Pre-prescribing: a safe way to learn at work?

Area of Science:

• Medical Education
• Patient Safety
• Pharmacology

Background:

• UK medical graduates require safe prescribing skills per General Medical Council mandate.
• Studies indicate poor graduate preparedness and significant prescribing error rates among junior doctors.
• Medical students in the UK are typically not permitted to prescribe independently.

Purpose of the Study:

• To evaluate the safety and feasibility of a novel pre-prescribing process for final-year medical students.
• To assess the effectiveness of a structured protocol involving student-written drug instructions and mandatory physician countersignature.

Main Methods:

• A controlled pre-prescribing protocol was developed collaboratively by medical, pharmacy, and nursing staff.
• Final-year medical student volunteers wrote pre-prescriptions on in-patient drug charts, requiring a doctor's countersignature.
• Key protocol elements included distinct drug chart stickers, aide-memoires for countersigning, and ward-based information sheets.

Main Results:

• Twelve final-year medical students participated, generating 586 pre-prescriptions.
• No adverse events were reported during the pilot implementation of the pre-prescribing process.
• Initial safety data for the pre-prescribing protocol is positive.

Conclusions:

• The small-scale implementation of pre-prescribing for medical students was successful.
• Further evaluation is needed to confirm the minimal risk of adverse events.
• Expansion of the pre-prescribing program is planned across South East Scotland, aiming for wider student participation.