Gibson Kyle R, Qureshi Zeshan U, Ross Michael T, Maxwell Simon R
Centre for Medical Education, University of Edinburgh, Edinburgh, UK.
Br J Clin Pharmacol. 2014 Jan;77(1):122-9. doi: 10.1111/bcp.12147.
Prescribing errors are common and inadequate preparation of prescribers appears to contribute. A junior doctor-led prescribing tutorial programme has been developed for Edinburgh final year medical students to increase exposure to common prescribing tasks. The aim of this study was to assess the impact of these tutorials on students and tutors.
One hundred and ninety-six tutorials were delivered to 183 students during 2010-2011. Each student completed a questionnaire after tutorial attendance which explored their previous prescribing experiences and the perceived benefits of tutorial attendance. Tutors completed a questionnaire which evaluated their teaching experiences and the impact on their prescribing practice. Student tutorial attendance was compared with end-of-year examination performance using linear regression analysis.
The students reported increased confidence in their prescribing knowledge and skills after attending tutorials. Students who attended more tutorials also tended to perform better in end-of-year examinations (Drug prescribing: r = 0.16, P = 0.015; Fluid prescribing: r = 0.18, P = 0.007). Tutors considered that participation enhanced their own prescribing knowledge and skills. Although they were occasionally unable to address student uncertainties, 80% of tutors reported frequently correcting misconceptions and deficits in student knowledge. Ninety-five percent of students expressed a preference for prescribing training delivered by junior doctors over more senior doctors.
A 'near-peer' junior doctor-led approach to delivering prescribing training to medical students was highly valued by both students and tutors. Although junior doctors have relatively less clinical experience of prescribing, we believe that this can be addressed by training and academic supervision and is outweighed by the benefits of these tutorials.
处方错误很常见，而开处方者准备不足似乎是一个原因。已为爱丁堡大学最后一年的医学生开发了一个由初级医生主导的处方辅导项目，以增加他们接触常见处方任务的机会。本研究的目的是评估这些辅导对学生和辅导教师的影响。
在2010 - 2011年期间，为183名学生提供了196次辅导。每个学生在参加辅导后都完成了一份问卷，该问卷探讨了他们以前的处方经历以及参加辅导的感知益处。辅导教师完成了一份问卷，评估他们的教学经历以及对他们处方实践的影响。使用线性回归分析将学生的辅导参与情况与年终考试成绩进行比较。
学生报告称，参加辅导后他们对处方知识和技能的信心有所增强。参加辅导次数较多的学生在年终考试中的表现也往往更好（药物处方：r = 0.16，P = 0.015；液体处方：r = 0.18，P = 0.007）。辅导教师认为参与提高了他们自己的处方知识和技能。尽管他们偶尔无法解决学生的疑惑，但80%的辅导教师报告经常纠正学生知识中的误解和缺陷。95%的学生表示更喜欢由初级医生而不是更资深的医生提供的处方培训。
由初级医生主导的“近同伴”方式为医学生提供处方培训，受到了学生和辅导教师的高度重视。尽管初级医生在处方方面的临床经验相对较少，但我们认为这可以通过培训和学术监督来解决，并且这些辅导的益处超过了这一不足。
