Teaching safe prescribing to medical students: perspectives in the UK

Abstract

Prescribing is a characteristic role of a medical practitioner. On graduating from medical school, students are presumed to have acquired the necessary pharmacology knowledge underpinning the therapeutics and developed their personal skills and behaviors in order to write a safe and effective prescription (The Four Ps). However, there are reports of errors in medical prescribing and dissatisfied feedback from recent graduates, which evidence potential flaws in the current training in the practice of prescribing. We examine the Four Ps from a systems approach and offer scope for educators and curriculum designers to review and reflect on their current undergraduate teaching, learning, and assessment strategies in a similar manner. We also adopt a national framework of common competencies required of all prescribers to remain effective and safe in their area of practice as a more objective layer to the broader learning outcomes of the General Medical Council Tomorrow’s Doctors 2009. This exercise demonstrates where standard, recognized competencies for safe prescribing can be accommodated pedagogically within existing medical curricula.

Assessment of quality of prescription writing among dental and medical students and practitioners in Kerala

“…The prevalence of errors in prescriptions among dental and medical practitioners in teaching institutions and clinical practice was found to be high, and most prescriptions did not follow the WHO prescription guidelines (India, UK, and Brazil). [ 13 14 15 16 17 18 ] Data on irrational drug use show an increasing trend worldwide often leading to adverse health consequences. [ 19 ] The WHO in 2010 reported that more than 50% of drugs were not correctly prescribed, dispensed, or sold.…”

“…These errors can lead to serious repercussions resulting in undesirable consequences such as worsening of treatment, increased cost of treatment, and other serious adverse events. [ 18 ] Most of these errors could be attributed to the lack of training in practical prescribing and failure to link theory and practice. [ 18 ]…”

“…[ 18 ] Most of these errors could be attributed to the lack of training in practical prescribing and failure to link theory and practice. [ 18 ]…”

“…In addition, use of electronic prescriptions can reduce the chances of inadvertent and careless error. [ 2 18 ]…”

Development and validation of an instrument to assess the prescribing readiness of medical students in Malaysia

“…In addition, prescribing is often perceived as only ‘the writing of drug on a prescription sheet’ instead of an appreciation of the whole process of good prescribing as encompassing essential aspects like information gathering, decision making, patient counselling, and monitoring, in accordance with the World Health Organization 6-step model [ 18 ]. Recently, Nazar et al (2015) developed a framework to teach safe and effective prescribing (based on the 4Ps) within the UK undergraduate medical curriculum that can be subsumed onto the GMC learning outcomes [ 19 ].…”