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Objective: To evaluate the effectiveness of a sequenced drug knowledge pilot in third professional year students in a capstone course. Methods: A three-phase drug knowledge pilot was conducted in spring 2022. Students completed a total of thirteen assessments, including nine low-stakes quizzes, three formative tests, and a final summative comprehensive exam. Results from the previous year’s cohort (historical control) who only completed a summative comprehensive exam were compared to the pilot (test group) results to assess effectiveness. The faculty spent over 300 h developing content for the test group. Results: The pilot group had a mean score of 80.9% on the final competency exam, which was one percent lower than the control group who had a less rigorous intervention. A sub-analysis was conducted that removed the students who failed (<73%) the final competency exam, and no significant difference in the exam score was found. One practice drug exam was found to be moderately correlated and significant (r = 0.62) with the final knowledge exam performance in the control. The number of attempts on the low-stakes assessments had a low correlation with the final exam score in the test group compared to the control (r = 0.24). Conclusion: The results of this study suggest a need to further investigate the best practices for knowledge-based drug characteristic assessments.

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