title: Medical students' errors in pharmacotherapeutics.
abstract: OBJECTIVE
  This study analysed the errors made by 16 final-year medical students in a classroom prescribing exercise. The aim was to gain greater understanding of the reasons for non-optimal prescribing and of how to improve basic training in pharmacotherapeutics.
  
  
  METHODS
  The task was to adjust a patient's phenytoin sodium dosage to achieve better control of seizures. It was based on a real-life case, and was presented as a written exercise. Process-tracing and think-aloud techniques were used to study the students' performance.
  
  
  RESULTS
  The results suggest that the root cause of the errors was lack of a knowledge base which integrated scientific knowledge with clinical know-how. Three different clinical reasoning strategies were observed. Students who followed an incremental strategy demonstrated superior scientific knowledge and this resulted in less hazardous errors. Those who followed gambling or backward-reasoning strategies appeared to possess inferior scientific knowledge and this resulted in more hazardous errors.
  
  
  CONCLUSIONS
  The results support current trends towards integrating basic medical science into a foundation of clinical know-how, as in the problem-based curriculum. They also emphasize the importance of a thorough grounding in medical science as a means of minimizing error.
authors.affiliation: School of Education, University of Manchester, Manchester, UK.
authors.forename: N C
authors.initials: NC
authors.lastname: Boreham
authors.forename: G E
authors.initials: GE
authors.lastname: Mawer
authors.forename: R W
authors.initials: RW
authors.lastname: Foster
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004358:Drug Therapy; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004739:England; D006801:Humans; D008508:Medication Errors; D016544:Patient Simulation; D013663:Teaching / Q000379:methods