Bridging the gap: improving safe prescribing from university to workplace

One of the challenges for Foundation Year 1 junior doctors is to apply the theoretical pharmacology from their undergraduate years into practical prescribing. The EQUIP study in 2009 investigated the causes of prescribing errors by junior doctors. Respondents in the study reported deficiencies in their education for prescribing skills and error prevention. The study suggested more could be done during undergraduate education to link theory with practice. This article describes an initiative from a hospital clinical pharmacy team to address this gap in contextual prescribing skills. Final year medical students (FY0s) were allocated to the Belfast Trust for an 11 week placement. The Clinical Pharmacy team developed a 3 h FY0 workshop focusing on practical prescribing scenarios identified as high risk by local medicines safety teams. The workshops included simulated case studies requiring the FY0 student to discuss medicine use with patients, prescribe admission drug charts and use local guidelines to safely prescribe high risk medicines. Each student was assessed using direct observation of procedural skills (DOPS). Feedback was overwhelmingly positive. Students appreciated the practical elements of the workshop. Initially there was an over-reliance on written medication history without verbally engaging the patient. Following pharmacist feedback before the DOPS students demonstrated a clear improvement in patient communication. Feedback from the FY0 students also identified additional learning needs that formed the basis of further teaching.