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Paper Description


Assessing prescription writing skills of pre-clerkship medical students in a problem-based learning curriculum


Authors: K.A.J. Al Khaja, S.S. Handu, H. James, V.S. Mathur, R.P. Sequeira
Abstract: Objective: To audit the acquisition of prescribing skills of pre-clerkship medical students in a problem-based learning (PBL) curriculum that incorporates a prescribing program. Material and methods: Student performance in pharmacotherapy stations included in six out of eight end-of-unit-objective structured practical examinations (OSPE) was evaluated using a rating checklist. Results: Prescription writing skills of 539 students (66.2% female and 33.8% male) were appraised. With the exception of refill element, the other physician-related components including prescriber?s identity, date of prescription order, patient?s identity, the symbol Rx ?Take Thou?, and prescriber?s signature were written by 96.1% of the students (95% confidence interval (CI) 94.1 ? 97.5). However, the drug-related components such as the appropriateness of drug(s) selected, strength, dosage form, quantity to be dispensed and directions for use were written satisfactorily by 50.2% of the students (95% CI 46.0 ? 54.4). With respect to prescribing skills, the mean total score of Year 4 students did not significantly differ from that of Year 2 (69.4 (CI 65.7 ? 73.1) vs. 66.3 (CI 62.7 to 69.9); p = 0.237). However, the mean scores of individual drug-related components such as appropriateness of drug(s) selected, dosage form, and direction for use were significantly higher in Year 4 than that of Year 2 students (p < 0.05). Of 381 rationally prescribed drugs, 81.1% were written with generic names. Conclusion: This study revealed that the students acquire prescribing skills to a limited extent during the pre-clerkship phase in a PBL program. Prescribing errors and deficits were found to be mainly associated with drug-related components. Further training and assessment of prescribing skills during the clerkship and internship period are needed to achieve mastery of this skill as a terminal competency of graduating physicians.
Published in: International Journal of Clinical Pharmacology and Therapeutics;43(9):429 - 435
URL: http://www.dustri.com/nc/article-response-page.html?artId=1313&doi=
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