Roisin Kelly-Laubscher 1, Kelly Quesnelle2.1. Department of Pharmacology & Therapeutics, School of Medicine, College of Medicine and Health, University College Cork, Ireland.2. Department of Biomedical Sciences, Xavier Ochsner College of Medicine, New Orleans, Louisiana, USA.Keywords: assessment, pharmacology, formative assessment, feedback, assessment design.Word count: 672Assessment is the driver of learning and the gatekeeper of success. The direction of driving (alignment with learning outcomes) and the type of gate (assessment method and design) determine what is learned and what is required to pass through the gates. Data from studies on prescribing competencies and medication errors suggest that some students may be passing through these gates with inadequate knowledge/understanding of pharmacology and therapeutics, with potential consequences for patient safety 1–3. Though diverse assessment methods are well reported in other disciplines, the literature contains few pharmacology-specific examples of curricular assessment. This special issue fills that gap by providing examples of different forms of assessment in evaluating student learning of pharmacology and pharmacology-related competencies 4–7. It also highlights the importance of assessment feedback as a tool for driving student learning.For staff, assessment results provide feedback that can inform both curriculum and instructional design. In this issue, Click et al .8 demonstrate that their students performed better on both local and national exams after a shift to a curriculum that was both integrated and incorporated active learning. In an excellent example of assessment outcomes informing instructional design, supervisor observations from an authentic workplace-based assessment9, involving student pre-prescribing, were used to inform discussions in the associated tutorials.For feedback to be useful to students, it needs to be provided with sufficient time for students to review it and use it to inform their learning. This type of assessment is usually low-stakes and is called formative assessment. Formative assessment and feedback are key components of inclusive assessment and are critical to driving student learning in the right direction, as well as the development of the metacognitive skills needed for students to become lifelong learners10–13. Examples of formative assessment and feedback evaluated in this issue include partial credit scoring of MCQs14, supervisor/preceptor feedback on medication review and prescribing in real-world settings 9,15 and non-linear slide decks for the assessment and learning of higher-order thinking skills 6. These approaches provide feedback that allows students to inform their learning and calibrate their expectationsDrawing on the limited literature on formative assessment and feedback in pharmacology specifically, as well as in STEM, health professions and the broader education literature, Angelo 10and Hepburn11 provide guidelines on best practice in the area. These papers identify increased workload as a factor that can impede the adoption of best practice in formative assessment and feedback provision. AI may provide some opportunities to minimise this workload, and in this issue, Berg et al . 12 outline their experience of providing a large cohort of students with AI-generated feedback, Thesen et al . 16 evaluate different AI based methods of generating USMLE quality multiple choice questions, and Gerard et al . 17 describe a multi-tool approach to using AI to evaluate the quality of multiple-choice questions. While AI shows promise here, caution is advised, especially in ensuring inclusive assessment13.While the studies published in this special issue highlight the growing body of work in pharmacology assessment, the number of non-pharmacology-specific papers that authors had to draw on indicates significant gaps in the literature. This may be a result of the increasing integration of health professions programmes, which require integrated assessments. However, the same assessment methods do not work equally well for all disciplines, and integrated assessments can sometimes allow students to score well while neglecting certain disciplines18. Therefore, even with integrated curricula and assessments, there is a need for pharmacology-specific evaluation of assessment methods. In addition, if we want to ensure that our assessments are inclusive, we need to challenge ourselves to start asking, “For whom did this assessment task work, and why?” There are many reasons why students perform poorly on assessments, several of which relate to the assessment task itself. If we can gain a deeper understanding of what works, for whom, and when, we can start to refine our assessments to ensure maximum impact in driving learning in the right direction and ensuring that all students with the requisite pharmacology knowledge pass through the gate.

Many science and health profession graduates lack fundamental pharmacology knowledge and the ability to apply pharmacology concepts in practice. This article reviews the current challenges faced by pharmacology educators, including the exponential growth in discipline knowledge and competition for curricular time. We then argue that pharmacology education should focus on essential concepts that enable students to develop beyond ‘know’ towards ‘know how to’. A concept-based approach will help educators prioritise and benchmark their pharmacology curriculum, facilitate integration of pharmacology with other disciplines in the curriculum, create alignment between universities, and improve the application of pharmacology knowledge to professional contexts such as safe prescribing practices. To achieve this, core concepts first need to be identified, unpacked, and methods for teaching and assessment using concept inventories developed. The International Society for Basic and Clinical Pharmacology Education Section (IUPHAR-Ed) Core Concepts in Pharmacology (CCP) initiative involves over 300 educators from the global pharmacology community. CCP has identified and defined the core concepts of pharmacology, together with key underpinning sub-concepts. To realise these benefits, pharmacology educators must identify, unpack, and develop methods to teach and assess core concepts. Work to develop a concept inventories is ongoing, including the identification of student misconceptions of the core concepts and the creation of a bank of multiple-choice questions to assess student understanding. Future work aims to develop and validate materials and methods to help educators embed core concepts within curricula. Potential strategies that educators can use to overcome factors that inhibit adoption of core concepts are presented.

Background and Purpose Development of core concepts in disciplines such as biochemistry, microbiology, and physiology transformed teaching. They provided the foundation for the development of teaching resources for global educators, as well as valid and reliable approaches to assessment. An international research consensus recently identified 25 core concepts of pharmacology. The current study aimed to define and unpack these concepts. Experimental approach A two-phase, iterative approach, involving 60 international pharmacology education experts was used. The first phase involved drafting definitions for the core concepts and identifying key sub-concepts via a series of online meetings and asynchronous work. These were refined in the second phase, through a two-day hybrid workshop followed by a further series of online meetings and asynchronous work. Key Results The project produced consensus definitions for a final list of 24 core concepts and 103 sub-concepts of pharmacology. The iterative, discursive methodology resulted in the modification concepts from the original study, including the change of ‘drug-receptor interaction’ to ‘drug-target interaction’ and the change of the core concept ‘agonists and antagonists’ to sub-concepts of drug-target interaction. Conclusion and Implications The definitions and sub-concepts of the 24 core concepts provide an evidence-based foundation for pharmacology curricula development and evaluation. The next steps for this project include the development of a concept inventory to assess acquisition of the concepts, as well as the development of cases studies and educational resources to support teaching by the global pharmacology community, and student learning of the most critical and fundamental concepts of the discipline.

Background and Purpose: In recent decades, a focus on the most critical and fundamental concepts has proven highly advantageous to students and educators in many science disciplines. Pharmacology, unlike microbiology, biochemistry or physiology, lacks a consensus list of such core concepts. Experimental approach: We sought to develop a research-based, globally relevant list of core concepts that all students completing a foundational pharmacology course should master. This two-part project consisted of exploratory and refinement phases. The exploratory phase involved empirical data mining of the introductory sections of five key textbooks, in parallel with an online survey of over 200 pharmacology educators from 17 countries across six continents. The refinement phase involved three Delphi rounds involving 24 experts from 15 countries across six continents. Key Results: The exploratory phase resulted in a consolidated list of 74 candidate core concepts. In the refinement phase, the expert group produced a consensus list of 25 core concepts of pharmacology. Conclusion and Implications: This list will allow pharmacology educators everywhere to focus their efforts on the conceptual knowledge perceived to matter most by experts within the discipline. Next steps for this project include defining and unpacking each core concept and developing resources to help pharmacology educators globally teach and assess these concepts within their educational contexts.