Kirkham Deborah, Darbyshire Daniel, Gordon Morris, Agius Steven, Baker Paul
Health Education North West, Genitourinary and HIV Medicine, Manchester, UK.
Royal Oldham Hospital, Emergency Medicine, Manchester, UK.
Clin Teach. 2015 Jun;12(3):187-92. doi: 10.1111/tct.12281.
Prescribing is an error-prone process for all doctors, from those who are newly qualified through to those at consultant level. Newly qualified doctors write the majority of in-patient prescriptions and therefore represent an opportunity for safety improvement. Attention to prescribing as a patient-safety issue and potential educational interventions to help improve the situation have been published, but offer little to inform educators why and how any interventions may succeed. In order to identify areas of good practice, and to provide evidence of areas requiring further investigation and innovation, we aimed to ascertain the full range of prescribing practices for final-year medical students and newly qualified doctors across a large geopolitical region of the UK.
A questionnaire methodology was used. One questionnaire was sent to those responsible for final-year education, and a further, different questionnaire was sent to those responsible for the training of newly qualified doctors, asking about prescribing education in their locality. Questionnaires were sent to 15 hospitals in total. Prescribing is an error-prone process for all doctors
Twelve hospitals contributed to final-year medical student data: a response rate of 80 per cent. A variety of methods, including student assistantship, pharmacist-led skills sessions and practical assessment, were offered to varying degrees. Free-text responses identified opportunities for different prescribing education and support. All 15 hospitals provided data on doctors' education, with interventions including e-learning, assessment and support from ward-based pharmacists.
Current education focuses on the technical and knowledge-based paradigm of prescribing. Human factors and the impact of electronic prescribing should play a part in future developments in prescribing education.
开处方对于所有医生来说都是一个容易出错的过程,从刚获得资格的医生到顾问级别医生均是如此。刚获得资格的医生开具了大部分住院处方,因此是改善安全性的一个契机。关于将开处方作为患者安全问题以及有助于改善这种情况的潜在教育干预措施的相关内容已发表,但对于教育工作者而言,几乎没有提供任何信息来解释为何以及任何干预措施可能如何取得成功。为了确定良好做法的领域,并提供需要进一步调查和创新领域的证据,我们旨在确定英国一个大地缘政治区域内最后一年医学生和刚获得资格医生的全方位开处方做法。
采用问卷调查方法。向负责最后一年教育的人员发送了一份问卷,并向负责培训刚获得资格医生的人员发送了另一份不同的问卷,询问他们所在地区的开处方教育情况。总共向15家医院发送了问卷。
12家医院提供了最后一年医学生的数据:回复率为80%。提供了多种方法,包括学生助理实习、药剂师主导的技能课程和实践评估,且程度各异。自由文本回复确定了不同开处方教育和支持的机会。所有15家医院都提供了医生教育的数据,干预措施包括电子学习、基于病房药剂师的评估和支持。
当前的教育侧重于开处方的技术和基于知识的范式。人为因素和电子处方的影响应在开处方教育的未来发展中发挥作用。