Documenting Co-Curricular Activities and EPAs as Pharmacy Accreditation Evidence

You’ve mapped your didactic courses to outcomes, organized your experiential education files, and written your assessment plan. But there’s a piece of the program that fits in none of those folders: the student-run professional organizations, the leadership roles, the service-learning projects, the conference attendance — and, if you run an ACPE-accredited program, the entrustment decisions your preceptors make about what each student can do with what level of supervision.

That piece is a bigger part of your accreditation than it looks. Both ACPE’s Standards 2025 [1] and CCAPP’s standards [3] name it explicitly, and when a reviewer asks how you know your graduates are practice-ready and professional, the answer has to come from here. This post walks through what the standards actually require, why this evidence is the hardest to keep, and a five-step method for documenting co-curricular activities and Entrustable Professional Activities (EPAs) as evidence you can point to at any point in the cycle.

What the Standards Actually Say

ACPE makes the requirement explicit in Standards 2025. The document’s introduction lists “the importance of both curricular and co-curricular experiences in advancing the professional development of students” as one of the four focal points of the revision [1]. Key element 2.1.m, Entrustable Professional Activities, requires that “the program develops and assesses the achievement of professional activities a graduate can perform routinely designed to gain the trust of the healthcare team and the public.” And key element 2.1.n, Professional Skills and Attitudes, requires activities and experiences “purposely designed and implemented to ensure an array of opportunities for students to document competency of advocacy, self-awareness, leadership, and professionalism” — noting that “these curricular and co-curricular activities complement and advance the learning that can occur outside, alongside, or within the curriculum.” [1]

The connection runs through the experiential side as well. The introduction to Standard 3 (Experiential Learning) says APPEs integrate, apply, reinforce, and advance what was developed in the “Pre-APPE curriculum, co-curriculum, and extracurricular activities.” [1] And Standard 7 closes the loop: the assessment plan must measure student achievement “at defined levels of the professional outcomes that support attainment of 2.1.a–n,” and “evidence should be provided to show that students are APPE-ready, and graduates are Practice-ready and Team-ready.” [1]

In other words, the co-curriculum is not an optional extra in ACPE’s framework. It is named as part of the curriculum, and the readiness evidence behind it has to be measurable.

The EPA framework behind 2.1.m is the American Association of Colleges of Pharmacy’s Curriculum Outcomes and Entrustable Professional Activities (COEPA) 2022 [5] — ACPE’s 2.1 outcomes are, in the standards document’s own words, adapted from it [1]. COEPA defines thirteen EPAs (reduced from fifteen), with EPAs 1–10 aligned to the steps of the Pharmacist Patient Care Process [2]. Two design points matter for documentation:

• EPAs are activities, not assessments. The document is explicit that EPAs “delineate essential tasks of a pharmacist that a PharmD graduate can be entrusted with,” and each EPA requires the learner to have acquired foundational knowledge, skills, and attitudes in the classroom before being entrusted with the task in the experiential setting. [2]
• Entrustment is judged on a supervision scale, not a grade scale. COEPA’s entrustment scale runs five levels — observe only, direct supervision, reactive supervision, intermittent supervision, general direction — and states that the expected performance level upon graduation is reactive supervision. Stakeholder feedback on the revision also asked that EPA assessments measure the trust of the observing pharmacist and that “these levels of entrustment are not tied to grades.” [2]

CCAPP does not use the word “entrustable” in its standards, but the co-curriculum is named just as explicitly. Criterion 3.3 requires that the curriculum support “development of student leadership, professionalism, and professional identity,” and lists among its example evidence “documentation of the ways student leadership groups work with faculty to support curricular and programmatic activities” and a description of activities that facilitate the principles in NAPRA’s “Principles of Professionalism for the Profession of Pharmacy.” Criterion 7.2, which requires the faculty to support fair and equitable student participation in provincial, regional, and national pharmacy, scientific, and other professional organizations, lists “documentation of student attendance at such events” among its example evidence. And Criterion 7.3 asks for a “description of professional curricular and extracurricular activities,” with examples that include service learning, volunteer experiences, community-engaged scholarship, social accountability, and student-led interprofessional activities. [3]

For Canadian programs, the outcomes anchor is the AFPC’s Educational Outcomes for First Professional Degree Programs in Pharmacy [4]: roles that retain CanMEDS terminology, in which Leader-Manager includes the key competency “Demonstrate leadership skills” and the Professional role is the overarching ethos of the discipline. That is where co-curricular evidence maps in Canada.

Why This Evidence Is the Hardest to Keep

Three things make co-curricular and EPA evidence different from everything else in your files:

• It lives outside the LMS. Bylaws, conference programs, event photos, service logs, and preceptor notes sit in student organizations, shared drives, and email threads — places your self-study process doesn’t naturally reach.
• It’s episodic and student-driven. Participation varies year to year, leadership turns over every term, and the faculty sponsor may change. Evidence that isn’t collected as it happens is evidence that has to be reconstructed later.
• It rarely gets tied to outcomes. “We have a student professional association” is a statement, not evidence. It becomes evidence only when you can say which outcomes it develops and how you know — the same gap as a course with no learning outcomes, except here the “course” is an activity nobody assigned.

EPAs carry one extra trap: they’re easy to conflate with course grades. A preceptor’s rotation evaluation is a course grade. The entrustment decision — the documented judgment about what level of supervision a student needs for a particular task — is a separate assessment. If the two live in the same field on the same form, neither your CQA process nor a reviewer can tell whether you assessed trust or performance.

A Five-Step Method

Step 1 — Inventory the co-curricular program. One line per activity: name, frequency, who runs it (student organization, faculty, or preceptor site), who participates, and which outcomes it touches. A typical inventory includes the student professional association and its leadership roles, participation in provincial, regional, and national professional conferences, service-learning and community events, student-led interprofessional activities, research opportunities, and mentorship or wellness programs.

Step 2 — Map each activity to outcomes. Under ACPE, the natural targets are 2.1.f (advocacy), 2.1.j (leadership), 2.1.k (self-awareness), 2.1.l (professionalism), and 2.1.h (interprofessional collaboration) for IPE activities. Under CCAPP, map to Criterion 3.3’s leadership, professionalism, and professional identity, and to the AFPC Leader-Manager and Professional roles. One line per activity in the map is enough — the goal is to answer “which outcomes does this activity develop?” in seconds, not in a committee meeting.

Step 3 — For EPAs, document the entrustment decision, not the grade. For each EPA your program tracks (all thirteen from COEPA, or a subset), keep a per-student record: which EPA, in which experience, at what supervision level, assessed by whom, and when. Use the five-level entrustment scale, and keep the record separate from the rotation grade. The progression across the program — direct supervision in an early IPPE, reactive supervision by the end of APPE — is the evidence that 2.1.m is being met, and it is what “APPE-ready” looks like in practice.

Step 4 — Build an evidence file for each activity. For a student organization: bylaws or charter, membership and leadership rosters, minutes, faculty sponsorship records, and budget support. For conference participation: the program, registration or attendance documentation, and any student abstracts or presentations — CCAPP’s Criterion 7.2 lists “documentation of student attendance at such events” as an example of evidence, so a roster is a sensible minimum. For service learning: the project description, hours, student reflection, and community partner feedback. The bar isn’t exhaustive — it’s that a reviewer can trace from the activity to the outcome, and from the outcome back to a document.

Step 5 — Fold it into continuous quality improvement. Once a year, summarize: participation rates, which activities covered which outcomes, what’s missing, and what changed. That summary feeds directly into the self-study — CCAPP’s Appendix 3 encourages describing evaluation processes rather than presenting all the data [3] — and into ACPE key element 7.3.b, under which the program “documents the use of assessment data for continuous improvement” of the curriculum [1]. The annual summary is also your early-warning system: a co-curricular activity that stops producing participation or evidence is a gap you can see a year before the visit, not one you discover during it.

Where It Goes Wrong

Four patterns show up in this part of self-studies:

• The photo album. Event photos with no outcomes, no participation data, and no faculty involvement. Photos add color to a self-study; they aren’t evidence of anything by themselves.
• The unclaimed activity. A student organization that runs itself, where the only faculty connection is a signature on a budget form. CCAPP’s Criterion 3.3 lists documentation of how student leadership groups work with faculty as example evidence — if that relationship doesn’t exist, document the gap and what you’ll do about it. That’s a strength, not a liability, in a self-study.
• Grade-as-entrustment. Preceptor evaluations that report the course grade and the supervision level in the same field. You can no longer tell whether you assessed trust or performance — exactly what stakeholders asked the COEPA revision to avoid.
• The one-time scramble. Co-curricular evidence assembled for the first time in the month before the self-study deadline, from a single coordinator’s memory. When that person leaves, the evidence goes with them. That’s the institutional knowledge risk, and it’s why the inventory and the annual summary matter more than any single document.

Keeping It Connected

The didactic map, the experiential files, and the co-curricular inventory are the same kind of object: activities that develop outcomes, with documents that prove it. The moment they live in separate systems, the program has three evidence problems instead of one — and the co-curricular one is the least likely to be found when it’s needed.

A connected view changes that. Start from any outcome — say, professionalism or leadership — and you can see which courses develop it, which rotations assess it, and which co-curricular activities support it, with a click through to the document behind each connection. That’s what an evidence map means for this part of the program: the co-curricular and entrustment records are kept connected all year, so the self-study section is written from a map you already maintain rather than a hunt you run once a cycle.

If you’ve organized the experiential side already, this is the natural next piece — see Organizing Your Experiential Education Evidence for the IPPE and APPE files, and Mapping Courses to the AFPC Educational Outcomes and ACPE Standards for the didactic map this post completes.

References

1. Accreditation Council for Pharmacy Education, "Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (Standards 2025)," ACPE, 2024. [Online]. Available: https://www.acpe-accredit.org/wp-content/uploads/ACPEStandards2025.pdf
2. American Association of Colleges of Pharmacy, "Curriculum Outcomes and Entrustable Professional Activities (COEPA) 2022," AACP, 2022. [Online]. Available: https://www.aacp.org/sites/default/files/2022-11/coepa-document-final.pdf
3. Canadian Council for Accreditation of Pharmacy Programs, "Accreditation Standards for Canadian Educational Programs Leading to the Doctor of Pharmacy (PharmD) Degree (2023 Revised Edition, file dated April 2025)," CCAPP, 2025. [Online]. Available: https://ccapp.ca/wp-content/uploads/2025/07/April10-2025_CCAPP-PharmD-Standards_ENG.pdf
4. Association of Faculties of Pharmacy of Canada, "Educational Outcomes for First Professional Degree Programs in Pharmacy in Canada (2017)," AFPC. [Online]. Available: https://www.afpcpharmacy.ca/educational-outcomes
5. American Association of Colleges of Pharmacy, "Educational Outcomes and EPAs," AACP. [Online]. Available: https://www.aacp.org/resource/educational-outcomes-and-epas