Department of Medicine, Sahlgrenska University Hospital, 413 46, Gothenburg, Sweden.
Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, 413 90, Gothenburg, Sweden.
Eur J Clin Pharmacol. 2019 May;75(5):687-696. doi: 10.1007/s00228-018-02619-4. Epub 2019 Jan 28.
To evaluate whether an educational intervention based on collegial discussions on patient cases could increase interns' professional confidence in prescribing.
In a randomized controlled study at Sahlgrenska University Hospital, Gothenburg, Sweden, 69 interns (median age: 29 years, 54% female) were allocated to an intervention or control group. The intervention consisted of two 3-h seminars based on collegial discussions of patient cases focused on performing medication reviews. This included reconciling the drug treatment and ascertaining that it is reasonable given the patient's current health status, as well as tips on practical handling of the medical records system and integrated decision support. Self-assessed confidence in performing medication reviews was evaluated with questionnaires distributed at baseline and at 6-month follow-up.
Fifty-seven (83%) interns completed the questionnaires. Although the opposite was found at baseline, intervention interns, in comparison with controls, at follow-up, were more confident in performing medication reviews (4.3 ± 0.9 vs. 3.6 ± 1.3, P = 0.034; 1 = completely disagree to 5 = completely agree). At follow-up, the intervention participants had increased their confidence in prescribing to a greater extent compared with the control participants, including performing medication reviews as well as taking responsibility for the medication list at discharge: + 1.5/+ 1 vs ± 0 on the 5-point agreement scale (all P ≤ 0.01). Among other positive outcomes, the intervention increased the interns' awareness of adverse effects as a potential cause of symptoms and their confidence in withdrawing a medication.
Structured collegial discussions on pharmacotherapy, even of a relatively short duration, can increase junior physicians' professional confidence in prescribing medicines.
评估基于病例讨论的教育干预是否可以提高实习医生开具处方的专业信心。
在瑞典哥德堡萨赫勒格伦斯卡大学医院进行的一项随机对照研究中，将 69 名实习医生（中位年龄：29 岁，54%为女性）分为干预组和对照组。干预组包括两次 3 小时的研讨会，基于对病例的同事讨论，重点是进行药物审查。这包括协调药物治疗，并确定根据患者当前的健康状况，药物治疗是否合理，以及有关实际处理病历系统和综合决策支持的技巧。通过在基线和 6 个月随访时分发问卷来评估自我评估的进行药物审查的信心。
57 名（83%）实习医生完成了问卷。尽管在基线时发现相反的情况，但与对照组相比，干预组在随访时对进行药物审查更有信心（4.3±0.9 对 3.6±1.3，P=0.034；1=完全不同意，5=完全同意）。在随访时，与对照组相比，干预组增加了他们的处方信心，包括进行药物审查以及对出院时的药物清单负责：在 5 分制同意量表上增加了+1.5/+1 对±0（所有 P≤0.01）。在其他积极结果中，干预措施提高了实习医生对不良反应作为症状潜在原因的认识，以及对停药的信心。
即使是相对较短时间的基于病例的药物治疗的同事讨论，也可以提高初级医生开具药物的专业信心。
