Prescribing Skills Assessment
Prescribing Skills Assessment
Training Workshop
PSA Question item stylesPrescribing, Prescription Review, Planning
Management and Data Interpretation
John Mucklow
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Station Description Marks Comments
1 Prescribing 1 10 1 question item of 10 marks
2 Prescribing 2 10 1 question item of 10 marks
3 Prescription Review 1 8 2 question items of 4 marks each
4 Planning Management 8 2 question items of 4 marks each
5 Communicating Information 6 3 question items of 2 marks each
6 Drug Calculation Skills 8 4 question items of 2 marks each
7 Prescribing 3 10 1 question item of 10 marks
8 Prescribing 4 10 1 question item of 10 marks
9 Prescription Review 2 8 2 question items of 4 marks each
10 Adverse Drug Reactions 8 4 question items of 2 marks each
11 Drug Monitoring 8 4 question items of 2 marks each
12 Data Interpretation 6 3 question items of 2 marks each
TOTAL MARKS 100
Prescribing Skills Assessment – Format
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
Competencies• Reasoning and judgement
Deciding on the most appropriate prescription (drug, dose, route and frequency) to write, based on the clinical circumstances and supplementary information.
• Measurable actionWriting a safe, effective and legal prescription for a single medicine, using the documentation provided to tackle a specific indication highlighted by the question.
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
This question type will present:• a clinical scenario• a request to write a prescription for a single appropriate
medicine or fluid on one of a variety of prescription charts
Typical scenarios will involve the treatment of:• acute conditions (e.g. acute asthma)• chronic conditions (e.g. reflux oesophagitis)• important symptoms (e.g. pain)
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
The candidate will have to exercise judgement when deciding between different drugs, formulations, routes, doses and dose intervals
Typical medicines will include those that are high-risk (e.g. insulin) or in common use (e.g. antibiotics), and IV fluids
Prescriptions must be legible, unambiguous and complete • approved name written in upper case• appropriate form and route• correct dose appropriately written without abbreviation• necessary details and instructions, signed
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
Items may involve prescriptions written into a variety of prescription forms, including:
• hospital once-only
• regular medicines
• fluid prescription charts
• general practice (FP10) forms
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
Good Prescribing question items should:• be based on a clinical scenario that might be faced by a
Foundation doctor
• expect actions that might reasonably be expected of a Foundation doctor
• avoid using over-elaborate clinical scenarios – restrict content to what is required to answer question
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history]
[Try to adhere to this general layout but there is room for flexibility]
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBINGOn examinationTemperature xx.x°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are…….
InvestigationsNa+ xxx mmol/L (137–144), K+ xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc.ECG shows ………CXR shows ………
[Provide sufficient information to enable the candidate to make a sound judgement about the need for and choice of treatment]
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
Good Prescribing question items should:• state clearly the symptom or problem to be addressed by
the prescription within the ‘Prescribing Request’ box
• require only one prescription to be written
Prescribing requestWrite a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem].
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Prescribing Item
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examinationTemperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are …….
InvestigationsNa+ xxx mmol/L (137–144), K+ xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc.ECG shows ………CXR shows ………
[Authors should provide sufficient information from the clinical examination and investigations to enable the candidate to make a sound judgement about the need for and choice of treatment]
Prescribing requestWrite a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem].(use the hospital ‘once-only medicines’ prescription chart provided)
Please paste any picture or other illustration that supports the clinical case into this box
PWS000ID This question item is worth 10 marks You may use the BNF at any time
ONCE ONLY MEDICINES
DateTim
e Medicine (Approved name) Dose Route Prescriber – sign + printTim
egiven
Given
by
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examinationTemperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are …….
InvestigationsNa+ xxx mmol/L (137–144), K+ xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc.ECG shows ………CXR shows ………
[Authors should provide sufficient information from the clinical examination and investigations to enable the candidate to make a sound judgement about the need for and choice of treatment]
Prescribing requestWrite a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem].(use the hospital ‘regular medicines’ prescription chart provided)
Please paste any picture or other illustration that supports the clinical case into this box
PWS000ID This question item is worth 10 marks
Date
Time
Drug (Approved name)
68Dose Route
12Prescriber – sign + print Start date 14
18Notes Pharmacy
22
You may use the BNF at any time Prescribing Item
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examinationTemperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are …….
InvestigationsNa+ xxx mmol/L (137–144), K+ xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc.ECG shows ………CXR shows ………
Prescribing requestWrite a prescription for ONE intravenous fluid that would be most appropriate for the patient at this point.(use the hospital fluid prescription chart provided)
Please paste any picture or other illustration that supports the clinical case into this box
PWS000ID This question item is worth 10 marks
INFUSION THERAPY
Date Start time
Infusion solution Medicine added Prescriber’s signature
Given by
Type/strength Volume Route Rate Duration Approved name Dose
You may use the BNF at any time Prescribing Item
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examinationTemperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are …….
InvestigationsNa+ xxx mmol/L (137–144), K+ xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc.ECG shows ………CXR shows ………
[Authors should provide sufficient information from the clinical examination and investigations to enable the candidate to make a sound judgement about the need for and choice of treatment]
Prescribing requestWrite a prescription for ONE drug that will help to [treat/alleviate/prevent] [symptom or problem].(use the general practice prescription form provided)
Please paste any picture or other illustration that supports the clinical case into this box
PWS000ID This question item is worth 10 marks
Pharmacy Stamp
Please don’t stamp over age box
Age0yr 0mths
D.o.B.00/00/0000
Title, Forename, Surname & AddressPatient NameAddress Line 1Address Line 2Town Postcode
Number of days’ treatmentN.B. Ensure dose is stated
Endorsements Drug nameDoseFrequency
Signature of PrescriberSignature
Date00/00/0000
ForDispenserNo. ofPrescns.on form
Xxxxx Health AuthorityDr AddressTown PostcodeTel: 00000 000 000
FP10NC0105
You may use the BNF at any time Prescribing Item
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBING
Answer page
• Clinical scenarios seldom have only one correct answer
• Identify those answers that you believe to be optimal and those that are suboptimal but worthy of credit
• Enter these on the Answer page that follows the question template.
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Marking guide for A and B. Candidates should be given 4 marks for an optimal answer that can’t be improved. They should get 3 marks for an answer that is good but is suboptimal on some grounds (e.g. cost-effectiveness, likely adherence). They should get 2 marks for an answer that is likely to provide benefit but is clearly suboptimal for more than one reason. They should get 1 mark for an answer that has some justification and deserves some credit.
PWS000ID This question item is worth 10 marks You may use the BNF at any time Answer Page
C. Timing. Candidates will also be given 1 mark for correctly dating (and timing) the prescription
D. Signature. Candidates will also be given 1 mark for signing the prescription
A. Drug choice Score Feedback/justification B. Dose and route Score Feedback/justification
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prescribing Item
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIBINGMarking guide for A and B. Candidates should be given 4 marks for an optimal answer.They should get 3 marks for an answer that is good but is suboptimal on some grounds (e.g. cost-effectiveness, likely adherence).They should get 2 marks for an answer that is likely to provide benefit but is clearly suboptimal for more than one reason.They should get 1 mark for an answer that has some justification and deserves some credit.
The mark achieved in A determines the maximum achievable mark in B.Candidates cannot compensate for a suboptimal choice of drug by correctly stating its dose and route.
C. Timing. Candidates will also be given 1 mark for correctly dating (and timing) the prescriptionD. Signature. Candidates will also be given 1 mark for signing the prescription
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Please use the British National Formulary, to which the candidates will have access throughout, as the ultimate arbiter of dose ranges, routes, indications, contra-indications, etc.
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Station Description Marks Comments
1 Prescribing 1 10 1 question item of 10 marks
2 Prescribing 2 10 1 question item of 10 marks
3 Prescription Review 1 8 2 question items of 4 marks each
4 Planning Management 8 2 question items of 4 marks each
5 Communicating Information 6 3 question items of 2 marks each
6 Drug Calculation Skills 8 4 question items of 2 marks each
7 Prescribing 3 10 1 question item of 10 marks
8 Prescribing 4 10 1 question item of 10 marks
9 Prescription Review 2 8 2 question items of 4 marks each
10 Adverse Drug Reactions 8 4 question items of 2 marks each
11 Drug Monitoring 8 4 question items of 2 marks each
12 Data Interpretation 6 3 question items of 2 marks each
TOTAL MARKS 100
Prescribing Skills Assessment – Format
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIPTION REVIEWCompetencies• Reasoning and judgement
Deciding which components of the current prescription list are inappropriate, unsafe or ineffective for a patient, based on their clinical circumstances
• Measurable actionIdentifying prescriptions (drugs, doses or routes) that are inappropriate, unsafe or ineffective from amongst the current list of prescribed medicines
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIPTION REVIEWThis question type will present:• a scenario that requires review of a current list of prescribed
medicines
Typically this question type will involve:• interpreting the list of medicines in light of a clinical problem,
spotting important drug interactions• identifying obvious or serious dosing errors• noting suboptimal prescriptions
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIPTION REVIEW• The total list of medicines for each question item should range
from 4–10
• Some knowledge of common effects, adverse reactions and interactions of common medicines will be assumed
• Candidates should have time to consult the BNF for relevant information that might be considered beyond the core knowledge base of a minimally competent Foundation doctor
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIPTION REVIEWGood Prescription Review question items should:
• state clearly in each of two questions associated with each list the reason why between 1 and 3 items on the list of prescriptions need to be identified
• typically ask the candidate to identify medicines that contain dosing errors, or are causing symptoms, contra-indicated, likely to interact, etc.Question ASelect the [ONE/TWO/THREE prescription/prescriptions] that [is/are] [contra-indicated/most likely to be a cause of/contains a serious dosing error/interact/, etc.].(mark [it/them] with a tick in column A)
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills AssessmentPrescribing Skills Assessment – Prescription Review Question Item Example
Prescription Review Item REV000ID This question item is worth 4 marks You may use the BNF at any time
CURRENT PRESCRIPTIONS
Drug name Dose Route Freq. A B
Drug 1 xx mg IV daily ☐ ☐
Drug 2 xx mg ORAL 12-hrly ☐ ☐
Drug 3 xx mg ☐ ☐
Drug 4 xx mg ☐ ☐
Drug 5 xx mg ☐ ☐
Drug 6 xx mg ☐ ☐
Drug 7 xx mg ☐ ☐
Drug 8 xx mg ☐ ☐
Drug 9 xx mg ☐ ☐
Drug 10 xx mg ☐ ☐
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom that might be used as the focus for one of the questions] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] His current regular medicines are listed (right). [Authors should try to adhere to this general layout but there is room for flexibility – the presentations should be fairly brief]
Question ASelect the [ONE/TWO/THREE prescription/prescriptions] that [is/are] [contra-indicated/most likely to be a cause of/contains a serious dosing error/interact/, etc.].(mark [it/them] with a tick in column A)
Question BSelect the [ONE/TWO/THREE prescription/prescriptions] that [is/are] [contra-indicated/most likely to be a cause of/contains a serious dosing error/interact/, etc.].(mark [it/them] with a tick in column B)
Answer box
Question A Marks per correct tick [1 or 2]
Write a brief justification in this box
Question B Marks per correct tick [1 or 2]
Write a brief justification in this box
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIPTION REVIEW CURRENT PRESCRIPTIONS
Drug name Dose Route Freq. A BDrug 1 xx mg IV daily ☐ ☐Drug 2 xx mg ORAL 12-hrly ☐ ☐Drug 3 xx mg ☐ ☐Drug 4 xx mg ☐ ☐Drug 5 xx mg ☐ ☐Drug 6 xx mg ☐ ☐Drug 7 xx mg ☐ ☐Drug 8 xx mg ☐ ☐Drug 9 xx mg ☐ ☐Drug 10 xx mg ☐ ☐
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PRESCRIPTION REVIEW Answer boxQuestion A Marks per correct tick [1 or 2]Write a brief justification in this box
Question B Marks per correct tick [1 or 2]Write a brief justification in this box
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Station Description Marks Comments
1 Prescribing 1 10 1 question item of 10 marks
2 Prescribing 2 10 1 question item of 10 marks
3 Prescription Review 1 8 2 question items of 4 marks each
4 Planning Management 8 2 question items of 4 marks each
5 Communicating Information 6 3 question items of 2 marks each
6 Drug Calculation Skills 8 4 question items of 2 marks each
7 Prescribing 3 10 1 question item of 10 marks
8 Prescribing 4 10 1 question item of 10 marks
9 Prescription Review 2 8 2 question items of 4 marks each
10 Adverse Drug Reactions 8 4 question items of 2 marks each
11 Drug Monitoring 8 4 question items of 2 marks each
12 Data Interpretation 6 3 question items of 2 marks each
TOTAL MARKS 100
Prescribing Skills Assessment – Format
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PLANNING MANAGEMENTCompetencies• Reasoning and judgement
Deciding which combination of therapies would be most appropriate to manage a particular clinical situation
• Measurable actionSelecting the most appropriate combination of treatment strategies based on individual patient circumstances
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PLANNING MANAGEMENTThis question type will present:• a clinical scenario followed by a request to identify the
important therapeutic strategies for initial management
This will involve:• selecting between options (e.g. medicines, fluids) that would
be of real benefit and others that would be neutral or harmful
The candidate will have to decide on:• the two most appropriate prescriptions, based on symptoms,
signs and investigations, from a list of five
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PLANNING MANAGEMENTThe treatment might be preventive, curative, symptomatic or palliative
The question tests the ability to plan treatment appropriate to individual patients. Candidates should be aware of situations where it is inappropriate to prescribe and also of the role of non-drug therapies. Some of these scenarios may relate to the management of clinical toxicological emergencies
The likely diagnosis (or differential diagnosis) will not necessarily be identified; planning management is sometimes necessary even when the diagnosis is not certain
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PLANNING MANAGEMENTGood Planning Management question items should:
• be based on a list of 5 management options from which the candidate will be required to select the 2 most appropriate
• contain sufficient information to allow a competent candidate to select the 2 best options unambiguously
• contain 3 distracting options that, while plausible, are clearly less appropriate than the correct answers in relation to the clinical scenario
QuestionSelect the TWO most appropriate management options at this stage.(mark them with a tick)
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Planning Management Item MAN000ID This question item is worth 4 marks You may use the BNF at any time
MANAGEMENT OPTIONS
A Option A ☐
B Option B ☐
C Option C ☐
D Option D ☐
E Option E ☐
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history] [Authors should try to adhere to this general layout but there is room for flexibility] On examinationTemperature xx°C, HR xx/min and regular, BP xxx/xx mmHg, JVP xxxxxx, RR xx/min, O2 sat xx% on air, HS xxxxxx, chest sounds xxxxxxx. Other important observations are …….
InvestigationsNa+ xxx mmol/L (137–144), K+ xxx mmol/L (3.5–4.9), U xxx mmol/L (2.5–7.0), Cr xxx µmol/L (60–110), eGFR etc.ECG shows ………CXR shows ………
[Authors should try to adhere to this general layout but there is room for flexibility – the presentations should contain sufficient information to allow candidates to select the 2 best options from the list you provide but should not be over-elaborate]
QuestionSelect the TWO most appropriate management options at this stage.(mark them with a tick)
Answer box
Option A Justification
Write a brief justification in this box
Option B Justification
Write a brief justification in this box
Option C Justification
Option D Justification
Option E Justification
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PLANNING MANAGEMENTMANAGEMENT OPTIONS
A Option A ☐B Option B ☐C Option C ☐D Option D ☐E Option E ☐
List options in alphabetical order, starting with a lower case letter, unless option is a proper noun. Identify the 2 correct answers by placing a tick in the column on the right.
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
PLANNING MANAGEMENTAnswer boxOption A JustificationWrite a brief justification in this box
Option B JustificationWrite a brief justification in this box
Option C Justification
Option D Justification
Option E Justification
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Station Description Marks Comments
1 Prescribing 1 10 1 question item of 10 marks
2 Prescribing 2 10 1 question item of 10 marks
3 Prescription Review 1 8 2 question items of 4 marks each
4 Planning Management 8 2 question items of 4 marks each
5 Communicating Information 6 3 question items of 2 marks each
6 Drug Calculation Skills 8 4 question items of 2 marks each
7 Prescribing 3 10 1 question item of 10 marks
8 Prescribing 4 10 1 question item of 10 marks
9 Prescription Review 2 8 2 question items of 4 marks each
10 Adverse Drug Reactions 8 4 question items of 2 marks each
11 Drug Monitoring 8 4 question items of 2 marks each
12 Data Interpretation 6 3 question items of 2 marks each
TOTAL MARKS 100
Prescribing Skills Assessment – Format
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
DATA INTERPRETATIONCompetencies• Reasoning and judgement
Deciding on the meaning of the results of investigations as they relate to decisions about ongoing drug therapy
• Measurable actionMaking an appropriate change to a prescription based on those data
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
DATA INTERPRETATIONThis question type will involve:• interpreting data in the light of a clinical scenario• deciding on the most appropriate course of action with regard
to prescribing
The correct course of action may involve:• withdrawing a medicine• reducing its dose• no change• increasing its dose• prescribing a new medicine
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
DATA INTERPRETATIONGood Data Interpretation question items should:
• be based on a clinical scenario where a treatment decision (e.g. choosing from a selection of treatment options, deciding on a dosage change) is based on interpreting data from an investigation (e.g. physiological measurement, blood test)
• be based on a list of 5 monitoring options relating to the treatment identified, from which the candidate will be required to select the most appropriate
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
DATA INTERPRETATIONGood Data Interpretation question items should:
• contain sufficient information to allow a competent candidate to select the best option unambiguously
• contain 4 distracting options that, while plausible, are clearly less appropriate in relation to responding to the data than the correct answer.
QuestionSelect the most appropriate decision option with regard to [the xxxx prescription/the treatment of xxxxxx] based on these data.(mark it with a tick)
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Data Interpretation Item DAT000ID This question item is worth 2 marks You may use the BNF at any time
DECISION OPTIONS
A Option A ☐
B Option B ☐
C Option C ☐
D Option D ☐
E Option E ☐
Case presentationA [age]-year-old [man/woman/child] presents to [location and situation] complaining of [symptom that might be used as the focus for one of the questions] etc. PMH. She/he has suffered from …. [describe any past medical history relevant to the scenario]. DH. She/he normally takes …. [list any current prescriptions]. SH. [include any relevant social history][Authors should try to adhere to this general layout but there is room for flexibility – the presentations should be fairly brief but identify the treatment for which a decision is required, the therapeutic indication and sufficient information about the patient to for the candidate to be able to identify the best decision option]
QuestionSelect the most appropriate decision option with regard to [the xxxx prescription/the treatment of xxxxxx] based on these data.(mark it with a tick)
Answer boxOption A Justification
Write a brief justification in this box
Option B Justification
Write a brief justification in this box
Option C Justification
Option D Justification
Option E Justification
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
DATA INTERPRETATIONMANAGEMENT OPTIONS
A Option A ☐B Option B ☐C Option C ☐D Option D ☐E Option E ☐
List options in alphabetical order, starting with a lower case letter, unless option is a proper noun. Identify the correct answer by placing a tick in the column on the right.
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
DATA INTERPRETATIONAnswer boxOption A JustificationWrite a brief justification in this box
Option B JustificationWrite a brief justification in this box
Option C Justification
Option D Justification
Option E Justification
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Station Description Marks Nature of task
1 Prescribing 1 10 Suggest 1 drug
2 Prescribing 2 10 Suggest 1 drug
3 Prescription Review 1 8 Choose 1–3 options from 4–10
4 Planning Management 8 Choose 2 options from 5
5 Communicating Information 6 Choose 2 options from 5
6 Drug Calculation Skills 8 Calculate 1 value
7 Prescribing 3 10 Suggest 1 drug
8 Prescribing 4 10 Suggest 1 drug
9 Prescription Review 2 8 Choose 1–3 options from 4–10
10 Adverse Drug Reactions 8 Choose 2 options from 5
11 Drug Monitoring 8 Choose 2 options from 5
12 Data Interpretation 6 Choose 1 option from 5
TOTAL MARKS 100
Prescribing Skills Assessment – Format
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
Station Description Marks Nature of task
1 Prescribing 1 10 Suggest 1 drug
2 Prescribing 2 10 Suggest 1 drug
3 Prescription Review 1 8 Choose 1–3 options from 4–10
4 Planning Management 8 Choose 2 options from 5
5 Communicating Information 6 Choose 2 options from 5
6 Drug Calculation Skills 8 Calculate 1 value
7 Prescribing 3 10 Suggest 1 drug
8 Prescribing 4 10 Suggest 1 drug
9 Prescription Review 2 8 Choose 1–3 options from 4–10
10 Adverse Drug Reactions 8 Choose 2 options from 5
11 Drug Monitoring 8 Choose 2 options from 5
12 Data Interpretation 6 Choose 1 option from 5
TOTAL MARKS 100
Prescribing Skills Assessment – Format
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
ONE/TWO BEST ANSWER QUESTIONS
Identify the topic Ensure it is important, and not trivial Draw material from encounters with students who
are not certain to pass, such as: unexpected ignorance misconceptions errors of judgement
What precise knowledge do you wish to test? Limit question to single testing point
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
ONE/TWO BEST ANSWER QUESTIONS
Write down the correct answer(s) Identify three/four plausible alternative
options that are: incorrect/clearly less correct than agreed answer not widely divergent not worded as ‘all/none of the above’
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.
Prescribing Skills Assessment
ONE/TWO BEST ANSWER QUESTIONS
Build the stem as a fictional scenario that includes all the information necessary to choose the correct answer (and no more)
Check that: stem is written economically lead-in and options follow logically
Slide compilation © 2011 The British Pharmacological Society & Medical Schools Council. All rights reserved.