How can prescribing skills be learnt and developed in undergraduate medical training: the perspectives of final year medical students on the impact of assistantships.

Background: There is evidence that graduates are unprepared for prescribing during their first post. In 2008 Dornan et al reported that 1 in ten prescriptions by foundation year doctors contain an error. Qualitative studies have shown that preparedness for prescribing is associated with experiential learning. This study aimed to understand the impact of assistantships on final year medical students learning of prescribing skills.

Methods: This was a qualitative study using a theoretically-sensitized approach. Data was collected from a single medical school. A sample of 8 final year medical students was used. They were interviewed in a focus group and one-to-one interviews. Triangulated data was collected from textual analysis of the local prescribing curriculum. The focus was on identifying what prescribing skills students learnt, how they learnt them and what factors affected their learning in the workplace during assistantships.

Results: Students learn a limited range of prescribing skills during their assistantships, focussed around a core group of drugs. They learn through working closely with junior doctors by practicing prescribing, and by creating learning opportunities within the workplace. Factors affecting learning could be divided into 3 main subthemes: learning factors, context factors and policy and curriculum factors.

Conclusions: This data highlighted the importance of students learning prescribing skills in the workplace, having a role in the team to prescribe in supervised practice. However, a number of barriers were identified to delivering assistantships as intended in practice.