issues with pacing or filler words

1

Verbal communication is occasionally unclear due to poor organization, low volume, or excessive fillers

0

Verbal communication is ineffective or difficult to follow

Nonverbal (3)

3

Nonverbal communication supports message (e.g., eye contact, posture, gestures)

2

Nonverbal communication is mostly appropriate, with some distracting behaviors

1

Nonverbal communication includes distracting behaviors or lacks engagement (e.g., minimal eye contact)

0

Nonverbal communication detracts from message (e.g., slouching, no eye contact, closed-off body language)

Organization (2)

2

Language is professional, organized, and free from filler words or distracting habits

1.5

Language is mostly professional; minor lapses in organization or clarity

1

Language may be informal or disorganized

0

Language is unprofessional, disorganized, or severely lacking clarity

Focus (2)

2

Responses to case questions are concise, accurate, and directly address the prompt

1.5

Answers case questions with moderate effectiveness and minor need for clarification

1

Responses to questions are incomplete or require significant clarification

0

Unable to answer case questions effectively

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Overall Impressions: Tips given to students

  • Drug Information: logical order with appropriate detail
  • Respond directly to questions from evaluator re: rationale of choices
  • Pronunciation and vocabulary
  • Sentence Structure (grammar)
  • Clarity of meaning
  • Eye contact, posture, body language
  • Set up your space for zoom: camera at the top of your screen, good background, good lighting, etc.
  • Breathe.
  • Confidence!

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Use of Resources: Tips given to students

  • Use what you already know – so much information is already in your brain!
  • You can use resources….BUT
    • Don’t let the drive to “look up the right answer” obscure your view of the big picture of your patient case
    • Best not to be using new resources during the evaluation time
  • Have a plan for:
    • Using screens and devices to access the case and resources
    • How to best take notes on your key recommendations to quickly reference during the evaluation

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Student Instructions

  • Develop and then prioritize a medication therapy problem list for this patient. 
  • Construct a therapeutic plan to resolve each identified medication therapy problem, and be prepared to provide rationale for your plan.
  • Be prepared to comment on the management of each of her medical conditions and verbally present all the necessary recommendations.   

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Common Questions – P2

  • List the actual and potential medication therapy problems that need to be addressed with this patient
  • What is your drug therapy recommendation to address the MTP? What is your rationale? What other choices did you consider?
  • What evidence supports your choice/goal?
  • Talk me through each of the 4 components of IESC for this medication & this patient
  • What SDOH are present and how are they contributing?

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Common Questions – P3

  • What is the most urgent problem that needs to be addressed?
  • According to guidelines, what would you recommend for this problem?
  • What are the efficacy goals and safety monitoring recommendations?
  • The patient is ready for discharge; what recommendations do you have for medication changes?
  • The patient has _________. Which of the patient’s home medications must be held and why?

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Application to Precepting

  • Students bring experience in verbally answering questions about a case
  • Provide students ~15-20 minutes for chart review
  • Ask students to talk through the PPCP
    • What MTP’s did you identify?
    • What recommendations do you have to resolve these MTP’s? What’s your rationale? What other options did you consider?
    • What’s your follow-up plan?

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Examples where this could be helpful

Student 1: He seems to have it together, but I’m not sure the depth of his understanding of key concepts.

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Student 2: She appears to have the knowledge and does very well when given lots of time in chart review -- but how do I help her increase her efficiency?

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Student 3: She’s really struggling to provide solid assessments & recommendations. How can I pinpoint errors in her thought process?

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