title: Assessing prescribing competence.
abstract: Prescribing of medicines is the key clinical activity in the working life of most doctors. In recent years, a broad consensus regarding the necessary competencies has been achieved. Each of these is a complex mix of knowledge, judgement and skills. Surveys of those on the threshold of their medical careers have revealed widespread lack of confidence in writing prescriptions. A valid and reliable assessment of prescribing competence, separate from an overall assessment of medical knowledge and skill, would have many benefits for clinical governance and patient safety, and would provide a measure of the success of training programmes in therapeutics. Delivering such an assessment presents many challenges, not least of which are the difficulty in identifying a surrogate marker for competent prescribing in clinical practice and the challenge of ensuring that competence assessed in a controlled environment predicts performance in clinical practice. This review makes the case for an on-line OSCE as the most valid form of assessment and sets out the requirements for its development, scope, composition and delivery. It describes an on-going attempt to develop a national assessment of prescribing skills towards the end of undergraduate medical training in the UK.
authors: Prescribing Skills Assessment Office, British Pharmacological Society, London, UK. j.mucklow@prescribe.ac.uk
authors: John
authors: J
authors: Mucklow
authors: Lynne
authors: L
authors: Bollington
authors: Simon
authors: S
authors: Maxwell
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D011307:Drug Prescriptions / Q000592:standards*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards*; D006801:Humans; D008962:Models, Theoretical; D006113:United Kingdom