title: Development and validation of an instrument to assess the prescribing readiness of medical students in Malaysia.
abstract: BACKGROUND
  Prescribing incompetence is an important factor that contributes to prescribing error, and this is often due to inadequate training during medical schools. We therefore aimed to develop and validate an instrument to assess the prescribing readiness of medical students (PROMS) in Malaysia.
  
  
  METHODS
  The PROMS comprised of 26 items with four domains: undergraduate learning opportunities; hands-on clinical skills practice; information gathering behaviour; and factors affecting the learning of prescribing skills. The first three domains were adapted from an existing questionnaire, while items from the last domain were formulated based on findings from a nominal group discussion. Face and content validity was determined by an expert panel, pilot tested in a class of final year (Year 5) medical students, and assessed using the Flesch reading ease. To assess the reliability of the PROMS, the internal consistency and test-retest (at baseline and 2 weeks later) were assessed using the Wilcoxon Signed Ranks test and Spearman's rho. The discriminative validity of the PROMS was assessed using the Mann-Whitney U-test (to assess if the PROMS could discriminate between final year medical students from a public and a private university).
  
  
  RESULTS
  A total of 119 medical students were recruited. Flesch reading ease was 46.9, indicating that the instrument was suitable for use in participants undergoing tertiary education. The overall Cronbach alpha value of the PROMS was 0.695, which was satisfactory. Test-retest showed no difference for 25/26 items, indicating that our instrument was reliable. Responses from the public and private university final year medical students were significantly different in 10/26 items, indicating that the PROMS was able to discriminate between these two groups. Medical students from the private university reported fewer learning opportunities and hands-on practice compared to those from the public university. On the other hand, medical students from the private university reported more frequent use of both web based and non-web-based resources compared to their public university counterparts.
  
  
  CONCLUSIONS
  The PROMS instrument was found to be a reliable and valid tool for assessing medical students' readiness to prescribe in Malaysia. It may also inform on the adequacy of medical programmes in training prescribing skills.
authors.affiliation: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. plai@ummc.edu.my.
authors.forename: Pauline Siew Mei
authors.initials: PS
authors.lastname: Lai
authors.affiliation: Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. debrasim@um.edu.my.
authors.forename: Si Mui
authors.initials: SM
authors.lastname: Sim
authors.affiliation: Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. chuass@um.edu.my.
authors.forename: Siew Siang
authors.initials: SS
authors.lastname: Chua
authors.affiliation: Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. tchook@ummc.edu.my.
authors.forename: Choo Hock
authors.initials: CH
authors.lastname: Tan
authors.affiliation: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. ngcj@um.edu.my.
authors.forename: Chirk Jenn
authors.initials: CJ
authors.lastname: Ng
authors.affiliation: Division of Clinical Science, School of Medicine and Allied Health Sciences, International Medical University, 57000, Kuala Lumpur, Malaysia. achik1fi@cmich.edu.|Central Michigan University College of Medicine, Mount Pleasant, MI, 48859, USA. achik1fi@cmich.edu.
authors.forename: Francis Ifejika
authors.initials: FI
authors.lastname: Achike
authors.affiliation: Division of Clinical Science, School of Medicine and Allied Health Sciences, International Medical University, 57000, Kuala Lumpur, Malaysia. cheonglieng_teng@imu.edu.my.
authors.forename: Cheong Lieng
authors.initials: CL
authors.lastname: Teng
mesh_terms: D000328:Adult; D011307:Drug Prescriptions / Q000592:standards*; D004501:Education, Medical / Q000592:standards; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D015203:Reproducibility of Results; D013337:Students, Medical; D055815:Young Adult