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Evaluation of rational prescribing skills assessment for graduating medical students
Author(s) -
Moch Shirra
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.516.7
Subject(s) - medical education , multiple choice , curriculum , constructive , test (biology) , psychology , intervention (counseling) , medical school , matching (statistics) , recall , medicine , mathematics education , process (computing) , nursing , pedagogy , computer science , pathology , significant difference , paleontology , cognitive psychology , biology , operating system
Prescribing medicines is the primary intervention that doctors offer to influence their patients’ health; however concerns have been expressed about the adequacy of prescribing training in medical school. This study analysed the exit‐level written assessment component of final‐year medical students at the University of the Witwatersrand, with respect to fitness‐for‐purpose to test rational prescribing skills. Examination questions were selected via an adjudicative process to determine a prescribing mark. Question items were then analysed according to Bloom's Revised and the SOLO Taxonomies. The framework of constructive alignment was used to interrogate fitness‐for‐purpose. A comparison of “A‐Type” (single best answer) multiple choice questions (MCQs) with “R‐Type” (extended matching) MCQs paradoxically highlighted students’ greater proficiency in the R‐Type questions ( p <0.0001). Students scored well on questions which tested recall and application of knowledge, but struggled with those involving evaluation. Questions were poorly distributed according to prescribing skills to be tested. Examination marks showed that 83.6% of students were competent to prescribe according to the graduating standards of the University. Despite high examination scores, this study illustrates a lack of constructive alignment between assessment requirements, curriculum delivery and objectives of the course.