A Comparison of the Arbitrary Set Fifty Percent Pass Mark Standard and Grade Point Average Attainment for Pharmacy Students at the University of Zambia: Implications for High-stakes decisions in Assessments

In many higher learning institutions and Health Professions Education (HPE) programmes in particular, there exists varying standard setting methods for assessment, certification and graduation of students’ academic performance. In Zambia, the historic arbitrary set 50% pass-fail standard is predominant in most health professions’ training programmes. Scientific validation of this practice, however, remains scarce. The aim of this study was to compare the academic performance on the historic arbitrary set 50% pass-fail standard to the Grade Point Average (GPA) score attainment for pharmacy students examined between 2013 and 2017 at the University of Zambia. A cross-sectional study was conducted with a total of 445 randomly selected final examination results for undergraduate pharmacy students examined between 2013 and 2017 at the University of Zambia. The data was analysed using Stata 13 and GraphPad Prism 5.  For all the statistical tests conducted, normality of the data was checked using the Shapiro-Wilk test. There was statistically significant difference between the historic arbitrary set 50% pass-fail standard and the course-specific examination composite score attainment in all the courses (P<0.0001). Additionally, there was a statistically significant difference between the examinees’ GPA score attained and the acceptable GPA score of 3.0 (Median GPA 1.75; IQR: 0.75-2.25 and 1.67; IQR: 1.0-2.0) for the fourth and fifth-year examinees respectively). The comparison of the academic performance on the arbitrary 50% pass-fail standard and GPA score attainment for pharmacy students revealed that despite students demonstrating ability to attain high course-specific composite scores using the arbitrary set 50% pass-fail standard, the attained median GPA score was statistically significantly less than the minimum acceptable GPA score of 3.0. While the 50% pass-fail standards’ precision to detect academic performance maybe questioned, the findings suggests that the incorporation of a credit point and GPA system for making assessment decisions to rate students, certification and graduation requirements in Health Professions Education may offer better precision and prediction to detect academic performance and competency attainment.