Abstract
PurposeThe pharmacology and clinical pharmacology and therapeutics (CPT) education during the undergraduate medical curriculum of NOVA Medical School, Lisbon, Portugal, was changed from a traditional programme (i.e. discipline-based, lectures) to a problem-based learning (PBL) programme (i.e. integrated, case-based discussions) without an increase in teaching hours. The aim of this study was to investigate whether this change improved the prescribing competencies of final-year medical students.MethodsFinal-year students from both programmes (2015 and 2019) were invited to complete a validated prescribing assessment and questionnaire. The assessment comprised 24 multiple-choice questions in three subdomains (working mechanism, side-effects and interactions/contraindications), and five clinical case scenarios of common diseases. The questionnaire focused on self-reported prescribing confidence, preparedness for future prescribing task and education received.ResultsIn total, 36 (22%) final-year medical students from the traditional programme and 54 (23%) from the PBL programme participated. Overall, students in the PBL programme had significantly higher knowledge scores than students in the traditional programme (76% (SD 9) vs 67% (SD 15); p = 0.002). Additionally, students in the PBL programme made significantly fewer inappropriate therapy choices (p = 0.023) and fewer erroneous prescriptions than did students in the traditional programme (p = 0.27). Students in the PBL programme felt more confident in prescribing, felt better prepared for prescribing as junior doctor and completed more drug prescriptions during their medical training.ConclusionChanging from a traditional programme to an integrated PBL programme in pharmacology and CPT during the undergraduate medical curriculum may improve the prescribing competencies of final-year students.
Highlights
Medical graduates should be able to prescribe rationally, because after graduation they go directly into clinical practice and prescribe drugs on a daily basis, often with minimal supervision [1]
Students in the new programme were significantly older than students in the traditional programme
Students in the problem-based learning (PBL) programme had significantly higher knowledge scores than students in the traditional programme (mean 76% (SD 9) vs 67% (SD 15); p = 0.002)
Summary
Medical graduates should be able to prescribe rationally (i.e. effectively, safely and at low cost), because after graduation they go directly into clinical practice and prescribe drugs on a daily basis, often with minimal supervision [1]. A significant proportion of medical graduates seem not to have acquired sufficient knowledge, skills and attitudes required for rational prescribing [1, 4,5,6]. This might be because of inadequate clinical pharmacology and therapeutics (CPT) education during the undergraduate medical curriculum. Compared with problem-based learning (PBL) methods, traditional methods seem to be associated with a lower level of prescribing knowledge and skills among medical students [1]. Most of these studies evaluated the shortterm effect of a single course and very few evaluated the effect of an entire PBL programme on students’ prescribing competence before they graduate
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