title: Implementation of the WHO-6-step method in the medical curriculum to improve pharmacology knowledge and pharmacotherapy skills.
abstract: OBJECTIVE
  The only validated tool for pharmacotherapy education for medical students is the 6-step method of the World Health Organization. It has proven effective in experimental studies with short term interventions. The generalizability of this effect after implementation in a contextual-rich medical curriculum was investigated.
  
  
  METHODS
  The pharmacology knowledge and pharmacotherapy skills of cohorts of students, from years before, during and after implementation of a WHO-6-step-based integrated learning programme were tested using a standardized assessment containing 50 items covering knowledge of basic (n = 25) and clinical (n = 24) pharmacology, and pharmacotherapy skills (n = 1 open question). All scores are expressed as a percentage of the maximum score possible per (sub)domain.
  
  
  RESULTS
  In total, 1652 students were included between September 2010 and July 2014 (participation rate 89%). The WHO-6-step-based learning programme improved students' knowledge of basic pharmacology (mean score ± SD, 60.6 ± 10.5% vs. 63.4 ± 10.9%, P < 0.01) and clinical or applied pharmacology (63.7 ± 10.4% vs. 67.4 ± 10.3%, P < 0.01), and improved their pharmacotherapy skills (68.8 ± 26.1% vs. 74.6% ± 22.9%, P 0.02). Moreover, satisfaction with education increased (5.7 ± 1.3 vs. 6.3 ± 1.0 on a 10-point scale, P < 0.01) and as did students' confidence in daily practice (from -0.81 ± 0.72 to -0.50 ± 0.79 on a -2 to +2 scale, P < 0.01).
  
  
  CONCLUSIONS
  The WHO-6-step method was successfully implemented in a medical curriculum. In this observational study, the integrated learning programme had positive effects on students' knowledge of basic and applied pharmacology, improved their pharmacotherapy skills, and increased satisfaction with education and self-confidence in prescribing. Whether this training method leads to better patient care remains to be established.
authors.affiliation: Department of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch.|Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Centre Utrecht, Utrecht.
authors.forename: Carolina J P W
authors.initials: CJ
authors.lastname: Keijsers
authors.affiliation: Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Centre Utrecht, Utrecht.
authors.forename: Wieke S
authors.initials: WS
authors.lastname: Segers
authors.affiliation: Department of Translational Neuroscience, University Medical Centre Utrecht, Utrecht.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: de Wildt
authors.affiliation: Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Centre Utrecht, Utrecht.
authors.forename: Jacobus R B J
authors.initials: JR
authors.lastname: Brouwers
authors.affiliation: Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Loes
authors.initials: L
authors.lastname: Keijsers
authors.affiliation: Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Centre Utrecht, Utrecht.
authors.forename: Paul A F
authors.initials: PA
authors.lastname: Jansen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D008297:Male; D009042:Motivation; D009426:Netherlands; D010601:Pharmacology, Clinical / Q000193:education*; D015397:Program Evaluation; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D058013:Test Taking Skills; D014944:World Health Organization; D055815:Young Adult
keywords: WHO-6-step; implementation; medical education; pharmacology; pharmacotherapy