Prescribing Safety Assessment 2016: Delivery of a national prescribing assessment to 7343 UK final‐year medical students

Abstract

AIMSNewly graduated doctors write a large proportion of prescriptions in UK hospitals but recent studies have shown that they frequently make prescribing errors. The prescribing safety assessment (PSA) has been developed as an assessment of competence in relation to prescribing and supervising the use of medicines. This report describes the delivery of the PSA to all UK final-year medical students in 2016 (PSA2016). METHODSThe PSA is a 2-hour online assessment comprising eight sections which cover various aspects of prescribing defined within the outcomes of undergraduate education identified by the UK General Medical Council. Students sat one of four PSA 'papers', which had been standard-set using a modified Angoff process. RESULTSA total of 7343 final-year medical students in all 31 UK medical schools sat the PSA. The overall pass rate was 95% with the pass rates for the individual papers ranging from 93 to 97%. The PSA was re-sat by 261 students who had failed and 80% of those candidates passed. The internal consistency (Cronbach's alpha) of the four papers ranged from 0.74 to 0.77 (standard error of measurement 4.13-4.24%). There was a statistically significant variation in performance between medical school cohorts (F = 32.6, P < 0.001) and a strongly positive correlation in performance for individual schools between PSA2015 and PSA2016 (r = 0.79, 95% CI 0.61-0.90; P < 0.01). CONCLUSIONSPSA2016 demonstrated the feasibility of delivering a standardized national prescribing assessment online. The vast majority of UK final-year medical students were able to meet a prespecified standard of prescribing competence. British Journal of Clinical Pharmacology WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Newly-graduated doctors prescribe medicines frequently and write a large proportion of prescriptions in UK hospitals but recent studies suggest that around one in 10 of their prescriptions may contain errors.• The ability to prescribe safely and effectively is one of the competencies identified as a key outcome of undergraduate medical education by the General Medical Council (the UK medical regulator).• There has been significant variation in the assessments used by medical schools to ensure that medical students have attained the necessary competence prior to graduation.• Prescribing is a complex skill to assess because of the number of prescribing scenarios that might be tested, the variety of documentation used and the challenge of marking large numbers of prescriptions in a standardized way. WHAT THIS STUDY ADDS• The Prescribing Safety Assessment (PSA) has been developed as a 2-hour online assessment of competence in relation to prescribing and supervising the use of medicines in a modern healthcare setting.• The PSA delivers a standard national prescribing assessment involving around 200 assessment events at academic centres around the UK (and overseas) each year and enables large numbers of prescriptions (around 60 000) to be instantaneously assessed against a standardized marking scheme.• There was significant v...

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