医学院校期间培养基本处方技能的信心：一项调查改良临床药理学课程效果的纵向问卷调查研究
Developing confidence in basic prescribing skills during medical school: a longitudinal questionnaire study investigating the effects of a modified clinical pharmacology course.
作者信息
Eriksson Anna L, Wallerstedt Susanna M
机构信息
Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden.
Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden.
出版信息
Eur J Clin Pharmacol. 2018 Oct;74(10):1343-1349. doi: 10.1007/s00228-018-2508-3. Epub 2018 Jun 28.
PURPOSE
To investigate if increased focus on pharmacotherapy during medical school can increase students' confidence in basic prescribing skills, that is, performing medication reviews and writing medication discharge summaries.
METHODS
In 2016, the clinical pharmacology course in medical school in Gothenburg, Sweden, was modified to facilitate the students' acquisition of prescribing skills, with (i) clarified learning outcomes; (ii) supply of a list of common drugs for self-completion; (iii) instructions to practice medication reviews/discharge summaries during the ward-based education; and (iv) a concluding compulsory seminar where the students were to present prescribing-related experiences from their ward-based attendance. Questionnaires were administered to students participating in the course before (2016; n = 101) and after (2017; n = 137) implementation of the modifications. Students were asked to grade their agreement from 1 (totally disagree) to 5 (totally agree) on statements related to their perceived confidence in basic prescribing skills.
RESULTS
In all, 195 students returned the questionnaire (response rate 82%; median age 24 years; 68% female). Confidence was rated higher after the modifications were implemented, both regarding medication reviews and medication discharge summaries, after vs. before 3.6 ± 1.2 vs. 3.2 ± 1.0 (P = 0.024), and 4.3 ± 0.9 vs. 3.9 ± 1.1 (P = 0.008), respectively. The adjusted odds for being confident in performing these tasks were 1.49/1.36 times greater after the course modifications (P = 0.047/0.019). Perceived confidence in performing medication reviews/summary reports was positively correlated with numbers performed (P < 0.0001).
CONCLUSIONS
Modifications of the clinical pharmacology course during medical school, focusing on students' training in pharmacotherapy, was associated with increased confidence of this core skill for a physician.
目的
研究医学院校增加对药物治疗的关注是否能提高学生在基本处方技能方面的信心，即进行用药评估和撰写出院用药总结。
方法
2016年，瑞典哥德堡医学院的临床药理学课程进行了修改，以促进学生获得处方技能，具体措施包括：（i）明确学习成果；（ii）提供一份常见药物清单供学生自行填写；（iii）指导学生在病房实习期间进行用药评估/出院总结；（iv）举办一场总结性的必修研讨会，学生需在会上汇报在病房实习期间与处方相关的经历。在课程修改实施前（2016年；n = 101）和实施后（2017年；n = 137），对参与该课程的学生进行问卷调查。要求学生对与基本处方技能相关的陈述，按照1（完全不同意）至5（完全同意）的等级进行打分，以表明他们的认同程度。
结果
共有195名学生返回问卷（回复率82%；中位年龄24岁；68%为女性）。在实施修改措施后，学生在用药评估和出院用药总结方面的信心评分均有所提高，用药评估方面，实施后与实施前分别为3.6±1.2和3.2±1.0（P = 0.024）；出院用药总结方面，实施后与实施前分别为4.3±0.9和3.9±1.1（P = 0.008）。课程修改后，对执行这些任务有信心的调整后优势比分别提高了1.49倍/1.36倍（P = 0.047/0.019）。对进行用药评估/总结报告的信心与实际完成数量呈正相关（P < 0.0001）。
结论
医学院校临床药理学课程的修改，侧重于学生在药物治疗方面的培训，与提高医生这一核心技能的信心相关。
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