Teaching of clinical pharmacology and therapeutics in UK medical schools: current status in 2009

Abstract

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Junior doctors feel poorly prepared by their training in Clinical Pharmacology and Therapeutics and commonly make prescribing errors. • Since 1993 the General Medical Council's guidance on undergraduate medical education ‘Tomorrow's Doctors’ has emphasized the integration of Clinical Pharmacology and Therapeutics teaching within the medical curriculum. • With the publication of a new version of Tomorrow's Doctors in 2009, medical schools will be further revising their Clinical Pharmacology and Therapeutics teaching. WHAT THIS STUDY ADDS • Although we know what the recommendations for undergraduate teaching of Clinical Pharmacology and Therapeutics teaching are, there are no published data describing what is currently happening in UK medical schools. • This paper describes the course structures, volume and range of teaching and assessment of Clinical Pharmacology and Therapeutics in the UK in 2009. • Our data provide a foundation for schools looking to revise the Clinical Pharmacology and Therapeutics Teaching in the light of Tomorrow's Doctors 2009. AIM To describe the current structure, delivery and assessment of Clinical Pharmacology and Therapeutics (CPT) teaching in UK medical schools. METHODS An online questionnaire was distributed to the person with overall responsibility for CPT teaching at all UK medical schools in June 2009. RESULTS Thirty of the 32 UK medical schools responded. 60% of schools have a CPT course although in 72% this was an integrated vertical theme. At 70% of schools pharmacologists have overall responsibility for CPT teaching (clinical 67%, non‐clinical 33%); at 20% teaching is run by a non‐specialist clinician and at 7% by a pharmacist. Teaching is commonly delivered by NHS clinicians (87%) and clinical pharmacists (80%) using lectures (90%) but additionally 50% of schools use e‐Learning and 63% have a student formulary. CPT is assessed throughout the curriculum at many schools through written, practical examinations and course work. 90% of schools have specific CPT content in their written examinations. 90% of respondents believed that their students were ‘fairly’ to ‘well’ prepared for the foundation year but only 37% of schools gather data on the competence of their graduates. CONCLUSIONS CPT teaching in UK medical schools is very diverse. Most schools do not assess the performance of their graduates as prescribers and there is a lack of evidence that many of the teaching approaches employed are suitable for the development of prescribing skills. It is vital that developments in CPT teaching are driven by validated, real‐world assessments of the prescribing skills of medical students and newly qualified doctors.

Pharmacology and Therapeutics Education in the European Union Needs Harmonization and Modernization: A Cross‐sectional Survey Among 185 Medical Schools in 27 Countries

“…Additionally, we excluded private medical schools because their education is not accessible for all students. A 24‐item web‐based questionnaire (using surveymonkey.com) was developed, based on comparable studies,7, 8, 9, 26 and validated by the Education Working Group of the EACPT during an online modification round ( Supplementary Material Figure 1 ). The questionnaire asked specific questions about undergraduate teaching and assessment of basic pharmacology, clinical pharmacology and therapeutics, and the preparedness of students for their future task as prescribers.…”

“…Indeed, a survey conducted under the auspices of the World Health Organization (WHO) in 1988 showed that European medical schools devoted relatively little time to teaching clinical pharmacology and that there was a lack of trained individuals in this area 7. However, it is not known whether the situation has improved in the meantime, although recent studies showed marked differences in the quality and quantity of CPT teaching and training between medical schools in the same country 8, 9. Although these findings are worrying, a new baseline evaluation is needed to serve as a starting point for a harmonized CPT curriculum throughout the EU, as suggested by the British Pharmacological Society (BPS) and European Association of Clinical Pharmacology and Therapeutics (EACPT) in 2007 3.…”

Education on prescribing for older patients in the Netherlands: a curriculum mapping

“…Hence, a major point for improvement is the assessment procedure, which may also improve learning efficiency [28]. In earlier studies, this loss of the explicit assessment procedure was already described for the UK after the introduction of the PBL [14,15]. Internationally, PBL or related teaching strategies are now the main teaching strategy in medical education [29], although another study describes that PBL introduction depends on culture and that on average, southern European countries had lower percentages of medical schools with PBL, at least in 2008 [30].…”

“…In 2009, O'Shaughnessy et al found large differences between UK medical schools in the content, learning strategies, and assessment procedures of curricula. In most medical schools, pharmacology and pharmacotherapy education was integrated vertically and/or horizontally [15]. However, given that most medical schools are still changing their curricula, these studies are probably out of date.…”

Pharm.D.s in the Midst of M.D.s and Ph.D.s: the Importance of Pharmacists in Medical Education

“…In BTomorrow's Doctors,^the General Medical Council's guidance on undergraduate medical education emphasized the importance of integrating clinical pharmacology and therapeutics teaching within the medical school curriculum [3]. Overall, it seems clear that pharmacology education in the medical school curriculum must improve, as insufficient knowledge about commonly used medications or the confidence to apply this knowledge will make it difficult for our future physicians to provide safe and effective patient care.…”