Inter-rater Reliability of Preceptors on Clinical Pharmacy Competency Evaluation

Abstract

Background:: Clinical competence of pharmacy students is better evaluated at their practice sites compared to the classroom. A clinical pharmacy competency evaluation rubric like that of the American College of Clinical Pharmacy (ACCP) is an effective assessment tool for clinical skills and can be used to show item reliability. The preceptors should be trained on how to use the rubrics as many inherent factors could influence inter-rater reliability. Objective:: To evaluate inter-rater reliability among preceptors on evaluating clinical competence of pharmacy students, before and after a group discussion intervention. Materials and Methods: In this quasi-experimental study in a United Arab Emirates teaching hospital, Seven clinical pharmacy preceptors rated the clinical pharmacy competencies of ten recent PharmD graduates referring to their portfolios and preceptorship. Clinical pharmacy competencies were adopted from ACCP and mildly modified to be relevant for the local settings. Results:: Inter-rater reliability (Cronbach's Alpha) among preceptors was reasonable being practitioners at a single site for 2-4 years. At domain level, inter-rater reliability ranged from 0.79 - 0.93 before intervention and 0.94 - 0.99 after intervention. No inter-rater reliability was observed in relation to certain competency elements ranging from 0.31 - 0.61 before the intervention, but improved to 0.79 - 0.97 after the intervention. Intra-class correlation coefficient improved among all individual preceptors being reliable with each other after group discussion though some had no reliability with each other before group discussion. Conclusion:: Group discussion among preceptors at the training site was found to be effective in improving inter-rater reliability on all elements of the clinical pharmacy competency evaluation. Removing a preceptor from the analysis did not affect inter-rater reliability after group discussion.