Section Pharmacotherapy, Department of Internal Medicine, Amsterdam University Medical Centers, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.
Eur J Clin Pharmacol. 2021 Mar;77(3):421-429. doi: 10.1007/s00228-020-03027-3. Epub 2020 Oct 23.
The pharmacology and clinical pharmacology and therapeutics (CPT) education during the undergraduate medical curriculum of NOVA Medical School, Lisbon, Portugal, was changed from a traditional programme (i.e. discipline-based, lectures) to a problem-based learning (PBL) programme (i.e. integrated, case-based discussions) without an increase in teaching hours. The aim of this study was to investigate whether this change improved the prescribing competencies of final-year medical students.
Final-year students from both programmes (2015 and 2019) were invited to complete a validated prescribing assessment and questionnaire. The assessment comprised 24 multiple-choice questions in three subdomains (working mechanism, side-effects and interactions/contraindications), and five clinical case scenarios of common diseases. The questionnaire focused on self-reported prescribing confidence, preparedness for future prescribing task and education received.
In total, 36 (22%) final-year medical students from the traditional programme and 54 (23%) from the PBL programme participated. Overall, students in the PBL programme had significantly higher knowledge scores than students in the traditional programme (76% (SD 9) vs 67% (SD 15); p = 0.002). Additionally, students in the PBL programme made significantly fewer inappropriate therapy choices (p = 0.023) and fewer erroneous prescriptions than did students in the traditional programme (p = 0.27). Students in the PBL programme felt more confident in prescribing, felt better prepared for prescribing as junior doctor and completed more drug prescriptions during their medical training.
Changing from a traditional programme to an integrated PBL programme in pharmacology and CPT during the undergraduate medical curriculum may improve the prescribing competencies of final-year students.
葡萄牙里斯本诺瓦医学院将本科医学课程中的药理学和临床药理学与治疗学（CPT）教育从传统课程（即基于学科的讲座）转变为基于问题的学习（PBL）课程（即综合的、基于案例的讨论），而教学时间没有增加。本研究旨在调查这种转变是否提高了应届医学生的处方能力。
邀请两个课程（2015 年和 2019 年）的应届毕业生完成一项经过验证的处方评估和问卷。评估包括三个子领域（作用机制、副作用和相互作用/禁忌症）的 24 个多项选择题和五个常见疾病的临床病例情景。问卷重点关注自我报告的处方信心、对未来处方任务的准备情况和所接受的教育。
共有 36 名（22%）传统课程的应届医学生和 54 名（23%）PBL 课程的应届医学生参与了研究。总体而言，PBL 课程的学生知识得分显著高于传统课程的学生（76%（SD 9）比 67%（SD 15）；p=0.002）。此外，PBL 课程的学生做出的不适当治疗选择明显较少（p=0.023），错误处方也比传统课程的学生少（p=0.27）。PBL 课程的学生在开处方方面更有信心，对作为初级医生开处方更有准备，在医学培训期间完成了更多的药物处方。
在本科医学课程中，将药理学和 CPT 从传统课程转变为综合的 PBL 课程可能会提高应届学生的处方能力。
