Comparison of pre-registration examination results forpharmacist interns in South Africa — transitioning frompaper-based to online format between 2015 and 2022

Background: The South African Pharmacy Council (SAPC) pre-registration examination is a key competency assessment for pharmacist interns seeking professional registration. Over the past decade, the examination method has evolved from paper-based to online at designated venues and then to remote online formats. Aim: To analyse pharmacist interns’ performance across three examination methods conducted by the SAPC between 2015 and 2022. Methods: An observational, longitudinal study analysed retrospective examination results of 4 843 pharmacist interns who attempted 5 437 pre-registration examinations, which are grouped into three periods: Period A (2015–2016, paper-based), Period B (2017–2019, online at designated venues), and Period C (2020–2022, remote online). Performance included pass rate and number of examination attempts across Paper 1 (pharmaceutical calculations) and Paper 2 (general and sector-specific knowledge). Results: The number of pharmacist interns who passed the first time showed a statistically significant increase when the format changed from paper-based to remote online examinations (p < .0001; Cramér’s V = 0.1314). Median marks of Paper 1 increased from 70.0% (IQR 62.0%–80.0%) to 77.5% (IQR 68.0%–83.0%), those of Paper 2 from 56.0% (IQR 46.0%–62.0%) to 70.0% (IQR 64.0%–75.0%), with overall pass rates increased from 59.0% in paper-based to 91.9% in remote online exams (p < .0001; Cramér’s V = 0.3805). Performance varied by university of graduation and pharmacy sector, while gender exerted minimal influence. Conclusion: The results revealed a significant improvement in performance across examination methods, with the highest first-attempt pass rates during remote online examinations.