Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates

Graaf

et al. 2018

Brit J Clinical Pharma

AimsPrescribing errors are an important cause of patient safety incidents and are frequently caused by junior doctors. This might be because the prescribing competence of final‐year medical students is poor as a result of inadequate clinical pharmacology and therapeutic (CPT) education. We reviewed the literature to investigate which prescribing competencies medical students should have acquired in order to prescribe safely and effectively, and whether these have been attained by the time they graduate.MethodsPubMed, EMBASE and ERIC databases were searched from the earliest dates up to and including January 2017, using the terms ‘prescribing’, ‘competence’ and ‘medical students’ in combination. Articles describing or evaluating essential prescribing competencies of final‐year medical students were included.ResultsTwenty‐five articles describing, and 47 articles evaluating, the prescribing competencies of final‐year students were included. Although there seems to be some agreement, we found no clear consensus among CPT teachers on which prescribing competencies medical students should have when they graduate. Studies showed that students had a general lack of preparedness, self‐confidence, knowledge and skills, specifically regarding general and antimicrobial prescribing and pharmacovigilance. However, the results should be interpreted with caution, given the heterogeneity and methodological weaknesses of the included studies.ConclusionsThere is considerable evidence that final‐year students have insufficient competencies to prescribe safely and effectively, although there is a need for a greater consensus among CPT teachers on the required competencies. Changes in undergraduate CPT education are urgently required in order to improve the prescribing of future doctors.

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Do final‐year medical students have sufficient prescribing competencies? A systematic literature review

Brinkman

Graaf

et al. 2018

Brit J Clinical Pharma

“…However, concerns have been expressed that medical graduates across the EU are not adequately prepared for their prescribing duties 3. In the UK, recently graduated doctors were found to be responsible for a large number of prescribing errors and reported not feeling adequately prepared for their prescribing responsibilities 4, 5. Furthermore, a recent multicenter study involving 17 European medical schools showed a general lack of essential prescribing competencies among 895 final‐year students, which has potential consequences for patient safety 6.…”

mentioning

confidence: 99%

Pharmacology and Therapeutics Education in the European Union Needs Harmonization and Modernization: A Cross‐sectional Survey Among 185 Medical Schools in 27 Countries

Brinkman

Clin Pharma and Therapeutics

Okorie

et al. 2017

Effective teaching in pharmacology and clinical pharmacology and therapeutics (CPT) is necessary to make medical students competent prescribers. However, the current structure, delivery, and assessment of CPT education in the European Union (EU) is unknown. We sent an online questionnaire to teachers with overall responsibility for CPT education in EU medical schools. Questions focused on undergraduate teaching and assessment of CPT, and students' preparedness for prescribing. In all, 185 medical schools (64%) from 27 EU countries responded. Traditional learning methods were mainly used. The majority of respondents did not provide students with the opportunity to practice real‐life prescribing and believed that their students were not well prepared for prescribing. There is a marked difference in the quality and quantity of CPT education within and between EU countries, suggesting that there is considerable scope for improvement. A collaborative approach should be adopted to harmonize and modernize the undergraduate CPT education across the EU.

“…The experienced or learned curriculum may differ substantially from the offered and planned curriculum, which was studied in this article [16]. UK medical students feel unprepared after graduation [9], and two other studies confirm a lacking self-confidence for two of the medical schools in this study [13,33]. It should be noted that the correlation between self-reporting confidence and performance appeared week [33].…”

Section: Discussionmentioning

confidence: 63%

“…An estimated 30 % of these errors can be attributed to insufficient knowledge and skills on the part of prescribers [7]. Medical students tend to copy the drug treatment choices of their teachers during clinical clerkships instead of basing their choices on their own independent analysis of the problem [8], which might be why junior doctors feel that they are not adequately prepared to prescribe after graduating [9]. Frail older people are at highest risk of prescribing errors because they often have multiple medical conditions for which they receive polypharmacy [6].…”

Section: Introductionmentioning

confidence: 99%

Education on prescribing for older patients in the Netherlands: a curriculum mapping

Keijsers

Wit

et al. 2015

Eur J Clin Pharmacol

Purpose Pharmacology and pharmacotherapy education is being increasingly integrated in medical curricula, which might lead to a specific loss of knowledge in these subjects. This, in turn, could lead to harmful prescribing errors, especially in vulnerable older patients. Methods Teachers who coordinated education in Dutch medical schools completed a structured interview on (geriatric) pharmacology and pharmacotherapy education.A list of core learning goals was developed. Pharmacology and pharmacotherapy education in general was compared to geriatric pharmacology and pharmacotherapy education. Results All Dutch medical schools participated. Contact hours for education in pharmacology and pharmacotherapy ranged from 39 to 107 h; ECTSs (representing 28 study hours) ranged from 0 to 3. The various curricula covered, on average, 79 % of all learning goals for these subjects: knowledge 85 %, skills 76 %, and attitudes 66 %; the curricula also covered specific geriatric goals: knowledge 87 % and skills 65 %. All geriatric learning goals were met if a geriatrician was among the coordinators. Half (4 of 8) of the medical schools lacked appropriate assessment procedures. Evaluation was mostly based on students' opinions. Teachers rated students as being moderately well prepared for daily practice. Conclusions There are large differences in the quantity and quality of (geriatric) pharmacology and pharmacotherapy education in Dutch medical schools. In general, more time should be devoted to skills and attitude, and the assessment procedures should be optimized with high priority. Other curricula with a problem-based approach might benefit from the points of improvement described in this article.