Developing professional confidence in the art of prescribing—a randomized controlled study on structured collegial discussions during internship

Abstract

Purpose To evaluate whether an educational intervention based on collegial discussions on patient cases could increase interns' professional confidence in prescribing.Methods In a randomized controlled study at Sahlgrenska University Hospital, Gothenburg, Sweden, 69 interns (median age: 29 years, 54% female) were allocated to an intervention or control group. The intervention consisted of two 3-h seminars based on collegial discussions of patient cases focused on performing medication reviews. This included reconciling the drug treatment and ascertaining that it is reasonable given the patient's current health status, as well as tips on practical handling of the medical records system and integrated decision support. Self-assessed confidence in performing medication reviews was evaluated with questionnaires distributed at baseline and at 6-month follow-up. Results Fifty-seven (83%) interns completed the questionnaires. Although the opposite was found at baseline, intervention interns, in comparison with controls, at follow-up, were more confident in performing medication reviews (4.3 ± 0.9 vs. 3.6 ± 1.3, P = 0.034; 1 = completely disagree to 5 = completely agree). At follow-up, the intervention participants had increased their confidence in prescribing to a greater extent compared with the control participants, including performing medication reviews as well as taking responsibility for the medication list at discharge: + 1.5/+ 1 vs ± 0 on the 5-point agreement scale (all P ≤ 0.01). Among other positive outcomes, the intervention increased the interns' awareness of adverse effects as a potential cause of symptoms and their confidence in withdrawing a medication. Conclusion Structured collegial discussions on pharmacotherapy, even of a relatively short duration, can increase junior physicians' professional confidence in prescribing medicines.

Confidence in managing human monkeypox cases in Asia: A cross-sectional survey among general practitioners in Indonesia

“…One factor associated with confidence was the length of experience in medical practice. Previous studies found that the length of learning experience (Chen et al, 2019;Hsieh and Nolan, 2015) and prolonged attachment and training in healthcare centers increased self-confidence in medical practices (Lonnbro et al, 2019;McNair et al, 2016). However, a systematic review of 12 studies between 1966 and 2004, found that longer experience in medical practice was associated with less knowledge.…”

Student Characteristics Associated with Passing the Exam in Undergraduate Pharmacology Courses—a Cross-sectional Study in Six University Degree Programs

“…To promote active learning, integrating physiology, pathophysiology, and pharmacology in preclinical teaching, the use of virtual patients has been suggested [20]. At a later stage in medical education, training and collegial discussions have been shown to be key success factor [21][22][23]. A potential explanation for the low interest in pharmacology among medical students, not directly related to the teaching sessions per se, may be the absence of a separate exam.…”

“It’s helpful to get the time and opportunity to discuss drug treatment; that’s what I think is the most important thing.”—A qualitative study on prescribing education in junior physicians

“…Indeed, active learning has been shown favorable among students [19], a finding which may also apply to post-graduate training. The small group format may facilitate discussions, and interaction between knowledgeable tutors and participants has been shown to increase the comfort of the group and their performance regarding the topics focused on [13,18,20]. Interestingly, a recent educational effort using small-group educational workshops with peers increased evidence-based practice among the participating health professionals [21].…”

“…The seminars were part of a randomized controlled study performed in Sahlgrenska University Hospital, Gothenburg, Sweden, consecutively recruiting interns between 2014 and 2016 and described elsewhere [13]. Internship in Sweden means post-graduate vocational training for 1.5 years to obtain a license to practice medicine and continue with specialization.…”

“…The participants' median age was 30 years (range 25-48 years); 57% were female and 26% were conducting research as part of their internship, their clinical work being prolonged correspondingly. The educational intervention has been described in detail elsewhere [13].…”