The pen is mightier than the sword. Reinstating patient care as the object of prescribing education

Hannah Gillespie, Eleanor McCrystal, Helen Jane Reid, Richard Conn, Neil Kennedy, Tim Dornan*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)
10 Downloads (Pure)

Abstract

Prescribing (writing medication orders) is one of residents’ commonest tasks. Superficially, all that has to be done is complete a form. Behind this apparent simplicity, though, lies the complex task of framing patients’ needs and navigating relationships between them and fellow clinicians. Mistakes, which compromise patient safety, commonly result. There is no evidence that competence-based education is preventing harm. We found a profound contradiction between medical students becoming competent, as defined by passing competence assessments, and becoming capable of treating real patients safely. We reinstated patients as the object of learning by allowing students to ‘pre-prescribe’ (complete, but not authorise prescriptions). This turned a disabling tension into a driver of curriculum improvement. Students ‘knotworked’ within interprofessional teams to the benefit of patients as well as themselves. Refocusing undergraduate medical education on patient care showed promise as a way of improving patient safety.
Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalMedical teacher
Early online date28 Jul 2020
DOIs
Publication statusPublished - 28 Jul 2020

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