A pilot study of a pharmacist-led prescribing program for final-year medical students

Abstract

BackgroundJunior doctors undertake a significant amount of prescribing; however, they are not well prepared for this, and report they would like more training in their undergraduate courses. To address this we tested a pharmacist-led prescribing program for final-year medical students.MethodsSixteen final-year students took part in the program. The program involved students writing prescriptions and getting feedback from clinical pharmacists, undertaking prescribing and calculation tutorials, and spending time in the pharmacy department. Evaluation included a pre- and post-assessment of their confidence and skills in prescribing, and a feedback session discussing the strengths and weakness of the program, and their perceptions about the role of pharmacists. Changes in the pre- and post-assessment of confidence and skills were examined with permutation and Mann-Whitney U tests.ResultsThere was a significant improvement in students’ confidence in prescribing, and a small but consistent improvement in prescribing skills. Of note, no student prescribed inappropriately and potentially harmfully after the program. Participants were positive about the program, and indicated a better understanding about the pharmacists’ role and their ability to support them as junior doctors.ConclusionsThis study has shown the potential effect of a pharmacist-led prescribing program on the skills and confidence in prescribing by medical students. It provided an interprofessional teaching opportunity, preparing students for a team-based approach to patient management.Electronic supplementary materialThe online version of this article (10.1186/s12909-019-1486-1) contains supplementary material, which is available to authorized users.

A Rapid Review of Prescribing Education Interventions

“…Teaching and Mentoring from Healthcare Professionals Other than Faculty Members Four case-based educational interventions included teaching and mentoring from qualified healthcare professionals other than faculty lecturers [24][25][26][27]. Two studies followed a group learning format using case-based scenarios [24,25], one study used experiential learning through observations of real-life prescribing situations [27] and one study implemented a mentoring scheme between learner and expert [26].…”

Pharmacist-led teaching as a longitudinal theme for medical school curriculums - a solution for reducing prescribing errors in junior doctors?

“…Newby et al described how an 8 week pharmacist-led programme led to dramatic improvements in the quality of prescribing; an increase in the amount of appropriate prescriptions, and a reduction in the number of inaccurate and potentially harmful prescriptions. However the number of inappropriate but not harmful prescriptions increased, and there was still an equally high number of students prescribing appropriately but apprehensively before and after the programme [1].…”

“…In addition, a study looking at the causes and consequences of inpatient prescribing errors stated “Alternative strategies for involving pharmacists should also be considered” [4]. Involving pharmacists in this style of teaching also helps to further interprofessional links and understanding, as Newby et al found [1]. A further systematic review by Kamarudin et al found a number of pharmacist-led programmes which resulted in a number of positive outcomes [5].…”

“…I read with interest ‘A pilot study of a pharmacist-led prescribing program for final-year medical students’ [1]. As a fourth year medical student at The University of Liverpool, I have been receiving regular pharmacist-led teaching since my third year, and would like to contribute to the key ideas discussed.…”

“…Prescribing errors are a common preventable source of morbidity and mortality, and as such it is our duty as healthcare professionals to minimise them as much as possible. As a considerable amount of prescriptions, and errors, are written by junior doctors, this raises the question of whether medical school curriculums could better prepare students for prescribing [1]. A systematic review by Brinkman et al found final year medical students lacked a number of competencies.…”