Active Learning to Promote Early and Effective Physician Interaction with Pharmaceutical Industry Marketing Practices.

Abstract

Interactions with pharmaceutical companies influence physicians' prescribing behavior. Less than half of US family medicine residency programs have educational curricula addressing their influence. However, medical students have extensive exposure to pharmaceutical industry marketing during their early years of training. We developed a successful and required active learning curriculum for medical students during their first-year of medical school. A philosopher bioethicist lectured to first-year medical students on the ethical issues surrounding the interactions with pharmaceutical representatives and outlined the three principles approach to clinical ethics as presented in the American Board of Internal Medicine Physician Charter (2002). The lecture also described the eight physician types offered by Fugh-Berman et al. Students watched two fictitious physician-pharmaceutical representative interactions. To promote active learning, students were provided a 3 × 3 Bingo card with each physician type. The bioethicist facilitated a discussion addressing the interactions. Two hundred twenty-nine first-year medical students participated in this required intervention. Fifty-two percent of first-year medical students had already interacted with pharmaceutical representatives. The session changed students' opinions of pharmaceutical representatives and their ability to identify strategies to mitigate their influence. Students articulated ethical issues involved in the interaction, techniques used by pharmaceutical representatives, and techniques that could be used by medical students or physicians. Ninety-one percent of students believed they could independently find reliable information about a drug. The session was effective to start the conversation regarding the ethical issues involved with the interaction between medical students/physicians and pharmaceutical representatives in the first year of medical school.