Shaughnessy A F, D'Amico F, Nickel R O
Department of Medical Education, St. Margaret Memorial Hospital, Pittsburgh, PA 15215.
DICP. 1991 Jan;25(1):17-21. doi: 10.1177/106002809102500103.
The objective of this study was to evaluate a novel method of physician education that uses copies of prescriptions written by study participants to provide feedback on their prescription-writing skills. A prospective, blind, completely random before-after design was used, with observation, intervention, and postintervention periods, each lasting four months. The study group comprised 20 family practice residents, stratified by year of training and randomly assigned to treatment or control groups. Copies of all prescriptions written by participating residents were evaluated for prescription-writing errors. During the intervention phase, prescription copies with errors were returned to the treatment group residents with a tactful comment pointing out the error and suggesting changes. Over the three time periods, there was a continuous decline in the rate of prescription-writing errors in the treatment group, but not in the control group. A significant number of physicians who received the feedback improved their prescription writing (p less than 0.01), but logistic regression failed to show a difference attributable to the intervention. In conclusion, written feedback on copies of prescriptions produced a small decrease in the number of prescription-writing errors. Further, long-term study may show a magnified effect of this teaching method.
本研究的目的是评估一种新型的医师教育方法，该方法利用研究参与者所开处方的副本，对其处方书写技能提供反馈。采用前瞻性、盲法、完全随机前后对照设计，设有观察期、干预期和干预后期，每个阶段持续四个月。研究组由20名家庭医学住院医师组成，按培训年份分层，并随机分配至治疗组或对照组。对参与研究的住院医师所开的所有处方副本进行处方书写错误评估。在干预期，将有错误的处方副本返还给治疗组住院医师，并附上委婉的评语，指出错误并提出修改建议。在三个时间段内，治疗组的处方书写错误率持续下降，而对照组则没有。大量收到反馈的医师改进了他们的处方书写（p<0.01），但逻辑回归未能显示出干预所致的差异。总之，对处方副本的书面反馈使处方书写错误数量略有减少。此外，长期研究可能会显示出这种教学方法的放大效果。
