Clinical Pharmacology Unit, University of Edinburgh, Medical Education Centre, Western General Hospital, Edinburgh, EH3 2XU, UK.
School of Medicine, Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), Medical School Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Br J Clin Pharmacol. 2017 Oct;83(10):2249-2258. doi: 10.1111/bcp.13319. Epub 2017 Jun 13.
Newly graduated doctors write a large proportion of prescriptions in UK hospitals but recent studies have shown that they frequently make prescribing errors. The prescribing safety assessment (PSA) has been developed as an assessment of competence in relation to prescribing and supervising the use of medicines. This report describes the delivery of the PSA to all UK final-year medical students in 2016 (PSA2016).
The PSA is a 2-hour online assessment comprising eight sections which cover various aspects of prescribing defined within the outcomes of undergraduate education identified by the UK General Medical Council. Students sat one of four PSA 'papers', which had been standard-set using a modified Angoff process.
A total of 7343 final-year medical students in all 31 UK medical schools sat the PSA. The overall pass rate was 95% with the pass rates for the individual papers ranging from 93 to 97%. The PSA was re-sat by 261 students who had failed and 80% of those candidates passed. The internal consistency (Cronbach's alpha) of the four papers ranged from 0.74 to 0.77 (standard error of measurement 4.13-4.24%). There was a statistically significant variation in performance between medical school cohorts (F = 32.6, P < 0.001) and a strongly positive correlation in performance for individual schools between PSA2015 and PSA2016 (r = 0.79, 95% CI 0.61-0.90; P < 0.01).
PSA2016 demonstrated the feasibility of delivering a standardized national prescribing assessment online. The vast majority of UK final-year medical students were able to meet a prespecified standard of prescribing competence.
在英国医院，刚毕业的医生书写了很大一部分处方，但最近的研究表明，他们经常开出处方错误。处方安全评估（PSA）是作为评估与处方相关的能力和监督药物使用的一种评估方法。本报告描述了 2016 年向所有英国医学应届毕业生提供 PSA（PSA2016）的情况。
PSA 是一项 2 小时的在线评估，由八个部分组成，涵盖了英国医学总会确定的本科教育成果中规定的处方的各个方面。学生参加了四个 PSA“试卷”中的一个，这些试卷是使用经过修改的 Angoff 过程进行标准设置的。
共有 31 所英国医学院的 7343 名应届医学毕业生参加了 PSA。总体通过率为 95%，各个试卷的通过率从 93%到 97%不等。261 名未通过的学生重新参加了 PSA，其中 80%的考生通过了。四套试卷的内部一致性（Cronbach's alpha）在 0.74 到 0.77 之间（测量标准误差为 4.13-4.24%）。医学院校群体之间的表现存在统计学上的显著差异（F=32.6，P<0.001），个别学校之间 PSA2015 和 PSA2016 的表现呈强正相关（r=0.79，95%置信区间 0.61-0.90；P<0.01）。
PSA2016 证明了在线提供标准化国家处方评估的可行性。绝大多数英国医学应届毕业生能够达到预定的处方能力标准。
