Kinston Ruth, McCarville Niamh, Hassell Andrew
Keele University, Stoke-on-Trent, UK.
Clin Teach. 2019 Dec;16(6):598-603. doi: 10.1111/tct.12991. Epub 2019 Jan 7.
Medical doctors are required to prescribe drugs safely and effectively upon qualification, a skill that many feel poorly prepared to undertake. To better prepare doctors, a whole-task approach that develops knowledge and skills, but that also considers the effect of the complex clinical workplace on prescribing, is optimal. We describe an evaluation of an experiential learning programme that allows senior medical students to gain experience with inpatient prescribing during their hospital assistantship.
A standard operating procedure (SOP) for medical student transcribing was implemented by the teaching hospitals associated with a single medical school. This included medical student prescriptions being written in purple ink. The evaluation consisted of an audit of transcribing activity and a student survey. We evaluated the usage of the initiative, adherence to the SOP and the propensity for error.
The survey was completed by 38 out of a possible 108 fifth-year students. All respondents agreed that the programme was helpful in aiding them to learn about prescribing. A total of 247 prescriptions for 50 patients were audited: 25.1% of the prescriptions written by students required some form of amendment by the supervising doctor or pharmacist; three (1.2%) prescription errors remained unidentified; and none presented a patient safety risk.
The purple-pen scheme affords medical students the opportunity to prescribe in the workplace, where they face authentic challenges when safely contributing to patient care. The identification of prescribing errors, feedback and the learners' own reflections helped the learners to focus on areas for improvement in prescribing prior to qualification.
医生在获得资格后需要安全有效地开药，而许多人认为自己在这方面准备不足。为了让医生更好地做好准备，一种全面任务方法是最佳选择，这种方法既能培养知识和技能，又能考虑复杂临床工作环境对开药的影响。我们描述了一项对体验式学习项目的评估，该项目让高年级医学生在医院实习期间获得住院患者开药的经验。
与一所医学院相关的教学医院实施了医学生抄写的标准操作程序（SOP）。这包括用紫色墨水书写医学生的处方。评估包括对抄写活动的审核和学生调查。我们评估了该举措的使用情况、对SOP的遵守情况以及出错倾向。
在可能参与的108名五年级学生中，有38名完成了调查。所有受访者都认为该项目有助于他们学习开药。共审核了50名患者的247张处方：学生开具的处方中有25.1%需要监督医生或药剂师进行某种形式的修改；有三张（1.2%）处方错误未被发现；且没有一个会带来患者安全风险。
紫色笔方案为医学生提供了在工作场所开药的机会，在那里他们在安全参与患者护理时面临真实的挑战。开药错误的识别、反馈以及学习者自己的反思有助于学习者在获得资格之前关注开药方面有待改进的领域。
