Factors influencing prescribing: an intern's perspective

Pearson, Sallie‐Anne; Rolfe, Isobel; Smith, Tony

doi:10.1046/j.1365-2923.2002.01267.x

Cited by 40 publications

(65 citation statements)

References 20 publications

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“…It is also implied in the literature that junior doctors or medical students might seek out advice of a senior nurse in relation to certain procedures, or medication advice. Pearson et al 12 examined factors which influence intern prescribing. The results from the qualitative study confirmed registrars as being the most approachable for advice; however, they did acknowledge nurses’ experience and guidance in prescribing medications.…”

Section: Discussionmentioning

confidence: 99%

Medical education and informal teaching by nurses and midwives

et al. 2014

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ObjectivesThe aim of this study was to examine the contribution of nurses and midwives to the education of medical colleagues in the clinical context.MethodsThe research design was a cross-sectional survey using an online questionnaire. A subsample of 2906 respondents, from a total of 4763 nurses and midwives participating in a web-based study, had taught doctors in the 12 months prior to the survey. The questionnaire generated mainly categorical data analysed with descriptive statistics.ResultsIn the group of respondents who taught doctors (n =2906), most provided informal teaching (92.9%, n=2677). Nearly a quarter (23.9%, n=695) self-rated the amount of time spent teaching as at least moderate in duration. The most common named teaching topics were documentation (74.8%, n=2005) and implementing unit procedures (74.3, n=1987), followed by medication charting (61.9%, n=1657) and choosing correct medications (55.8%, n=1493). Respondents felt their contributions were unrecognised by the doctors and students they taught (43.9%, n=1256).ConclusionsEducational contributions while unrecognised could be considered positively by the respondents. However, discussion of teaching responsibilities is necessary to support the development of teaching protocols and supervision responsibilities as respondents reported teaching clinical medical tasks related to medications, consent and other skills within the medical domain. Study limitations include the nature of self-reported responses which cannot be validated and data drawn from a survey concluded in 2009.

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Section: Discussionmentioning

confidence: 99%

Medical education and informal teaching by nurses and midwives

et al. 2014

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“…10 Sampling continued until theme redundancy. 16 A preliminary interview topic guide was developed with input from the steering committee.…”

Section: Methodsmentioning

confidence: 99%

Prescribing in Teaching Hospitals: a Qualitative Study of Social and Cultural Dynamics

Page¹,

Bajorek

Brien

2008

Pharmacy Practice and Res

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Background: General practitioners integrate an array of social and environmental factors into their prescribing decisions. In teaching hospitals, despite the involvement of multiple practitioners in making and acting on prescribing decisions, little is known about the influence of roles, relationships, professional subcultures and underlying beliefs, on prescribing practices. Aim: To explore the social and cultural dynamics of prescribing in teaching hospitals. Method: Consultants, registrars, junior doctors, nurses and pharmacists from 2 large Sydney teaching hospitals were sampled purposively and invited to participate in a qualitative study involving semi-structured interviews. The interview topics explored included: attitudes about prescribing, roles and responsibilities, communication of decisions, influences on prescribing and factors contributing to prescribing errors. Interviews were transcribed verbatim and the content analysed thematically. Results: Participants included 8 consultants, 8 registrars, 9 junior doctors, 7 nurses and 11 pharmacists. 5 distinct sets of social and cultural influences on prescribing behaviours were identified. The dominant set of influences related to the structure of how prescribing took place and chief among these were the strong intra-professional relationships of medical teams. Other social and cultural influences related to how prescribing decisions were communicated, underlying assumptions within medical teams, knowledge acquisition and the hospital environment. Conclusion: Prescribing in teaching hospitals is shaped by a complex web of social and cultural dynamics. An appreciation of these influences may be vital to the success of strategies to improve use of medicines in teaching hospitals. J Pharm Pract Res 2008; 38: 286-91.

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“…This tension between 'experience and evidence' and managing the complexities of relating within a hierarchical medical culture are a common experience for the doctor in training. [18][19][20] Similarly, qualitative studies of hospital trainees report that prescribing is influenced by the habits of senior supervising clinicians, who are the 'opinion leaders' as to how and when to deviate from guidelines. 21 Less experienced doctors may prescribe more appropriately according to guidelines, 22 but develop behaviours 23 and prescribing habits similar to their supervisors as training progresses.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Antibiotic prescribing for the future: exploring the attitudes of trainees in general practice

et al. 2014

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ResultsRegistrars were aware of the importance of evidence-based antibiotic prescribing and the impact of their decisions on resistance. Many expressed a sense of dissonance between their knowledge and behaviours. Contextual influences on their decisions included patient and system factors, diagnostic uncertainty, transitioning from hospital medicine, and the habits of, and relationship with, their supervisor. ConclusionUnderstanding how trainees in general practice perceive and develop antibiotic prescribing habits will enable targeted educational interventions to be designed and implemented at a crucial stage in training, working towards ensuring appropriate antibiotic prescribing in the future.

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Factors influencing prescribing: an intern's perspective

Cited by 40 publications

References 20 publications

Medical education and informal teaching by nurses and midwives

Medical education and informal teaching by nurses and midwives

Prescribing in Teaching Hospitals: a Qualitative Study of Social and Cultural Dynamics

Antibiotic prescribing for the future: exploring the attitudes of trainees in general practice

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