Education team finalistsBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2057 (Published 15 April 2016) Cite this as: BMJ 2016;353:i2057
- Nigel Hawkes, freelance journalist
- London, UK
Prescribing Safety Assessment
Doctors in their first foundation year often struggle with prescribing. A study in 2014 showed that they made more errors than other doctors, while doing most of the prescribing. Many admit to finding the role challenging and one for which they are poorly prepared.
“There’s no other area where the doctors’ error rate is so clear and where graduates have indicated there’s a challenge,” says Simon Maxwell, consultant physician and professor of student learning at Edinburgh University. “It’s a patient safety issue. Day to day, the opportunity is there to do good or ill every time the pen comes out.”
Backed by the British Pharmacological Society and the Medical Schools Council, Maxwell has led development of Prescribing Safety Assessment (PSA), an online tool for assessing prescribing competency now used by all 31 UK medical schools. In 2015, 7576 final year students sat the PSA, 91% passing first time. Each year 80 000 prescriptions are assessed and marked, a task that would be impossible if done manually, and the PSA has become one of the largest online medical assessments in the world. Medical schools in other countries are adopting it.
“In the early stages participation was voluntary, then some medical schools made it a requirement; now all are involved and it’s effectively mandatory,” Maxwell says. “It would have been a difficult leap to have imposed it in one go, but gradually we’ve got to that point. It shouldn’t be seen as a big stick, nor a hurdle to trip graduates up. But we’re talking about the final common pathway in all the thinking that goes into diagnostics, and however good you are as a doctor, if you don’t get the final bit …