Student- run clinic: effect of a medical masters’ curriculum-embedded student-run clinic on prescribing skills of medical students at Erasmus MC, Rotterdam

Abstract

Aims: the prevalence of prescribing errors are common, especially among junior doctors. Undergraduate master students acquire few opportunities to prescribe medication during their studies. The implementation of an embedded Student-run-clinic (SRC) offers the opportunity for medical student to practice their prescribing skills in a safe environment. The aim of this study was to examine the impact of participation in SRC on medical students' attitudes towards and academic performance in pharmacotherapy.

Methods: this was a retrospective cohort study among first-year medical students at Erasmus Medical Centre, The Netherlands. The amount of errors, type of errors, and impact of these errors made in the skill-based formative assessment were analyzed. Secondly, the percentage scores within different subcategories (A-L) from the National Dutch Pharmacotherapy assessment (NDPA) were analyzed. Lastly, medical students were asked about their attitude towards and confidence in pharmacotherapy through online survey questionnaires.

Results: In the skill-based formative assessment no significant difference was observed in the amount of errors, type of errors and its consequence between the SRC and non-SRC group. The SCR group made less opium law errors (9.4%) and prescribed amount errors (20%) compared to the non-SRC group. 7.6% more SRC students passed the National Dutch pharmacotherapy assessment on their first attempt than non-SRC students and scored on average a higher percentage in the following 8/12 categories: pain medication (A), cardiovascular (C), antidepressants ( E) , benzodiazepines (F), antibiotics (G), pharmacokinetic (H), drug allergy (I) and good use of medicines (K). This difference was significant for pain medication (A) and benzodiazepines (F) ( p = <0.05). The survey questionnaires revealed that SRC students prescribed more often during internships in the beginning of their master year compared to non-SRC students. In addition, the SCR-group showed a consequent increase in scores over the duration of the year, but this is not the case for the non-SRC group.

Conclusion: In short, SRC offers an opportunity for medical students to learn how to prescribe medication safely at their 'own' outpatient polyclinic. Although SRC is a great learning experience for students. The question is whether this learning experience can be quantitatively determined by means of assessments.