Creating a culture of thoughtful prescribing

Area of Science:

• Medical Education
• Clinical Communication
• Health Professions Training

Background:

• Poor communication among healthcare professionals affects 170,000 Dutch patients annually, leading to inappropriate therapy in 44% of cases.
• Physician training in communicating therapeutic content often lacks structure, contributing to these communication breakdowns.

Purpose of the Study:

• Introduce a structured format for creating and communicating therapeutic plans.
• Offer students opportunities for practice and feedback on therapeutic planning and communication skills.

Main Methods:

• Developed the Individualized Therapy Evaluation and Plan (ITEP) framework for decision-making and communication.
• Assessed student therapeutic plans using a 15-point criteria form for simple and complex cases.
• Tracked improvements in complex case scores over three years with increased ITEP practice.

Main Results:

• In 2003, 82% of students succeeded with simple cases, but only 32% with complex cases.
• Subsequent years showed significant improvement in complex case scores, rising from an average of 3.8 to 6.8.
• Increased practice with the ITEP method correlated with better performance on complex therapeutic plans.

Conclusions:

• Medical students can manage simple drug regimens but require structured practice, like the ITEP, for complex cases involving multiple disease states.
• The ITEP framework demonstrates potential for enhancing therapeutic communication skills in medical education.