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ACPE 2007 Standard 13 requires programs to integrate, apply, reinforce and advance knowledge, skills and attitudes throughout the curriculum.1 ACPE Guideline 15.1 states that Pharm.D. programs should "incorporate periodic, psychometrically sound, comprehensive, knowledge-based, and performance-based formative and summative assessments, including nationally standardized assessments."(1) Colleges of Pharmacy have utilized different methods to meet these requirements by offering progress examinations that vary by five features. Exams were either nationally or locally developed (such as an annual skills master assessment examination(2) or a Milemarker exam).(3-5) The types of questions used were either case-based, multiple choice, OSCE (objective-structured clinical exam) or performance-based, or essay-based.(6,7) The amount of material on the exam was either semester specific or cumulative.(6,7) Exams were either high-stakes(affected program progression or course grade) or low-stakes (did not impact progression or course grade).(6,7) The frequency of exam administration varied from the end of each semester, each professional year, or the didactic curriculum prior to advanced pharmacy practice experiences (APPE).(6,7) To address ACPE requirements and the challenges experienced by others with progress exams, we created our own bi-annual integrated examination, assessing knowledge (multiple-choice) and skills (OSCE). These exams are embedded into final examinations of the pharmacy practice courses (I through VI) offered in each semester (fall and spring) of the first three professional years. A first year (P1) integrated exam (IE) committee was formed in 2008, followed by similar committees in 2009 and 2010 for the second (P-2) and third (P-3) years, respectively. Each of the three committees includes a committee chair, course coordinators within the specific professional year and assessment and curriculum committee members. Every semester, the IE committee responsible for each professional year: 1. Identifies the most pertinent skills and knowledge-based content from each course offered during their respective semester, 2. Develops measurable IE objectives addressing the pertinent content, 3. Creates or revises multiple-choice and performance-based IE questions derived from IE objectives, accounting for 10% of the final course grade in the corresponding pharmacy practice course that semester, and 4. Sends objectives and exam questions for review and revision by the IE review committee. The IE review committee is a fourth committee, led by a committee chair and is composed of curriculum and assessment committee members. The IE review committee: 1. Reviews and revises the objectives and test questions submitted by each of the three IE committees ensuring before the exam is administered that the objectives and test questions are aligned and well-designed, and 2. Evaluates student performance on each question, revising the objectives and questions as needed for the next year's iterations. This process has effectively promoted the culture of assessment by engaging 63.6% of faculty members in the complexities of developing, administering, and assessing student performance across the professional curriculum. As well, this assessment process has transformed student understanding of the depth of learning and retention expected within the professional curriculum and for practice. References for Abstract and Award Application 1. Accreditation Council for Pharmacy Education. Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree. http://www.acpe.accredit.org/. Accessed June 28, 2011. 2. Szilagyi JE. Curricular progress assessments: The MileMarker. Am J Pharm Educ. 2008; 72(5) Article 101. 3. Sansgiry SS, Chanda S, Lemke TL, Szilagyi JE. Effect of incentives on student performance on Milemarker examinations. Am J Pharm Educ. 2006; 70 Article 103. 4. Sansgiry SS, Nadkarni A, Lemke T. Perceptions of PharmD Students Towards a Cumulative Examination: The Milemarker Process. Am J Pharm Educ. 2004; 68(4) Article 93. 5. Alston GL, Love BL. Development of a reliable, valid annual skills mastery assessment examination. Am J Pharm Educ. 2010; 74(5) Article 80. 6. Kirschenbaum HL, Brown ME, Kalis MM. Programmatic curricular outcomes assessment at colleges and schools of pharmacy in the United States and Puerto Rico. Am J Pharm Educ. 2006; 70 Article 08. 7. Plaza CM. Progress examinations in pharmacy education. Am J Pharm Educ. 2007; 71(2) Article 34.