Abstract
PurposeThis report describes the development and validation process of an assessment with national consensus in appropriate and safe pharmacotherapy.MethodsA question-database on safe prescription based on literature of pharmacotherapy-related harm was developed by an expert group from Dutch medical faculties. Final-year medical students concluded a 2-year education program on appropriate and safe prescription by one of nine assessment variants of 40 multiple-choice questions each. An expert panel of professionals (n = 10) answered all database questions and rated questions on relevance. Questions were selected for revision based on lack of relevance or poor test and item characteristics.ResultsA total of 576 final-year medical students of the Radboud University was assessed. There was no significant difference in performance between students and content expert group (p = 0.7), probably due to learning behavior. Out of 165 questions, 59 were selected for revision.ConclusionJoint national effort from a team of experts in prescription and pharmacotherapy is an appropriate way to achieve a valid and reliable last-year student drug prescription assessment.
Highlights
Many studies report a high rate of inappropriate prescribing as a potential cause of preventable morbidity and mortality [1, 2]
It is relevant to note that for the hospital setting, most drugs are prescribed by junior doctors with limited clinical experience [3]
The cause of a prescribing error is probably multifactorial, and related to for example time pressure or interruptions, it is shown that junior doctors tend to copy the drug treatment choices of their supervisors instead of basing their choices on their own independent analysis of the [4]
Summary
Many studies report a high rate of inappropriate prescribing as a potential cause of preventable morbidity and mortality [1, 2]. In this light, it is relevant to note that for the hospital setting, most drugs are prescribed by junior doctors with limited clinical experience [3]. The cause of a prescribing error is probably multifactorial, and related to for example time pressure or interruptions, it is shown that junior doctors tend to copy the drug treatment choices of their supervisors instead of basing their choices on their own independent analysis of the [4]. One way or the other, it is prerequisite that junior doctors are well prepared for the high-risk task of prescribing, before
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