Division of Medical and Dental Education, University of Aberdeen, Aberdeen and School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.
Br J Clin Pharmacol. 2010 Oct;70(4):604-8. doi: 10.1111/j.1365-2125.2009.03581.x.
The question of whether new medical graduates are adequately prepared for the challenge of prescribing has been raised. Although broad outcomes for prescribing competency have been agreed, clarity is needed on the detailed outcomes expected of new graduates. This study aimed to create a consensus on the required competencies for new graduates in the area of prescribing.
We used a modified Delphi approach based on the findings of a systematic review of educational interventions for improved prescribing. Panellists were asked to rank the importance of a list of 53 possible learning outcomes and to add any additional outcomes felt to be missing.
Of the 48 experts who were invited to participate, 28 agreed (58%). Forty-five learning outcomes were included from the original list of 53. A further nine outcomes were suggested by panellists, of which five were included. The wording of three outcomes was changed in line with suggestions from the panellists. Many of the agreed outcomes relate to improving patient safety through medication review, checking appropriateness of the drug for the patient, recognizing the prescriber's limitations and seeking advice when needed. Enhanced communication with the patient and healthcare team, better documentation in the notes and discharge letters were key areas featured in this Delphi exercise.
This study has identified 50 learning outcomes for teaching prescribing. These build on the existing British Pharmacological Society document by focusing specifically on prescribing, with greater emphasis on avoiding medication errors and better communication.
新的医学毕业生是否为开处方的挑战做好了充分准备,这一问题已经提出。虽然已经就处方能力的广泛结果达成了共识,但需要明确新毕业生所期望的详细结果。本研究旨在就处方领域新毕业生所需的能力达成共识。
我们使用了一种基于系统评价教育干预措施以提高处方能力的发现的改良 Delphi 方法。小组成员被要求对 53 项可能的学习结果进行重要性排序,并添加他们认为缺失的任何其他结果。
在被邀请参与的 48 名专家中,有 28 名(58%)同意参与。从最初的 53 项中包含了 45 项学习结果。小组成员还提出了另外 9 项结果,其中 5 项被纳入。根据小组成员的建议,对三个结果的措辞进行了修改。许多已达成的结果都涉及通过药物审查来提高患者安全性、检查药物对患者的适宜性、认识到开处方者的局限性并在需要时寻求建议。增强与患者和医疗团队的沟通、更好地记录在医嘱和出院记录中是这项 Delphi 研究中的重点领域。
本研究确定了 50 项教学处方的学习结果。这些结果建立在现有的英国药理学会文件基础上,专门针对处方,更加强调避免药物错误和更好的沟通。