title: Development and Validation of the McMaster Prescribing Competency Assessment for Medical Trainees (MacPCA).
abstract: BACKGROUND
  Prescribing is an essential skill for all physicians, built on knowledge of clinical pharmacology, therapeutics and toxicology across the life cycle. The decline in organized clinical pharmacology training in medical schools, combined with an expanding pharmacopeia and increasing complexity of patient care, makes prescribing competency difficult for medical students to master.
  
  
  OBJECTIVE
  To develop and validate the McMaster Prescribing Competency Assessment (MacPCA), an online tool suitable for evaluating clinical pharmacology knowledge and prescribing skills of medical trainees in Canada.
  
  
  METHODS
  The MacPCA was developed using an online examination platform scalable to multiple sites across Canada. Questions represented 8 domains of safe and effective prescribing with level of difficulty aimed at a final year medical student. Validation assessment concentrated on face and construct validity.
  
  
  RESULTS
  58 participants (7, 12 and 21 medical students in Years 1, 2, and 3, respectively and 8 undergraduate controls) were recruited. Mean scores were 31% (SD 13.6), 46% (SD 14.9), 75% (SD 8.3) and 81% (SD 10.5) for the controls, Year 1, Year 2, and Year 3 (final year) students, respectively. Combined Year 2/Year 3 scores were significantly better than control/Year 1 scores (p<0.0001). Final year student feedback indicated the test was fair, clear and unambiguous, aimed at the right level, with sufficient time for completion.
  
  
  CONCLUSIONS
  The MacPCA demonstrated good face validity and successfully discriminated between upper year medical students and their junior colleagues. Further expansion of testing and validation is warranted.
authors.forename: Vincent
authors.initials: V
authors.lastname: Wu
authors.forename: Oscar
authors.initials: O
authors.lastname: Chan
authors.forename: Simon R
authors.initials: SR
authors.lastname: Maxwell
authors.forename: Mitchell A
authors.initials: MA
authors.lastname: Levine
authors.forename: Dan
authors.initials: D
authors.lastname: Perri
authors.forename: Rolf J
authors.initials: RJ
authors.lastname: Sebalt
authors.forename: Bandar
authors.initials: B
authors.lastname: Baw
authors.forename: Anne
authors.initials: A
authors.lastname: Holbrook
mesh_terms: D002170:Canada; D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013337:Students, Medical