Julie M. Noffsinger, MD, MD, University of Colorado Denver, Aurora, CO, Jennifer B. Soep, MD, University of Colorado Denver, Aurora, CO
Background: With increased utilization of the Electronic Health Record (EHR), medical students have limited opportunities to write prescriptions, and they do not observe residents or faculty writing them. We implemented a targeted approach to teach and assess this important skill in our 3rd year pediatric clerkship.
Methods: Prescription writing is listed as one of our core learning objectives for the clerkship. In orientation, we review key aspects of writing pediatric prescriptions, have each student complete a prescription for a sample patient, and remind them this is a skill they should master during the clerkship. On the last day of the rotation, the students are asked to write a prescription for amoxicillin for a sample patient given the weight of the patient, formulation, and recommended dosage. We identified five required elements of the prescription: 1) name and formulation of drug, 2) dosage and frequency, 3) route, 4) length of treatment, 5) amount to be dispensed (including refills).
Results: In the first three blocks of the year, 40 students have completed the prescription writing skill assessment. Of those, only 20% were able to correctly write out a prescription with all five of the elements . Thirty-five percent of the students missed three or more of the five required elements.
Discussion:During the exercise at orientation, students often comment that they have never written a prescription. We suspect that our intervention was ineffective because students are not given adequate opportunities to practice prescription writing during their rotations. However, even while using EHRs, providers must know how to correctly write a prescription to minimize medication errors. We need to develop additional methods to train students as well as provide more opportunities to practice writing prescriptions for them to be competent in this important skill before they become practicing physicians.