gms | German Medical Science

In a hospital setting, most prescriptions are filled out by novices. Yet they also make up the group most prone to prescription errors. Since the majority of prescription errors can be sorted into common subgroups and avoided with rather simple measures, special training emphasizing “aversion of common prescription errors” is warranted in medical school. Thus, such training was developed, implemented, and evaluated in a randomized, controlled cross over study.

We implemented prescription training in the internal medicine curriculum taught in the fifth year of medical school. This training is mandatory for all students.

In the first module, the students listen to a lecture on common prescribing errors, which includes some practical examples. Then, working in small groups, students solve specific cases representing most common situations in which prescribing errors occur. Best solutions are subsequently discussed with the lecturer. In the second module, students examine a real patient on the internal medicine ward and take his history. Using the information gathered, the students devise a diagnostic and therapeutic plan following specific written instructions. These plans are then compared with the original chart. A detailed discussion of the prescription plan follows in the afternoon. After the training the students take a graded exam, prescribing medication for a standardized virtual patient. Aside from the correct diagnosis and therapy plan, points are awarded for avoiding prescription errors.

In order to evaluate the effect of the prescription training, 74 students were randomly assigned to two groups. One group participated in the control-intervention first and received the prescription training afterwards. The other group first received the prescribing training and then participated in the control-intervention. Before, during, and after the interventions, the students took a prescription exam. The number of mistakes decreased from 70% to 30% due to prescription training. We also investigated, whether participation in clerkships contributes to the acquisition of prescribing skills. No effect of clerkships in internal medicine on the error rates in prescribing of medication could be observed.

The author declare that she has no competing interests.