Developing confidence in basic prescribing skills during medical school: a longitudinal questionnaire study investigating the effects of a modified clinical pharmacology course

Abstract

PurposeTo investigate if increased focus on pharmacotherapy during medical school can increase students’ confidence in basic prescribing skills, that is, performing medication reviews and writing medication discharge summaries.MethodsIn 2016, the clinical pharmacology course in medical school in Gothenburg, Sweden, was modified to facilitate the students’ acquisition of prescribing skills, with (i) clarified learning outcomes; (ii) supply of a list of common drugs for self-completion; (iii) instructions to practice medication reviews/discharge summaries during the ward-based education; and (iv) a concluding compulsory seminar where the students were to present prescribing-related experiences from their ward-based attendance. Questionnaires were administered to students participating in the course before (2016; n = 101) and after (2017; n = 137) implementation of the modifications. Students were asked to grade their agreement from 1 (totally disagree) to 5 (totally agree) on statements related to their perceived confidence in basic prescribing skills.ResultsIn all, 195 students returned the questionnaire (response rate 82%; median age 24 years; 68% female). Confidence was rated higher after the modifications were implemented, both regarding medication reviews and medication discharge summaries, after vs. before 3.6 ± 1.2 vs. 3.2 ± 1.0 (P = 0.024), and 4.3 ± 0.9 vs. 3.9 ± 1.1 (P = 0.008), respectively. The adjusted odds for being confident in performing these tasks were 1.49/1.36 times greater after the course modifications (P = 0.047/0.019). Perceived confidence in performing medication reviews/summary reports was positively correlated with numbers performed (P < 0.0001).ConclusionsModifications of the clinical pharmacology course during medical school, focusing on students’ training in pharmacotherapy, was associated with increased confidence of this core skill for a physician.