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INNOVATIVE LEARNING METHODS FOR
RATIONAL DRUGS PRESCRIBING.
ITTHIPANICPONG C.,CHOMPOOTAWEEP S., CHONGTRAKUL P.,
NANTAWAN P., THAMAREE S., WITTAYALERTPANYA S.,
LIMPANASITHIKUL W., LILITKARNTAKUL P. and WANGSATURAKA D.
Department of Pharmacology, Faculty of Medicine, Chulalongkorn University.
Bangkok 10330, THAILAND
ABSTRACTThis study was designed to use innovative learning methods in rational
drug prescribing in the third year medical students in the 2002 academic year who attended the three weeks block of Degeneration and Diseases of Aging. A modified problem-based learning (PBL) was the main educational strategy in this module. Three key problems were ‘polyuria’, ‘knee pain’, and ‘dyspnea’. For each problem, students met in tutorial groups to identify their learning objectives. After the tutorial sessions, students attended a lecture and adviced on a self-directed learning (SDL) period. They would then meet in groups to summarise what they had learned and discussed what drugs were most appropriate for the patient with the problem according to the principles of rational drug use. Students were also asked to submit a prescription for the patient in each of the cases. To promote students’ use of information technology in their SDL, we created a web site (www.sdl.academic.chula.ac.th. ), named ‘PBL RDU EBM Web Based Instruction’. We designed it as a gateway to other relevant electronic sources in pharmacology and medicine. Multiple choice questions (MCQ) were used for the assessment of the students’ conceptual knowledge. An individual structured report was designed for prescription writing skills and attitude assessment.
Most students (79.60%) received good marks for their MCQ examination and structured reports (87.56%). They also demonstrated positive attitudes towards the course’s learning outcome.
Irrational drug prescribing causes a high
healthcare expenditure each year. It also
affects individual in term of getting
unnecessary drugs which sometime harmful
to them. There is a need for medical schools to
create new physicians who possess conceptual
knowledge, skill and attitude in rational drug
prescribing.
Problem statement :
Educational strategies
MODIFIED PROBLEM-BASED LEARNING
10 groups of 3rd year medical students with 20 students in each group
case scenarios(polyuria, knee pain and dyspnea)
2 facilitators in each group
formulate learning objective
A set of learning objective was developed by students in the group.The students were asked to write prescription in each scenario.
Self-directed learning
I students search through provided learning resources• Textbooks, literatures, articles• Online textbook, journals and medical databases• Web-Based Instruction in Pharmacology (WWW.SDL.ACADEMIC.CHULA.AC.TH) (PBL RDU EBM Web Based Instruction)
II Meet resource persons
Concept formulation
• Presentation of the acquired information• Discussion on rational prescribing for management of the patient. (RDU) using evidence-based medicine.• Conclusion
PBL = Problem-based learning, RDU = Rational drug use, EBM = Evidence-based medicine
Rational drug prescribing
Evidence-Based Medicine
Written communication
Holistic approach
Roles of doctor
Basic and clinical science
Medical ethics
Leadership and teamwork
Professional and personal development
Learning outcomes of the course
Student assessment
Educational outcomes
Assessment
methods
Rational
drug
prescribing
Evidence-
based
medicine
Written
communication
Holistic
approachRoles of
doctor
Professional
and personal
development
Basic and
clinical
science
Medical
ethics
Leadership
and
teamwork
Written examination
(MCQ 5 choices and - - - - -
short essay)
Rating scale - - - - -
(5 points)
Structured report
on rational -
drug prescribing
/ / / /
/ / / /
/ / / / / / //
1) Diagnosis2) Indication3) Prescription writing (rational prescribing)
3.1) Efficacy 3.2) Risk 3.3) Cost4) Underpinning prescription writing5) Duration of treatment and follow up period6) Patient education7) Conclusion8) References
Components of a structured report
Structured report grade distribution
A+B++B = 87.56%
18%
30%
32%
A+B++B = 79.60%
MCQ grade distribution
Students’ attitude towards the achievement of course learning outcomes :
Learning Outcomes Total score 5
• problem solving ability 4.10• apply concept of evidence-based medicine 4.03• utilize information technology for 4.09 information searching• rational drug prescribing 4.20• holistic mind 4.03• basic and clinical science knowledge 3.85• ethics 3.65• self-directed learning 4.07• attitude towards working in healthcare team 3.84
Conclusion
Innovation of the learning method for rational drug prescribing was a modified problem-based learning using the created web-based instruction inPharmacology (WWW.SDL.ACADEMIC.CHULA.AC.TH)( PBL, RDU, EBM Web Based Instruction) as one of the learning resources and utilize structured report for authentic assessment in addition to conventional assessment methods.The result demonstrated good conceptual knowledge and practice in rational drug prescribing.To maintain the studentcompetency in rational drug prescribing, the process hasto be repeated and continued through the whole curriculum.
1) Outcome-Based Education. AMEE Education Guide
no.14 1999
2) Wangsaturaka D. Wiwanitkit V. An evaluation of
prescription writing and rational prescribing in
Third-Year Medical Students, Faculty of Medicine,
Chulalongkorn University. Thai J Pharmacol 2000
May-Aug; 22(2): 115-20.
References