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Development and Validation of the McMaster Prescribing Competency Assessment for Medical Trainees (MacPCA)
Summary
The McMaster Prescribing Competency Assessment (MacPCA) effectively evaluates medical trainees' prescribing skills. It showed good validity and distinguished between senior and junior medical students.
Area of Science:
- Medical Education
- Clinical Pharmacology
- Healthcare Professional Training
Background:
- Prescribing is a critical physician skill, yet medical students face challenges mastering it due to declining pharmacology training and increasing care complexity.
- Ensuring prescribing competency is vital for patient safety and effective healthcare delivery.
Purpose of the Study:
- To develop and validate the McMaster Prescribing Competency Assessment (MacPCA), an online tool for assessing medical trainees' clinical pharmacology knowledge and prescribing skills in Canada.
- To create a scalable, accessible assessment tool for evaluating prescribing competency across Canadian medical schools.
Main Methods:
- Developed an online examination platform for the MacPCA, featuring questions across 8 domains of safe prescribing.
- Targeted question difficulty for final-year medical students and validated the assessment using face and construct validity measures.
- Recruited 58 participants, including undergraduate controls and medical students from Years 1, 2, and 3.
Main Results:
- Final-year medical students (Year 3) achieved significantly higher scores (81%) compared to Year 1 students (46%) and controls (31%).
- The MacPCA demonstrated a clear progression in scores, with combined Year 2/Year 3 students outperforming controls and Year 1 students (p<0.0001).
- Feedback from final-year students indicated the assessment was fair, clear, appropriately challenging, and allowed sufficient completion time.
Conclusions:
- The McMaster Prescribing Competency Assessment (MacPCA) shows strong face validity and effectively differentiates between senior and junior medical trainees.
- The tool is a promising resource for evaluating prescribing competency in Canadian medical education.
- Further research and validation are recommended to expand the MacPCA's application and impact.
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