EXPERIENTIAL LEARNING METHODS IMPROVES RATIONAL PRESCRIBING SKILL IN MEDICAL STUDENTS

https://doi.org/10.22146/jpki.56906

Mega Pandu Arfiyanti(1*), Gandes Retno Rahayu(2), Eti Nurwening Sholikhah(3)

(1) Universitas muhammadiyah semarang
(2) Department of Medical Education and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta – INDONESIA
(3) Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta – INDONESIA
(*) Corresponding Author

Abstract


Background: Rational prescribing is an important skill for medical doctors. Many graduates still feel insufficiently prepared to make rational prescribing and fail to demonstrate the related clinical reasoning after graduation. For these reasons, it is important to improve the medical student teaching of rational prescribing. The aim of this study is proving the effectiveness of experiential learning methods to improve rational prescribing skills of medical students.

Methods: This study used a one-group pretest-posttest design. Rational prescribing courses use experiential learning methods for 6 year medical students. Every student provided evaluation of rational prescribing and clinical reasoning through pretest and posttest, and we analyzed the results by paired t test.

Results: The change in the rational prescribing skill of the students is significant between pretest and posttest. However, in the hypertension case the scores are not significant between pretest and posttest. Also, the scores of clinical reasoning based on drug interaction and evidence based methods are not significant in the hypertension and otitis media cases.

Conclusions: Experiential learning methods can enhance rational prescribing skill in medical students but the students were still not able to choose appropriate medications based on drug interaction and evidence based approach.


Keywords


experiential learning, rational prescribing, pharmacotherapy, medical education

Full Text:

PDF


References

  1. Richir MC, Tichelaar J, Stam F, Thijs A, Danner SA, Schneider AJ, et al. A context-learning pharmacotherapy program for preclinical medical students leads to more rational drug prescribing during their clinical clerkship in internal medicine. Clin Pharmacol Ther. 2008;84(4):513–6.
  2. Han WH, Maxwell SRJ. Are medical students adequately trained to prescribe at the point of sgraduation? Views of first year foundation doctors. Scott Med J. 2006;51(4):27–32.
  3. Aronson JK. Editors’ view: A prescription for better prescribing. Br J Clin Pharmacol. 2006;61(5):487–91.
  4. Van Unen RJ, Tichelaar J, Schneider AJ, Geijteman ECT, Nanayakkara PWB, Thijs A, et al. The feasibility of incorporating structured therapeutic consultations with real patients into the clinical clerkship internal medicine. Naunyn Schmiedebergs Arch Pharmacol. 2012;385(11):1111–6.
  5. Heaton A, Webb DJ, Maxwell SRJ. Undergraduate preparation for prescribing: The views of 2413 UK medical students and recent graduates. Br J Clin Pharmacol. 2008;66(1):128–34.
  6. Hay A, Smithson S, Mann K, Dornan T. Medical students’ reactions to an experience-based learning model of clinical education. Perspect Med Educ. 2013;2(2):58–71.
  7. Kolb D. Experiential learning: Experience as the source of learning and development. FT Press. 2014. 31–40 p.
  8. Yardley S, Teunissen PW, Dornan T. Experiential learning: AMEE Guide No. 63. Med Teach. 2012;34(2).
  9. Akici A, Gören MZ, Aypak C, Terzioglu B, Oktay S. Prescription audit adjunct to rational pharmacotherapy education improves prescribing skills of medical students. Eur J Clin Pharmacol. 2005;61(9):643–50.
  10. Brinkman DJ, Tichelaar J, Van Agtmael MA, De Vries TPGM, Richir MC. Self-reported confidence in prescribing skills correlates poorly with assessed competence in fourth-year medical students. J Clin Pharmacol. 2015;55(7):825–30.
  11. Makmor-Bakry M, Azmi N, Ali AM. Mannequin-simulator as a new teaching and learning method in performance-based pharmacotherapy. Indian J Pharm Educ Res. 2013;47(3):1–5.
  12. Richir MC, Tichelaar J, Geijteman ECT, De Vries TPGM. Teaching clinical pharmacology and therapeutics with an emphasis on the therapeutic reasoning of undergraduate medical students. Eur J Clin Pharmacol. 2008;64(2):217–24.
  13. Hogerzeil H V, Barnes KI, Henning RH, Kocabasoglu YE, Moller H, Smith AJ, et al. World Health Organization Essential Drugs and Medicines Policy Geneva. 2001;
  14. Hassan NB, Ismail HC, Naing L, Conroy RM, Abdul Rahman AR. Development and validation of a new Prescription Quality Index. Br J Clin Pharmacol. 2010;70(4):500–13.
  15. Issenberg SB, McGaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Med Teach. 2005;27(1):10–28.
  16. McGaghie WC. Does simulation based medical education with deliberate practice yield better results than traditional clinical education? a meta analytic comparative review of the evidence. Acadm Meded. 2012;86(6):706–11.
  17. Steadman RH, Coates WC, Yue MH, Matevosian R, Larmon BR, McCullough L, et al. Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Crit Care Med. 2006;34(1):151–7.
  18. Illing J, Morrow G, Kergon C, Burford B, Spencer J, Peile E, et al. How prepared are medical graduates to begin practice? A comparison of three diverse UK medical schools. Rep to Educ Comm [Internet]. 2008;(September). Available from: http://wrap.warwick.ac.uk/48953/
  19. Muir F. The understanding and experience of students, tutors and educators regarding reflection in medical education: a qualitative study. Int J Med Educ. 2010;1:61–7.
  20. Rowe AD, Wood LN. Student perceptions and preferences for feedback. Asian Soc Sci. 2008;3:78–88.
  21. Sandars J. The use of reflection in medical education: AMEE Guide No. 44. Med Teach. 2009;31(8):685–95.
  22. Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Healthc. 2007;2(2):115–25.
  23. Cooney D, Pascuzzi K. Polypharmacy in the Elderly: Focus on Drug Interactions and Adherence in Hypertension. Clin Geriatr Med [Internet]. 2009;25(2):221–33. Available from: http://dx.doi.org/10.1016/j.cger.2009.01.005
  24. Kolb AY, Kolb DA. Learning Styes and Learning Spaces: A review of Multidisciplnary Application of Experiental Learning Theory in Higher Education. 2004;(January)
  25. Dornan T, Bundy C. What can experience add to early medical education? Consensus survey. Bmj. 2004;329(7470):834.



DOI: https://doi.org/10.22146/jpki.56906

Article Metrics

Abstract views : 1406 | views : 1551

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Mega Pandu Arfiyanti,Gandes Retno Rahayu, Eti Nurwening Sholikhah

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Pendidikan Kedokteran Indonesia (The Indonesian Journal of Medical Education) indexed by:


JPKI Stats