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. 2022 Dec;88(12):5218-5226.
doi: 10.1111/bcp.15443. Epub 2022 Jul 5.

Do we become better prescribers after graduation: A 1-year international follow-up study among junior doctors

Erik M Donker  1   2 , David J Brinkman  1   2 , Floor van Rosse  3 , Ben Janssen  4 , Wilma Knol  5 , Glenn Dumont  6 , Philippe G Jorens  7 , Alain Dupont  8 , Thierry Christiaens  9 , Jeroen van Smeden  10   11 , Itte de Waard-Siebinga  12 , Laura E J Peeters  2   13 , Ronald Goorden  14 , Marleen Hessel  11 , Birgit Lissenberg-Witte  15 , Milan Richir  1   2   16 , Michiel A van Agtmael  1   2 , Cornelis Kramers  17 , Jelle Tichelaar  1   2 ; Education committee of the Dutch Society for Clinical Pharmacology and Biopharmacy
Affiliations

Do we become better prescribers after graduation: A 1-year international follow-up study among junior doctors

Erik M Donker et al. Br J Clin Pharmacol. 2022 Dec.

Abstract

Aim: The aim of this study was to investigate how the prescribing knowledge and skills of junior doctors in the Netherlands and Belgium develop in the year after graduation. We also analysed differences in knowledge and skills between surgical and nonsurgical junior doctors.

Methods: This international, multicentre (n = 11), longitudinal study analysed the learning curves of junior doctors working in various specialties via three validated assessments at about the time of graduation, and 6 months and 1 year after graduation. Each assessment contained 35 multiple choice questions (MCQs) on medication safety (passing grade ≥85%) and three clinical scenarios.

Results: In total, 556 junior doctors participated, 326 (58.6%) of whom completed the MCQs and 325 (58.5%) the clinical case scenarios of all three assessments. Mean prescribing knowledge was stable in the year after graduation, with 69% (SD 13) correctly answering questions at assessment 1 and 71% (SD 14) at assessment 3, whereas prescribing skills decreased: 63% of treatment plans were considered adequate at assessment 1 but only 40% at assessment 3 (P < .001). While nonsurgical doctors had similar learning curves for knowledge and skills as surgical doctors (P = .53 and P = .56 respectively), their overall level was higher at all three assessments (all P < .05).

Conclusion: These results show that junior doctors' prescribing knowledge and skills did not improve while they were working in clinical practice. Moreover, their level was under the predefined passing grade. As this might adversely affect patient safety, educational interventions should be introduced to improve the prescribing competence of junior doctors.

Keywords: clinical pharmacology; graduate; medical education; pharmacotherapy; prescribing knowledge and skills.

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Conflict of interest statement

All authors declared no competing interests for this work.

Figures

FIGURE 1
FIGURE 1
Study overview
FIGURE 2
FIGURE 2
Mean knowledge scores per topic (n = 326). PK, pharmacokinetics
FIGURE 3
FIGURE 3
Score development of prescribing skills (n = 325)
See this image and copyright information in PMC

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