Department of Internal Medicine, Division of Diabetes, Endocrinology, Angiology, Nephrology and Clinical Chemistry, University Hospital of Tübingen, Otfried-Mueller-Str. 10, 72076, Tübingen, Germany.
Naunyn Schmiedebergs Arch Pharmacol. 2010 Aug;382(2):171-6. doi: 10.1007/s00210-010-0530-9. Epub 2010 Jun 10.
Prescribing correctly represents one of the most essential skills of a doctor when it comes to patient safety. Unfortunately, prescribing errors still account for a large proportion of avoidable drug-related problems (DRP). Despite this shortcoming, many medical schools do not provide specific prescribing training and assume that students acquire sufficient prescribing skills during regular medical clerkships. We therefore investigated whether there is an association between the individual time spent by students in internal-medicine clerkships and the number of prescription errors committed in a standardized prescribing test for common drug-related problems in a medical inpatient setting. Seventy-four fifth-year medical students (25 +/- 3 yrs, 24 m, 50 f) who had completed their formal pharmacology training filled in prescription charts for two standardized patient paper cases. The charts were rated by two blinded consultants from the field of internal medicine using a checklist for common prescription errors. Students were divided into three groups according to the number of weeks previously spent in internal-medicine clerkships. Group differences in the number of prescription errors made were subsequently examined. Students committed 69% +/- 12% of all possible prescription mistakes. There was no significant difference between the group without clerkships in internal medicine (G1) (71 +/- 9%), the group with one to four weeks (G2) (67 +/- 15%), and the group with more than five weeks of clerkships (G3) (71 +/- 10%), p = .76. Medical students do not seem to acquire the necessary skills to avoid common prescription errors during regular clerkships in internal medicine. This study provides evidence to suggest that specific prescription training within medical education is warranted in order to prevent DRP.
正确开具处方是医生保障患者安全的最重要技能之一。不幸的是，开具处方错误仍然占可避免药物相关问题 (DRP) 的很大比例。尽管存在这一缺陷，许多医学院校并未提供专门的处方培训，并假定学生在常规的内科实习期间能够获得足够的处方技能。因此，我们调查了学生在内科实习中花费的个人时间与在标准化住院患者药物相关问题处方测试中犯的处方错误数量之间是否存在关联。74 名五年级医学生（25 +/- 3 岁，24 名男性，50 名女性）完成了正规药理学培训后，填写了两个标准化患者纸质病例的处方表。这些表格由两位来自内科领域的盲审顾问使用常见处方错误检查表进行评分。学生根据之前在内科实习中花费的周数分为三组。随后检查了组间处方错误数量的差异。学生犯了所有可能的处方错误的 69% +/- 12%。没有实习经历的组 (G1) (71 +/- 9%)、实习一到四周的组 (G2) (67 +/- 15%) 和实习超过五周的组 (G3) (71 +/- 10%) 之间没有显著差异，p =.76。医学生似乎没有在常规内科实习中获得避免常见处方错误所需的技能。这项研究提供了证据，表明在医学教育中需要进行专门的处方培训，以预防 DRP。
