William Harvey Research Institute, Queen Mary University of London, London, UK.
St George's, University of London, London, UK.
Br J Clin Pharmacol. 2024 Feb;90(2):493-503. doi: 10.1111/bcp.15919. Epub 2023 Nov 9.
The United Kingdom (UK) Prescribing Safety Assessment (PSA) is a 2-h online assessment of basic competence to prescribe and supervise the use of medicines. It has been undertaken by students and doctors in UK medical and foundation schools for the past decade. This study describes the academic characteristics and performance of the assessment; longitudinal performance of candidates and schools; stakeholder feedback; and surrogate markers of prescribing safety in UK healthcare practice.
We reviewed the performance data generated by over 70 000 medical students and 3700 foundation doctors who have participated in the PSA since its inception in 2013. These data were supplemented by Likert scale and free text feedback from candidates and a variety of stakeholder groups. Further data on medication incidents, collected by national reporting systems and the regulatory body, are reported, with permission.
We demonstrate the feasibility, high quality and reliability of an online prescribing assessment, uniquely providing a measure of prescribing competence against a national standard. Over 90% of candidates pass the PSA on their first attempt, while a minority are identified for further training and assessment. The pass rate shows some variation between different institutions and between undergraduate and foundation cohorts. Most responders to a national survey agreed that the PSA is a useful instrument for assessing prescribing competence, and an independent review has recommended adding the PSA to the Medical Licensing Assessment. Surrogate markers suggest there has been improvement in prescribing safety in practice, temporally associated with the introduction of the PSA but other factors could be influential too.
The PSA is a practical and cost-effective way of delivering a reliable national assessment of prescribing competence that has educational impact and is supported by the majority of stakeholders. There is a need to develop national systems to identify and report prescribing errors and the harm they cause, enabling the impact of educational interventions to be measured.
英国处方安全评估（PSA）是一项时长 2 小时的在线基本处方能力评估，旨在评估和监督药物的使用。过去十年，英国医学和基础医学院的学生和医生一直在进行这项评估。本研究描述了评估的学术特征和表现；候选人及学校的纵向表现；利益相关者的反馈；以及英国医疗实践中处方安全的替代指标。
我们回顾了自 2013 年 PSA 启动以来，超过 70000 名医学生和 3700 名基础医生参与该评估所产生的表现数据。这些数据补充了候选人以及各种利益相关者群体的李克特量表和自由文本反馈。经许可，我们还报告了从国家报告系统和监管机构收集的关于药物事件的进一步数据。
我们证明了在线处方评估的可行性、高质量和可靠性，这在独特的方面提供了一种衡量处方能力的方法，该方法符合国家标准。超过 90%的候选人首次尝试就通过了 PSA，而少数人则需要进一步培训和评估。通过率在不同机构和本科和基础课程之间存在一些差异。对全国性调查的大多数回应者都认为 PSA 是评估处方能力的有用工具，独立审查建议将 PSA 添加到医学许可评估中。替代指标表明，实践中的处方安全性有所提高，这与 PSA 的引入时间相关，但其他因素也可能有影响。
PSA 是一种实用且具有成本效益的方法，可以可靠地评估全国范围内的处方能力，具有教育影响力，并得到大多数利益相关者的支持。需要开发国家系统来识别和报告处方错误及其造成的危害，以便衡量教育干预的效果。
