Abstract
To examine the ability of interns to prescribe appropriatelyfor common clinical conditions at the commencement and completion of theintern year. Interns' perceptions of their ability to prescribe and theperceived influences on their practices were also assessed.The study was conducted at a teaching hospital in urban NewSouth Wales, Australia. A self-complete questionnaire was administered to56 interns at the beginning and end of internship. At the beginning of theyear respondents were asked to identify how equipped they felt they wereto perform specific functions related to prescribing practice. Interns werealso asked to write hospital prescriptions for four common clinical casesscenarios: post-operative pain, urinary tract infection, asthma, andcommunity-acquired pneumonia. At the end of the year interns were askedto prescribe for the same clinical scenarios and also asked to identify themain influences on their practice.At the beginning of the year 54% of interns felt equipped tochoose an appropriate drug for common clinical conditions, however, fewfelt they were able to determine the appropriate dose (23% of respondents)or dose frequency (25%).A previously validated four-point rating scale was used by two assessorsto judge appropriateness of prescribing [Kappa = 0.6]. At the beginning ofthe year at least two-thirds of interns were prescribing `inappropriately'for all clinical conditions. By the end of the year 75% were prescribing`appropriately' for all conditions.The main perceived influences on prescribing practices were registrars,consultants, books and pharmacists.
The use of hypothetical clinical cases to exploreprescribing ability has shown that doctors are ill-equipped to performvarious aspects of prescribing on graduating from medical school. Althoughour findings may not translate into practice directly they highlight theexistence of a potential problem that warrants further study, especially inthe areas of actual practice and the influences on it in the earlypostgraduate years.
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Pearson, S., Smith, A., Rolfe, I. et al. Intern Prescribing for Common Clinical Conditions. Adv Health Sci Educ Theory Pract 5, 141–150 (2000). https://doi.org/10.1023/A:1009882315981
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DOI: https://doi.org/10.1023/A:1009882315981