Barriers and solutions for the European prescribing exam: a qualitative world café study

To harmonize and modernize clinical pharmacology and therapeutics (CPT) education across Europe, we developed the European Prescribing Exam. Before its introduction into medical degree programs, it is crucial to understand the potential barriers to its implementation and ways to overcome them. Therefore, the aim of this study was to identify barriers and potential solutions to the implementation of the European Prescribing Exam.

This qualitative World Café (WC) study involved CPT teachers who participated in a 2-day event focused on the European Prescribing Exam. There were five tables in the WC, each dedicated to a different topic of implementation: (1) organization, (2) technical aspects, (3) content, (4) rollout logistics, and (5) politics. Participants rotated randomly between the tables every 20 min. During each round, they were encouraged to identify barriers and solutions, which were then discussed. The rounds continued until data saturation was reached. Findings were summarized at the end of the WC. We used inductive thematic analysis using a semantic approach to analyze the data.

In total, 26 CPT teachers (female: n = 14) from 19 medical schools in 15 European countries participated. After four rounds, 86 potential barriers and 86 solutions were identified. Most barriers were related to the topics "Content" (n = 22), "Organization" (n = 20), and "Technical aspects" (n = 18). Thematic analysis identified 11 themes, three of which were overarching, meaning they applied to multiple topics. The most significant themes included barriers related to curricula, motivation, information technology, and relevance.

This study shows that organizing and implementing the European Prescribing Exam will be challenging. However, participants proposed potential solutions for nearly all barriers, which suggest that the implementation of the European Prescribing Exam is feasible.