New Online Competency Modules Standardize CPA Pharmacist Training at Academic Medical Center

At the 2025 American Society of Health-System Pharmacists Pharmacy Futures meeting, Esther E. Ukpokpo, PharmD, a PGY-2 ambulatory care pharmacy resident from Yale New Haven Health, shared results from a major initiative to enhance the onboarding and clinical competency assessment of pharmacists practicing under collaborative practice agreements (CPAs). With more than 80 pharmacists managing care across 15 specialty disease states, the health system faced a challenge familiar to many institutions: how to ensure pharmacists entering and practicing within these advanced roles have consistent, disease-specific training.¹

To meet this need, the team developed a series of structured online assessment modules aligned with ambulatory care practice requirements. Their goal was to promote consistent, high-quality, pharmacist-led care by standardizing the way clinical competence is evaluated—both at initial onboarding and as part of ongoing professional development.¹

Why Competency Modules Matter in Collaborative Practice

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CPAs allow pharmacists to manage complex patient care activities, such as initiating or modifying therapy, ordering laboratory tests, or conducting follow-up, under a formalized agreement with physicians. As the scope of pharmacy practice expands, especially in ambulatory care and specialty settings, ensuring pharmacists are equipped to safely and effectively manage patients becomes essential.

Creating disease-specific competency assessments also ensures alignment with evolving standards of care. For example, CPAs are especially impactful in managing chronic conditions such as diabetes, heart failure, and rheumatoid arthritis, where pharmacist intervention has been shown to improve outcomes and reduce hospitalizations.²

Building Modules: A Structured Approach

Fifteen specialty areas were initially identified for assessment module development, chosen for their clinical complexity and pharmacist involvement. Using a roadmap strategy, the team established milestones and recruited expert pharmacists involved directly in CPA-driven patient care.¹

Each module was developed using a uniform template that included¹:

• A disease state overview
• Clinical guidelines and pharmacotherapy considerations
• Institutional care pathways (where available)
• The site’s clinical CPA as a foundational guide
• Ten case-based assessment questions designed to evaluate real-world clinical decision-making

Notably, the content was designed for long-term use, with built-in flexibility for future updates in response to guideline changes or practice evolution.¹

Results: Broad Implementation and Specialty Representation

The project was broadly successful. It resulted in 11 clinical modules, covering 73% of the CPA specialty areas; 2 ambulatory practice skills modules on motivational interviewing and managing challenging patient interactions; 100% participation from subject matter experts across the selected areas; and full integration of modules into the institution’s online learning portal.¹

All 10 clinical modules included core components: guidelines, dosing, contraindications, adverse effects, monitoring parameters, and follow-up needs. Eight of the 10 referenced institutional pathways, and half included diagnostic tools to support complex decision-making.¹

With full deployment in Yale New Haven Health’s learning management system, the modules are now accessible to pharmacists across the health system for onboarding and continuing education. This approach not only ensures a baseline standard of care but also supports ongoing professional development, reflecting a growing trend toward lifelong learning in clinical pharmacy practice.³

Next Steps: Measuring Impact and Expanding Reach

Although development and implementation are complete, next steps include evaluating the real-world effectiveness of the modules, refining content based on pharmacist feedback and performance, and extending the framework to additional specialties as more CPAs are established.

This initiative serves as a model for other institutions looking to scale pharmacist-led care safely and effectively. By embedding standardized clinical training into pharmacist workflows, health systems can improve consistency in patient management and support the continued evolution of pharmacy practice.

REFERENCES

1. Ukpokpo EE, Cordon M, Luon S, Renauer M. Developing standardized online assessment modules to evaluate clinical competency for pharmacists practicing within collaborative practice agreements (CPAs). Presented at: American Society of Health-System Pharmacists 2025 Pharmacy Futures. Charlotte, NC; June 9, 2025.

2. Newman TV, San-Juan-Rodriguez A, Parekh N, et al. Impact of community pharmacist-led interventions in chronic disease management on clinical, utilization, and economic outcomes: An umbrella review. Res Social Admin Pharm. 2020;16(9):1155-1165. doi:10.1016/j.sapharm.2019.12.016

3. ASHP Statement on Professionalism. American Society of Health-System Pharmacists. 2022. Accessed June 9, 2025. https://www.ashp.org/-/media/assets/policy-guidelines/docs/statements/professionalism.ashx