gms | German Medical Science

Objectives: To ensure a safe and effective drug therapy, conveying relevant information in a prescription talk is essential. We analysed simulated prescription talks conducted by Cologne medical students and tested whether the quality of this talks changed after discussing the scenario with peer students.

Materials & methods: In a one-week course, 5^th year medical students are prepared for their final year. In this course, one student out of a group of four was to prescribe an antibiotic in a simulated doctor-patient conversation. This was observed by fellow students who then discussed the situation with the student under moderation by a pharmacist. Immediately afterwards, the same student conducted the prescription talk again. We videotaped the conversations and evaluated by means of content analysis based on a self-developed checklist in a pre-post comparison. All course participants were asked to describe a prescription talk in a written test based on a case vignette four days after the simulated conversation. The test results of students who participated in the above scenario (either as the “doctor” or as an observer) were compared with the results of fellow students who attended the course but not the drug-prescription scenario.

Results: We obtained data from 38 simulated doctor-patient conversations. Content analysis revealed clear deficits in spontaneously led prescription talks. Even essential information as on adverse drug reactions were often lacking. However, prescription talks became clearly more informative and comprehensive after the short, pharmacist-guided peer discussion. With respect to a comprehensive, informative prescription conversation, the written test showed that both students who conducted the conversation and those who merely observed it performed significantly better than students who did neither.

Conclusion: Repeating a simulated prescription talk after a short peer discussion seems to sensitise medical students to patient-relevant information on drug therapy. Four days after simulating a prescription talk, we saw differences in this regard between students who participated in the simulation and those who did not. The sustainability of this simple intervention has to be tested, e.g. by re-evaluating the students during their final year.