Of equal importance is the ability of the teacher to present essential information about pharmacology and therapeutics as part of an integrated curricula in a way that engages the student and enhances their appreciation of the applicability of these various disciplines to clinical practice. This review seeks to investigate elements that are specific to the needs of the target audience and will explore the potential of this book in achieving those aims. Medicine, Education, Pharmacology, therapeutics, pharmacy. Creative Commons Attribution 4. This article has been peer reviewed.
Waller and Anthony P. The role-playing sessions consist of three phases: consultation, argumentation and feedback. Before the start of a consultation, the doctors are given a written patient case. The second phase argumentation starts immediately after the consultations. In this phase, the doctor has to substantiate the chosen therapy. Finally, during the third phase, all students sit together and discuss the various drug treatments and the performance of the doctors, guided by a clinical pharmacologist.
In , Miller suggested a framework for clinical assessment Fig. According to this framework, students, residents or physicians must have knowledge in order to carry out the required professional functions effectively. Students must also know how to use the knowledge that they have accumulated.
Medical Pharmacology and Therapeutics by Derek G. Waller and Anthony P. Sampson – ScienceOpen
For example, they must develop the skill that is needed to acquire information from a variety of human and laboratory sources, to analyse and interpret data and, finally, to translate such findings into a rational diagnostic or therapeutic plan. When this quality is functionally adequate, it is defined as a competence. Furthermore, students must not only be able to demonstrate that they know and know how , but also to show how they do it when confronted with a patient, which is called performance.
Finally, it is important what a graduate actually does when functioning independently in clinical practice. According to Miller, this action component of professional behaviour is the most difficult to measure. The Objective Structured Clinical Examination OSCE and structured clinical examinations in general are well-known and approved methods for assessing competence and performance [ 34 ]. As far as the OSCE is concerned, this has also been shown to be useful for assessing therapeutic competence. Nevertheless, it is important that the manner in which the students are assessed is as similar as possible to the approach used in teaching them.
It is obvious that the ideal situation, i. Based on current theories of cognitive psychology and medical education, we have also discussed context-learning as an effective approach to teaching medical students how to prescribe rationally. Until recently, there were only two groups of people who were permitted to prescribe drugs — registered medical practitioners and registered dental practitioners.
Since , some nurses, pharmacists and physician assistants have also been able to prescribe drugs for medical conditions within their area of competence [ 35 ]. Consequently, given this increasing number of registered prescribers with different qualifications, it has become increasingly important to train prescribers sufficiently in how to choose and prescribe drugs rationally. Furthermore, many hospital admissions and even deaths are caused by possibly avoidable medication errors [ 36 ].
In addition, the curriculum must fulfil the criteria of context-learning, i. During this phase, little attention is given to the prescription of drugs in clinical practice. Medical students are already allies; they are interested in clinical pharmacology and really want to learn how to prescribe drugs rationally. Physicians should also become allies, since they can provide the clinical context for teaching and can prevent students from copying the bad prescribing habits of some of the physicians that train medical students.
The vertical lines describe the simultaneous use of these three components in order to realise a context-learning curriculum. Let us use the example of a clinical pharmacology department that provides a course of lectures in basic and clinical pharmacology during the first three years of a classical medical curriculum. The aim of the department is to expand its teaching activities and use the context-learning methodology as much as possible. Therefore, the lectures in basic and clinical pharmacology must be transformed according to the criteria of context-learning, i. The lecture concludes by discussing the patient case according to the six-step approach, including how to write a new prescription [ 18 ].
The clinical pharmacology lectures in the second and third year can be transformed in a similar way by presenting real patients, followed by lectures on different classes of drugs. Simultaneously with the clinical pharmacology lectures, students must develop a personal drug formulary by, for example, using an E-learning programme [ 3 ]. In the fourth year, students start on their clinical clerkships. In collaboration with their clinical colleagues, the clinical pharmacology department introduces a therapeutic assignment during these clerkships.
Concurrently, students must follow a skills training programme in order to learn how to prescribe rationally six steps. During the clinical clerkships in the fifth and sixth years, prescriptions written by the students are evaluated by a clinical pharmacologist in collaboration with a physician and pharmacist during therapeutic sessions. It is evident that in an integrated or problem-based medical curriculum it will be difficult to organise lectures.
However, an advantage of this type of curriculum is that teaching is already centred on patient cases. As a result, clinical pharmacologists can introduce learning tasks with respect to basic and clinical pharmacology and therapeutics. In such a curriculum, it will probably be easier to train students in the six-step approach in small group-teaching sessions and practice prescribing in a clinical setting. Obviously, there are various possibilities for context-learning teaching activities, and the above-mentioned are just a few examples of these.
Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author s and source are credited. National Center for Biotechnology Information , U.
European Journal of Clinical Pharmacology. Eur J Clin Pharmacol. Published online Jan Milan C. Richir , Jelle Tichelaar , Eric C. Geijteman , and Theo P. Eric C.
Theo P. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Oct 5; Accepted Nov This article has been cited by other articles in PMC. Abstract Background The rational prescribing of drugs is an essential skill of medical doctors. Introduction The field of modern clinical pharmacology began to develop in the second half of the 19th century when physicians began to realise that agents such as heavy metals and plant extracts, then in use, more often made diseases worse instead of better [ 1 ].
From core learning objectives to competencies In many curricula, the teaching in clinical disciplines is centred on symptoms and diagnosis, and little or no time is given to the principles of drug treatment. Open in a separate window. Therapeutic decision-making Although, as described previously, there are many essential therapeutic skills, the final choice of a drug treatment for a patient can be looked upon as a core skill in therapeutics.
How to teach and learn therapeutics Gaining knowledge and at the same time applying this knowledge in practice is essential for learning in general and, presumably, also for the development of treatment scripts by medical students. Box 1. Acknowledgments Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author s and source are credited.
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