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Can a novel constructivist theory-informed feedback intervention reduce prescribing errors ? A pre-post study.

Ian Coombes1,2, Peter Donovan3,4, Brooke Bullock5

  • 1School of Pharmacy, University of Queensland, 20 Cornwall St, Woolloongabba, QLD, 4102, Australia. ian.coombes@health.qld.gov.au.

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Summary
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A new theory-informed feedback intervention significantly reduced prescribing errors among medical interns. This approach enhances patient safety by improving intern prescribing practices through learner-centered feedback and planning.

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Area of Science:

  • Medical Education
  • Patient Safety
  • Pharmacology

Background:

  • Medical interns often struggle with prescribing, leading to patient safety risks.
  • Existing error rates in intern prescribing remain high despite current educational and supervisory measures.
  • Current feedback practices primarily focus on error correction rather than performance improvement.

Purpose of the Study:

  • To explore the effectiveness of a theory-informed feedback intervention in improving medical interns' prescribing practices.
  • To investigate if a constructivist-theory learner-centered approach can reduce prescribing errors.
  • To assess the impact of individualized feedback sessions on prescribing performance.

Main Methods:

  • A pre-post study design was employed in two Australian teaching hospitals.
  • A constructivist-theory informed prescribing feedback intervention, based on Feedback-Mark 2 Theory, was implemented.
  • Prescribing errors were evaluated by comparing error rates per medication order before and after the intervention, with feedback provided by clinical pharmacologists and pharmacist educators.

Main Results:

  • The study analyzed prescribing data from 88 interns across five terms.
  • A significant reduction in prescribing errors was observed at both sites post-intervention (p < 0.001).
  • The median errors per order decreased from 0.48 to 0.30 after the intervention.

Conclusions:

  • Theory-informed, learner-centered feedback interventions can improve interns' prescribing practices.
  • This novel intervention contributed to a notable reduction in medical interns' prescribing errors.
  • Implementing theory-informed feedback strategies is recommended for enhancing prescribing safety in medical education.