title: A study to enhance medical students' professional decision-making, using teaching interventions on common medications.
abstract: OBJECTIVE
  To create sustained improvements in medical students' critical thinking skills through short teaching interventions in pharmacology.
  
  
  METHODS
  The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination). Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group) was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed.
  
  
  RESULTS
  Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies.
  
  
  CONCLUSIONS
  Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training.
authors.affiliation: Faculty of Health and Life Sciences, Institute of Learning and Teaching, School of Medicine, University of Liverpool, Liverpool, UK; jwilcock@liverpool.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Wilcock
authors.affiliation: Educational Developer, Centre for Lifelong Learning, University of Liverpool, Liverpool, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Strivens
mesh_terms: D003657:Decision Making; D004504:Education, Medical, Undergraduate / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010379:Peer Group; D010567:Pertussis Vaccine / Q000494:pharmacology; D010600:Pharmacology / Q000193:education*; D013337:Students, Medical / Q000523:psychology*; D006113:United Kingdom
chemical_list: D010567:Pertussis Vaccine
keywords: antenatal pertussis vaccination; critical thinking; medical education; patient centredness; prescribing; professionalism