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. 2018 Apr;84(4):615-635.
doi: 10.1111/bcp.13491. Epub 2018 Jan 25.

Do final-year medical students have sufficient prescribing competencies? A systematic literature review

David J Brinkman  1   2 , Jelle Tichelaar  1   2 , Sanne Graaf  1 , René H J Otten  3 , Milan C Richir  1   2 , Michiel A van Agtmael  1   2
Affiliations

Do final-year medical students have sufficient prescribing competencies? A systematic literature review

David J Brinkman et al. Br J Clin Pharmacol. 2018 Apr.

Abstract

Aims: Prescribing errors are an important cause of patient safety incidents and are frequently caused by junior doctors. This might be because the prescribing competence of final-year medical students is poor as a result of inadequate clinical pharmacology and therapeutic (CPT) education. We reviewed the literature to investigate which prescribing competencies medical students should have acquired in order to prescribe safely and effectively, and whether these have been attained by the time they graduate.

Methods: PubMed, EMBASE and ERIC databases were searched from the earliest dates up to and including January 2017, using the terms 'prescribing', 'competence' and 'medical students' in combination. Articles describing or evaluating essential prescribing competencies of final-year medical students were included.

Results: Twenty-five articles describing, and 47 articles evaluating, the prescribing competencies of final-year students were included. Although there seems to be some agreement, we found no clear consensus among CPT teachers on which prescribing competencies medical students should have when they graduate. Studies showed that students had a general lack of preparedness, self-confidence, knowledge and skills, specifically regarding general and antimicrobial prescribing and pharmacovigilance. However, the results should be interpreted with caution, given the heterogeneity and methodological weaknesses of the included studies.

Conclusions: There is considerable evidence that final-year students have insufficient competencies to prescribe safely and effectively, although there is a need for a greater consensus among CPT teachers on the required competencies. Changes in undergraduate CPT education are urgently required in order to improve the prescribing of future doctors.

Keywords: clinical pharmacology; competence; medical curriculum; medical student; pharmacotherapy; prescribing; therapeutics.

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Figures

Figure 1
Figure 1
Flowchart of the systematic literature search
Figure 2
Figure 2
Identified articles describing prescribing competencies (formula image) and evaluating prescribing competencies (formula image) per year. Articles published before 2000 (n = 8) were not included
See this image and copyright information in PMC

References

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