Using a self-regulated learning-enhanced video feedback educational intervention to improve junior doctor prescribing

Patel, Rakesh; Green, William; Shahzad, Muhammad; Church, Helen; Sandars, John

doi:10.1080/0142159x.2020.1748183

Cited by 9 publications

(4 citation statements)

References 62 publications

(65 reference statements)

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“… 41 Due to this, several interview participants believed it would be more efficient if pharmacists could plan the discharge reconciliation for checking and signoff by the doctors, rather than the other way round. Although pharmacists performing discharge reconciliations are associated with a significant reduction in medicine errors, 42 this may reduce a junior doctor's opportunity to develop their medicine and prescribing knowledge 43 and needs to be considered in terms of the pharmacy workforce.…”

Section: Discussionmentioning

confidence: 99%

Exploring pharmacists' perspectives on preparing discharge medicine lists: A qualitative study

Gjone

Burns

Teasdale

et al. 2023

Exploratory Research in Clinical and Social Pharmacy

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Section: Discussionmentioning

confidence: 99%

Exploring pharmacists' perspectives on preparing discharge medicine lists: A qualitative study

Gjone

Burns

Teasdale

et al. 2023

Exploratory Research in Clinical and Social Pharmacy

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“…junior doctors) and settings (hospital), where feedback was provided as fortnightly "good prescribing tip" emails to all intern prescribers. Whilst other intervention studies that have demonstrated improved prescribing outcomes, used simulation [36,37] or video methods [25]. The advantage of our intervention is that it was grounded in practice, where prescribing occurs, and so accounts for the highly complex and unpredictable context of prescribing in hospitals [38,39].…”

Section: Discussionmentioning

confidence: 99%

Can a novel constructivist theory-informed feedback intervention reduce prescribing errors ? A pre-post study

et al. 2023

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Context Medical interns (interns) find prescribing challenging and many report lacking readiness when commencing work. Errors in prescribing puts patients’ safety at risk. Yet error rates remain high, despite education, supervision and pharmacists’ contributions. Feedback on prescribing may improve performance. Yet, work-based prescribing feedback practices focus on rectifying errors. We aimed to explore if prescribing can be improved using a theory-informed feedback intervention. Methods In this pre-post study, we designed and implemented a constructivist-theory informed prescribing feedback intervention, informed by Feedback-Mark 2 Theory. Interns commencing internal medicine terms in two Australian teaching hospitals were invited to engage in the feedback intervention. Their prescribing was evaluated by comparing errors per medication order of at least 30 orders per intern. Pre/baseline (weeks 1–3) were compared with post intervention (weeks 8–9). Interns’ baseline prescribing audit findings were analysed and discussed at individualised feedback sessions. These sessions were with a clinical pharmacologist (Site 1) and a pharmacist educator (Site 2). Results Eighty eight intern’s prescribing over five 10-week terms was analysed from two hospitals. The frequency of prescribing errors significantly reduced at both sites after the intervention, across all five terms (p < 0.001).There were initially 1598 errors in 2750 orders (median [IQR] 0.48 [0.35–0.67] errors per order) and after the intervention 1113 errors in 2694 orders (median [IQR] 0.30 [0.17–0.50] errors per order). Conclusion Our findings suggest interns’ prescribing practices may improve as a result of constructivist -theory learner centred, informed feedback with an agreed plan. This novel intervention, contributed, to a reduction in interns’ prescribing errors. This study suggests new strategies for improving prescribing safety should include the design and implementation of theory-informed feedback interventions.

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“…Our study focused on junior doctors as the main prescribers in hospitals, but in the UK, independent nurses and pharmacist prescribers also have an important role, thus provision of prescribing feedback to multiprofessional prescribers should be explored. Future educational interventions could consider combining individualised EP feedback data with modern initiatives including simulation and video-stimulated feedback 13 32…”

Section: Discussionmentioning

confidence: 99%

Learning from electronic prescribing errors: a mixed methods study of junior doctors’ perceptions of training and individualised feedback data

et al. 2022

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ObjectivesTo explore the views of junior doctors towards (1) electronic prescribing (EP) training and feedback, (2) readiness for receiving individualised feedback data about EP errors and (3) preferences for receiving and learning from EP feedback.DesignExplanatory sequential mixed methods study comprising quantitative survey (phase 1), followed by interviews and focus group discussions (phase 2).SettingThree acute hospitals of a large English National Health Service organisation.Participants25 of 89 foundation year 1 and 2 doctors completed the phase 1 survey; 5 participated in semi-structured interviews and 7 in a focus group in phase 2.ResultsFoundation doctors in this mixed methods study reported that current feedback provision on EP errors was lacking or informal, and that existing EP training and resources were underused. They believed feedback about prescribing errors to be important and were keen to receive real-time, individualised EP feedback data. Feedback needed to be in manageable amounts, motivational and clearly signposting how to learn or improve. Participants wanted feedback and better training on the EP system to prevent repeating errors. In addition to individualised EP error data, they were positive about learning from general prescribing errors and aggregated EP data. However, there was a lack of consensus about how best to learn from statistical data. Potential limitations identified by participants included concern about how the data would be collected and whether it would be truly reflective of their performance.ConclusionsJunior doctors would value feedback on their prescribing, and are keen to learn from EP errors, develop their clinical prescribing skills and use the EP interface effectively. We identified preferences for EP technology to enable provision of real-time data in combination with feedback to support learning and potentially reduce prescribing errors.

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Using a self-regulated learning-enhanced video feedback educational intervention to improve junior doctor prescribing

Cited by 9 publications

References 62 publications

Exploring pharmacists' perspectives on preparing discharge medicine lists: A qualitative study

Exploring pharmacists' perspectives on preparing discharge medicine lists: A qualitative study

Can a novel constructivist theory-informed feedback intervention reduce prescribing errors ? A pre-post study

Learning from electronic prescribing errors: a mixed methods study of junior doctors’ perceptions of training and individualised feedback data

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