Establishing a Prescribing teaching programme in undergraduate medicine

Introduction The Essentials of Clinical Practice (ECP) is a week-long teaching programme delivered to RCSI Senior Cycle 2 (SC2) final year students. It focuses on medical professionalism and is designed to highlight common problems faced by newly qualified interns (clinical emergencies, ethical and legal aspects of patient care, communication). The ability to prescribe safely and effectively represents a challenging task, as it involves a complex set of sub-competencies, each of which demands a mixture of knowledge, judgement and skill (1). The Department of Geriatric and Stroke Medicine is responsible for delivering a 3-hour session on medication prescribing and patient safety in the older adult. DESCRIPTION OF TEACHING PROGRAMME The ECP is delivered in a small group case-based teaching format of 8 to 12 students. Students are expected to have prepared the relevant material on prescribing (available on RCSI Moodle website) in advance. They are encouraged to participate actively in case discussions and to reflect on what they have learned. The first hour involves an interactive lecture on prescribing safely in older adults, with particular focus on issues such as polypharmacy, adverse drug events, pharmacokinetics, pharmacodynamics, medication errors and the principles of good prescribing. The second hour is an accompanying video on a particular prescribing error involving Vincristine (World Health Organisation ‘Learning from Error’). Emphasis is placed on identifying reasons for errors and developing ideas for improved patient safety. Finally, students are required to complete 5 case-based prescribing scenarios. In total, 14 parameters are assessed, of which 4 of these test a student’s comprehension of critical drug interactions, weekly medication prescribing and drug allergy respectively. These scenarios are designed to assess the students’ knowledge of good prescribing practices and common prescribing pitfalls. CONCLUSION Overall, the verbal feedback comments were positive and students enjoyed the participation and exposure to real life case scenarios during the lecture. Further emphasis needs to be placed on teaching students about medication interactions, the significance of drug allergies and prescribing weekly and controlled medications.