A context-learning pharmacotherapy program for preclinical medical students leads to more rational drug prescribing during their clinical clerkship in internal medicine.
ABSTRACT The irrational prescribing of drugs seems to be a general problem in medical practice, occasionally leading to serious consequences. In order to improve the drug prescribing performance of medical students, a compulsory context-learning pharmacotherapy module was implemented in 1998 in the medical curriculum of 2nd-4th-year medical students at theVU University Medical Center (VUmc), Amsterdam, The Netherlands. As part of this program, preclinical medical students are taught how to select, prescribe, and evaluate a drug regimen rationally. The aim of this study was to investigate the effect of this preclinical pharmacotherapy program on the quality of rational prescribing during the ensuing clinical clerkship of these students in internal medicine. The results of this study indicate that preclinical context-learning in pharmacotherapy leads to the use of more rational prescribing modalities by medical students during their ensuing clinical clerkship in internal medicine. This effect was obtained not only with respect to the clinical topics in which training had been given as part of the pharmacotherapy curriculum, but also for other disease situations that the students dealt with. This implies that students not only remember the specific information they have learned during the training, but are also able to apply the acquired skills in new situations (transfer effect).
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ABSTRACT: In this study we aimed to evaluate the impact of Rational Pharmacotherapy (RPT) course program, reinforced by video footages, on the rational pharmacotherapy skills of the students. RPT course program has been conducted in Dokuz Eylul University School of Medicine since 2008/9. The course has been organised in accordance with World Health Organisation (WHO) Good Prescribing Guide. The aim of the course was to improve the problem solving skills (methodology for selection of the (p)ersonel-drug, prescription writing and informing patient about his illness and drugs) and communication skills of students. The impact of the course has been measured by pre/post-test design by an objective structured clinical examination (OSCE). In academic year 2010/11, to further improve OSCE score of the students we added doctor-patient communication video footages to the RPT course programme. During training, the students were asked to evaluate the doctor-patient communication and prescription on two video footages using a checklist followed by group discussions. Total post-test OSCE score was significantly higher for 2010/11 academic year students (n = 147) than it was for 2009/10 year students (n = 131). The 2010/11 academic year students performed significantly better than the 2009/10 academic year students on four steps of OSCE. These steps were "defining the patient's problem", "specifying the therapeutic objective", "specifying the non-pharmacological treatment" and "choosing a (drug) treatment, taking all relevant patient characteristics into account". The present study demonstrated that the implementation of video footages and group discussions to WHO/Good Prescribing Method improved the fourth-year medical students' performance in rational pharmacotherapy skills.Indian Journal of Pharmacology 01/2013; 45(1):4-8. · 0.58 Impact Factor
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ABSTRACT: Prescribing is an essential skill for physicians. Despite the fact that prescribing habits are still developing in residency, formal pharmacotherapy curricula are not commonplace in postgraduate programs. To teach first-year and second-year family medicine residents a systematic prescribing process using a medication prescribing framework, which could be replicated and distributed. A hybrid model of Web-based (www.rationalprescribing.com) and in-class seminar learning was used. Web-based modules, consisting of foundational pharmacotherapeutic content, were each followed by an in-class session, which involved applying content to case studies. A physician and a pharmacist were coteachers and they used simulated cases to enhance application of pharmacotherapeutic content and modeled interprofessional collaboration. This systematic approach to prescribing was well received by family medicine residents. It might be important to introduce the process in the undergraduate curriculum-when learners are building their therapeutic foundational knowledge. Incorporating formal pharmacotherapeutic curriculum into residency teaching is challenging and requires further study to identify potential effects on prescribing habits.Canadian family physician Medecin de famille canadien 11/2013; 59(11):e493-8. · 1.19 Impact Factor
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ABSTRACT: Prescribing errors occur in up to 10 per cent of junior doctor prescriptions, and medical students feel underprepared for the challenges of prescribing once qualified. A number of studies have looked into the effectiveness of new interventions, in particular pharmacist-taught prescribing courses, but there is little data on how students perceive these new strategies. The aim of this project was to evaluate a teaching programme of practical prescribing skills, conducted by hospital pharmacists, via a series of focus groups. A pharmacist-taught course in practical prescribing was introduced to final-year medical students during clinical placements at five different hospitals. A focus group was conducted at each participating hospital and emerging themes were identified. Key emerging themes from the focus group analysis showed that students felt more confident in prescribing after completing the course. Students valued the opportunity to gain practical prescribing experience by using problem-based exercises, which encouraged them to prescribe on real drug charts, or to spot prescribing errors or drug interactions on charts constructed by pharmacists. Pharmacists were felt to be knowledgeable and approachable teachers. Students highlighted controlled drug prescriptions and familiarity with the British National Formulary (BNF) as key topics that hadn't been covered in conventional pharmacology teaching. A practical prescribing course can help prepare medical students by giving them the tools to tackle complex prescribing scenarios. Pharmacists as teachers were well received, and specific topics, including controlled drug prescribing and using sample drug charts, should be the focus of these types of courses.The Clinical Teacher 02/2014; 11(1):38-42.