Prescribing Skills Assessment Office, British Pharmacological Society, London, UK.
Br J Clin Pharmacol. 2012 Oct;74(4):632-9. doi: 10.1111/j.1365-2125.2011.04151.x.
Prescribing of medicines is the key clinical activity in the working life of most doctors. In recent years, a broad consensus regarding the necessary competencies has been achieved. Each of these is a complex mix of knowledge, judgement and skills. Surveys of those on the threshold of their medical careers have revealed widespread lack of confidence in writing prescriptions. A valid and reliable assessment of prescribing competence, separate from an overall assessment of medical knowledge and skill, would have many benefits for clinical governance and patient safety, and would provide a measure of the success of training programmes in therapeutics. Delivering such an assessment presents many challenges, not least of which are the difficulty in identifying a surrogate marker for competent prescribing in clinical practice and the challenge of ensuring that competence assessed in a controlled environment predicts performance in clinical practice. This review makes the case for an on-line OSCE as the most valid form of assessment and sets out the requirements for its development, scope, composition and delivery. It describes an on-going attempt to develop a national assessment of prescribing skills towards the end of undergraduate medical training in the UK.
开药是大多数医生工作生涯中的关键临床活动。近年来，人们对必要的能力已经达成了广泛共识。这些能力中的每一项都是知识、判断和技能的复杂组合。对即将步入职业生涯的医生的调查显示，他们普遍对开处方缺乏信心。对开药能力进行独立于整体医疗知识和技能评估之外的有效和可靠评估，将对临床治理和患者安全带来诸多益处，并能衡量治疗学培训计划的成功程度。进行这种评估存在许多挑战，其中最主要的是难以在临床实践中确定胜任开药的替代指标，以及难以确保在受控环境中评估的能力能够预测临床实践中的表现。本文通过在线客观结构化临床考试（OSCE）来证明其是最有效的评估形式，并阐述了其开发、范围、组成和实施的要求。本文还介绍了英国正在进行的一项旨在评估医学生在本科阶段结束时的开药技能的全国性评估。
