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Published on: August 1, 2019
Improved junior paediatric prescribing skills after a short e-learning intervention: a randomised controlled trial
Morris Gordon1, Madawa Chandratilake, Paul Baker
1Mary Seacole Building, MS 1.90, Frederick Road Campus, University of Salford, Greater Manchester, M6 6PU, UK. morris@betterprescribing.com
Insights
A new e-learning course significantly improved junior doctors' pediatric prescribing skills and confidence. These positive outcomes for prescribing education were sustained for at least three months.
Area of Science:
- Medical Education
- Clinical Pharmacy
- Pediatric Medicine
Background:
- Medication errors are prevalent, with junior doctors frequently involved in acute care settings.
- Paediatric prescribing presents unique challenges, yet educational resources are limited.
- Developing effective prescribing education for junior doctors is crucial for patient safety.
Purpose of the Study:
- To develop and evaluate a cost-effective e-learning resource for paediatric prescribing.
- To enhance the prescribing skills and confidence of junior doctors in paediatric care.
- To assess the long-term effectiveness of the e-learning intervention.
Main Methods:
- A non-blinded randomized controlled trial involving 162 junior doctors.
- Intervention group completed a 1-2 hour e-learning module on paediatric prescribing.
- Prescribing skills, habits, and confidence were assessed at baseline, and at 1 and 3 months post-intervention.
Main Results:
- No significant baseline differences in prescribing assessment scores between groups.
- The e-learning group demonstrated significantly higher prescribing assessment scores post-intervention (79% vs. 63%, p<0.0001).
- Improved scores and confidence were maintained in the e-learning group at 3 months (p<0.0001).
Conclusions:
- A brief, low-cost e-learning intervention effectively improved paediatric prescribing skills in junior doctors.
- The positive effects on prescribing skills and confidence were sustained for at least three months.
- Educationally sound, low-fidelity e-learning is a viable method for enhancing prescribing education.
Objective:
Medication errors are common, with junior doctors accounting for the majority in acute healthcare. Paediatrics is uniquely challenging, but the evidence base to guide prescribing education is limited. The authors set out to develop a short, educationally sound, low cost e-learning resource for paediatric prescribing to improve junior doctors' prescribing skills and to evaluate its effectiveness.
Design:
A non-blinded randomised controlled trial.
Setting:
North Western Deanery Foundation School, UK.
Participants:
162 volunteer foundation (junior) doctors randomised into control (86) and intervention (76) groups.
Interventions:
On study entry, participants were assessed on prescribing skill, prescribing habits and confidence. The intervention group completed the e-learning course designed for the study, which took 1-2 h. At 1 and 3 months after the intervention, both groups were assessed on similar prescribing assessments, habits and confidence.
Main Outcome Measures:
Total score (expressed as a percentage) on prescribing assessments, confidence and satisfaction scores.
Results:
There were no preintervention differences in prescribing assessments (67% vs 67%, p=0.56). Postintervention, the e-learning group scored significantly higher than the control group (63% vs 79%, p<0.0001). At 3 months, the e-learning group still scored significantly higher (69% vs 79%, p<0.0001), with improved confidence scores (p<0.0001).
Conclusions:
This short e-learning resource significantly improved the paediatric prescribing skills of junior doctors. Outcomes were maintained at 3 months, suggesting the utility of low cost, low fidelity, educationally sound e-learning interventions. However, the direct impact on patient outcomes following this intervention has yet to be determined.
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