Key Learning Outcomes for Clinical Pharmacology and Therapeutics Education in Europe: A Modified Delphi Study

Abstract

Harmonizing clinical pharmacology and therapeutics (CPT) education in Europe is necessary to ensure that the prescribing competency of future doctors is of a uniform high standard. As there are currently no uniform requirements, our aim was to achieve consensus on key learning outcomes for undergraduate CPT education in Europe. We used a modified Delphi method consisting of three questionnaire rounds and a panel meeting. A total of 129 experts from 27 European countries were asked to rate 307 learning outcomes. In all, 92 experts (71%) completed all three questionnaire rounds, and 33 experts (26%) attended the meeting. 232 learning outcomes from the original list, 15 newly suggested and 5 rephrased outcomes were included. These 252 learning outcomes should be included in undergraduate CPT curricula to ensure that European graduates are able to prescribe safely and effectively. We provide a blueprint of a European core curriculum describing when and how the learning outcomes might be acquired.

Figure 1

Flowchart of the systematic literature search.

Figure 2

Total number of learning outcomes per subcategory (n = 34) for knowledge (blue; n = 192), skills (yellow; n = 47), and attitudes (green; n = 13). The red line demonstrates the mean % “(very) important” per subcategory (calculated by dividing the total % “(very) important” per subcategory by the number of outcomes within that subcategory). TDM, Therapeutic Drug Monitoring.

Figure 3

Blueprint of an integrated context‐based European core curriculum in clinical pharmacology and therapeutics describing when and how learning outcomes might be taught and assessed during the early (i.e., years 1–3 in Europe and years 1–2 in the USA) and later years (i.e., years 4–6 in Europe and years 3–4 in the USA) of the medical curriculum. Journal clubs refer to discussing the scientific CPT literature in small groups of students in order to teach critical appraisal skills. Case‐based discussion groups involve discussing written patient cases in small groups of students together with a tutor. Role‐playing sessions refers to conducting therapeutic consultations with simulated patients. Pre‐prescribing seminars involve medical students writing instructions on in‐patient drug charts, which have to be validated by a doctor before drugs are dispensed. Prescribing tutorials involve ward‐based practical tutorials about common therapeutic problems and high‐risk medicines for medical students during clinical attachments. Student‐run clinics are real‐patient clinics designed to teach and train prescribing skills grounded in a real‐life context and to provide students with early clinical experience and responsibility under the supervision of a senior clinician. Workplace‐based assessment entails direct observation of prescribing in clinical practice under the supervision of a senior clinician. OSCE, objective structured clinical examination.