Systematic review on safe prescribing training for medical students.
Resumo
Introduction: Medication errors present a significant challenge to patient safety, stemming from inaccuracies in prescribing, dispensing, administration, and monitoring. These errors emphasise the urgent need to enhance safe prescribing training for medical students. This systematic review evaluates educational interventions aimed at improving prescribing competencies among medical undergraduates. Methods: A comprehensive search across Scopus, PubMed, Web of Science, ScienceDirect, and Google Scholar identified 16 primary studies that met the inclusion criteria. The interventions examined included case-based workshops, simulation-based training, e-learning platforms, interprofessional education, and pharmacist-led initiatives. Results: Findings consistently indicated that structured, longitudinal teaching, particularly when it integrates clinical relevance, decision-support tools, and hands-on practice, significantly enhanced students’ prescribing accuracy and confidence. Additionally, effective training in obtaining patient histories, identifying treatment goals, and recognising contraindications, drug interactions, and comorbidities was deemed critical for reducing medication errors. However, inconsistencies were observed in training content, duration, and delivery methods across institutions. Conclusion: The review highlights the importance of integrating a standardised, evidence-based safe prescribing curriculum that incorporates digital innovations, real-time feedback, and collaborative learning. This will equip future healthcare professionals with the necessary competencies to minimise prescribing errors and uphold patient safety.
Downloads
Metrics
-
Resumo28
-
pdf 44
Referências
Rodziewicz TL, Hipskind, J. E., & Houseman, B. Medical error reduction and prevention. National Library of Medicine; StatPearls Publishing, 2023.
E et al. Interventions to reduce medication errors in adult medical and surgical settings: a systematic review. Ther Adv Drug Saf., 2020, 112042098620968309. http://dx.doi.org/10.1177/2042098620968309
Ross S, Loke YK. Development of learning outcomes for an undergraduate prescribing curriculum (British Pharmacological Society prescribing initiative). Br J Clin Pharmacol., 2010, 70(4), 604-8. http://dx.doi.org/10.1111/j.1365-2125.2009.03581.x
O'Shaughnessy M et al. Agreement between renal prescribing references and determination of prescribing appropriateness in hospitalized patients with chronic kidney disease. QJM., 2017, 110(10), 623-8. http://dx.doi.org/10.1093/qjmed/hcx086
Hilmer SN et al. Do medical courses adequately prepare interns for safe and effective prescribing in New South Wales public hospitals? Intern Med J., 2009, 39(7), 428-34. http://dx.doi.org/10.1111/j.1445-5994.2009.01942.x
Swetha K et al. Assessment of hands-on training on interns' prescription writing skills at a tertiary care teaching hospital. Asian J Pharm Clin Res., 2024, 17(7), 19-24. https://doi.org/10.22159/ajpcr.2024v17i7.51029
Kalfsvel L et al. Better performance of medical students on pharmacotherapy knowledge and skills tests is associated with practising with e-learning program P-scribe. Br J Clin Pharmacol., 2022, 88(3), 1334-46. http://dx.doi.org/10.1111/bcp.15077
Peeters MJ et al. A computer-based module for prescribing error instruction. Am J Pharm Educ., 2009, 73(6), 101. http://dx.doi.org/10.5688/aj7306101
Ward S, Wasson G. Bridging the gap: improving safe prescribing from university to workplace. Int J Clin Pharm., 2016, 38(5), 1023-6. http://dx.doi.org/10.1007/s11096-016-0346-x
Cullinan S et al. Use of an e-Learning Educational Module to Better Equip Doctors to Prescribe for Older Patients: A Randomised Controlled Trial. Drugs Aging., 2017, 34(5), 367-74. http://dx.doi.org/10.1007/s40266-017-0451-0
Vernon V et al. Building Interprofessional Competencies Through a Collaborative Prescribing Activity With Osteopathic, Pharmacy, and Physician Assistant Students. MedEdPORTAL., 2024, 2011403. http://dx.doi.org/10.15766/mep_2374-8265.11403
Guilding C et al. Making it work: the feasibility and logistics of delivering large-scale interprofessional education to undergraduate healthcare students in a conference format. J Interprof Care., 2018, 32(5), 653-5. http://dx.doi.org/10.1080/13561820.2018.1496074
Al Khaja KA et al. Assessing prescription writing skills of pre-clerkship medical students in a problem-based learning curriculum. Int J Clin Pharmacol Ther., 2005, 43(9), 429-35. http://dx.doi.org/10.5414/cpp43429
Parker H et al. Pharmacist-led, video-stimulated feedback to reduce prescribing errors in doctors-in-training: A mixed methods evaluation. Br J Clin Pharmacol., 2019, 85(10), 2405-13. http://dx.doi.org/10.1111/bcp.14065
Altmiller G, Pepe LH. Influence of Technology in Supporting Quality and Safety in Nursing Education. Nurs Clin North Am., 2022, 57(4), 551-62. https://doi.org/10.1016/j.cnur.2022.06.005
Cullinan S et al. Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: a qualitative study. Br J Clin Pharmacol., 2015, 79(5), 860-9. http://dx.doi.org/10.1111/bcp.12555
Stroup DF et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA., 2000, 283(15), 2008-12. http://dx.doi.org/10.1001/jama.283.15.2008
Moher D et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev., 2015, 4(1), 1. http://dx.doi.org/10.1186/2046-4053-4-1
Reed DA et al. Association between funding and quality of published medical education research. JAMA., 2007, 298(9), 1002-9. http://dx.doi.org/10.1001/jama.298.9.1002
Kalfsvel LS et al. Does formative assessment help students to acquire prescribing skills? Eur J Clin Pharmacol., 2023, 79(4), 533-40. http://dx.doi.org/10.1007/s00228-023-03456-w
Van der Steen CNW et al. A pharmacotherapy self-assessment improves prescribing by prompting junior doctors to study further. Br J Clin Pharmacol., 2021, 87(8), 3268-78. http://dx.doi.org/10.1111/bcp.14747
Tichelaar J et al. The effect of different levels of realism of context learning on the prescribing competencies of medical students during the clinical clerkship in internal medicine: an exploratory study. Eur J Clin Pharmacol., 2015, 71(2), 237-42. http://dx.doi.org/10.1007/s00228-014-1790-y
Bebitoglu BT et al. The short- and long-term effects of a course on rational drug use: A comparative study between prefinal- and final-year undergraduate medical students who attended the course in different clinical years. J Educ Health Promot., 2021, 10, 213. http://dx.doi.org/10.4103/jehp.jehp_1152_20
Sharma V et al. Constructing Patient Example for Teaching Medical Students: Implementing A WHO Initiative. JK-Practitioner., 2019, 24(3-4), 28. https://www.jkpractitioner.com/pdfs/vol2434/paper6.pdf
Brinkman DJ et al. Switching from a traditional undergraduate programme in (clinical) pharmacology and therapeutics to a problem-based learning programme. Eur J Clin Pharmacol., 2021, 77(3), 421-9. http://dx.doi.org/10.1007/s00228-020-03027-3
Mokrzecki S et al. Pharmacist-Led Education for Final Year Medical Students: A Pilot Study. Front Med (Lausanne)., 2021, 8, 732054. http://dx.doi.org/10.3389/fmed.2021.732054
Elbeddini A, Tayefehchamani Y. Development and evaluation of an online medication safety module for medical students at a rural teaching hospital: the Winchester District Memorial Hospital. BMJ Open Qual., 2021, 10(2). http://dx.doi.org/10.1136/bmjoq-2021-001385
Roberts AA et al. Feasibility study of prospective audit, intervention and feedback as an antimicrobial stewardship strategy at the Lagos University Teaching Hospital. Niger Postgrad Med J., 2020, 27(1), 54-8. http://dx.doi.org/10.4103/npmj.npmj_115_19
Direitos de Autor (c) 2025 Serviço de Publicações da Universidade de Múrcia
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Os trabalhos publicados nesta revista estão sujeitos aos seguintes termos:
1. O Serviço de Publicações da Universidade de Murcia (o editor) preserva os direitos económicos (direitos de autor) das obras publicadas e favorece e permite a sua reutilização ao abrigo da licença de utilização indicada no ponto 2.
2. Os trabalhos são publicados sob uma licença Creative Commons Atribuição-NãoComercial-NãoDerivada 4.0.
3. Condições de autoarquivamento. Os autores estão autorizados e incentivados a divulgar eletronicamente as versões pré-impressas (versão antes de ser avaliada e enviada à revista) e / ou pós-impressas (versão avaliada e aceita para publicação) de seus trabalhos antes da publicação, desde que favorece sua circulação e difusão mais precoce e com ela possível aumento de sua citação e alcance junto à comunidade acadêmica.
