Teaching the Rational Use of Medicinesto medical students: a qualitative research

Abstract

BackgroundPrescribing is a complex and challenging task that must be part of a logical deductive process based on accurate and objective information and not an automated action, without critical thinking or a response to commercial pressure. The objectives of this study were 1) develop and implement a discipline based on the WHO’s Guide to Good Prescribing; 2) evaluate the course acceptance by students; 3) assess the impact that the Rational Use of Medicines (RUM) knowledge had on the students habits of prescribing medication in the University Hospital.MethodsIn 2003, the RUM principal, based in the WHO's Guide to Good Prescribing, was included in the official curriculum of the Botucatu School of Medicine, Brazil, to be taught over a total of 24 hours to students in the 4th year. We analyzed the students' feedback forms about content and teaching methodology filled out immediately after the end of the discipline from 2003 to 2010. In 2010, the use of RUM by past students in their medical practice was assessed through a qualitative approach by a questionnaire with closed-ended rank scaling questions distributed at random and a single semistructured interview for content analysis.ResultsThe discipline teaches future prescribers to use a logical deductive process, based on accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost) on selecting drugs and to write a complete prescription. At the end of it, most students considered the discipline very good due to the opportunity to reflect on different actions involved in the prescribing process and liked the teaching methodology. However, former students report that although they are aware of the RUM concepts they cannot regularly use this knowledge in their daily practice because they are not stimulated or even allowed to do so by neither older residents nor senior medical staff.ConclusionsThis discipline is useful to teach RUM to medical students who become aware of the importance of this subject, but the assimilation of the RUM principles in the institution seems to be a long-term process which requires the involvement of a greater number of the academic members.

Evaluation of knowledge, attitude and behavior about rational use of medicines in second year medical students

“…Though it is now a well-accepted fact that RUM is an important issue and that doctors are the major prescribers of medicines, teaching of RUM is not given much importance in most of the medical colleges. 10 This can be considered as a major cause of errors in prescribing with its adverse consequences subsequently. [12][13][14] Teaching hospitals should consider that promoting RUM is their moral duty towards humanity, which they can do through their teaching staff who can most effectively imbibe this concept into the minds of future doctors.…”

“…Most of the earlier studies in medical students have evaluated their knowledge about self-medication. [7][8][9] Some interventional studies have attempted to improve prescribing habits of medical students by employing various interventions 10,11 , but we did not come across any published study that has evaluated the different facets about RUM in medical students. Hence this study was conducted to evaluate the knowledge, attitude and practice about RUM in medical students.…”

Studies on the concept, knowledge and attitude of the rational use of medicines among the sixth semester 2nd MBBS student of Jawaharlal Nehru Institute of Medical Sciences, Porompat, Imphal, Manipur, India

“…Though it is now a well-accepted fact that RUM is an important issues and that doctor are the major prescribers of medicines, teaching of RUM is not given much importance in most of the medical colleges. 16 This can be considered as a major cause of errors in prescribing with its adverse consequences subsequently 80.3% of the student feel the need to integrate the RUMs subject to other clinical While examining the usefulness of the RUM to the Prescribers and the students, the significance level is value 0.87 (p-0.01) and value 0.23(p -0.05), the knowledge of students towards the practice on RUM and integrated learning value 0.55(p-0.01) and value 0.46 (p-0.01) shown as table II and III. 17 Initiative and willingness on the part of the student is also up to the mark (91.8%).…”

Prescribing Skills for Undergraduate Medical Students: Time to Redress the Neglect?

“…At present in Nepal the exercise is being conducted at Manipal College of Medical Sciences, Institute of Medicine and KIST Medical College 6 . The P-drug selection process uses a logical deductive process, using accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost, on selecting drugs and writing a complete prescription 7 . In a medical school in Brazil students liked the methodology and the opportunity to reflect on various factors involved in the prescribing process but could not use it much in practice due to lack of stimulation and not being allowed to do so by older residents and senior doctors 7 .…”