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Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study.

Oshikoya KA, Senbanjo IO, Amole OO - BMC Med Educ (2009)

Bottom Line: The effect of internship training on the prescribing ability of the interns was also sought.The ability of the interns to prescribe rationally (66, 81.4%) and safely (47, 58%) was provided by undergraduate CPT teaching.Similarly, respondents who had rotated through the four major clinical rotations and at least a special posting (chi2 = 11.57, P < 0.001) or four major clinical rotations only (chi2 = 11.25, P < 0.001) were significantly more confident to prescribe drugs unsupervised.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pharmacology Department, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. med_modhospital@yahoo.com

ABSTRACT

Background: A sound knowledge of pathophysiology of a disease and clinical pharmacology and therapeutics (CPT) of a drug is required for safe and rational prescribing. The aim of this study was therefore to assess how adequately the undergraduate CPT teaching had prepared interns in Nigeria for safe and rational prescribing and retrospectively, to know how they wanted the undergraduate curriculum to be modified so as to improve appropriate prescribing. The effect of internship training on the prescribing ability of the interns was also sought.

Methods: A total of 100 interns were randomly selected from the Lagos State University Teaching Hospital (LASUTH), Ikeja; Lagos University Teaching Hospital (LUTH), Idiaraba; General Hospital Lagos (GHL); the EKO Hospital, Ikeja; and Havana Specialist Hospital, Surulere. A structured questionnaire was the instrument of study. The questionnaire sought information about the demographics of the interns, their undergraduate CPT teaching, experience of adverse drug reactions (ADRs) and drug interactions since starting work, confidence in drug usage and, in retrospect; any perceived deficiencies in their undergraduate CPT teaching.

Results: The response rate was 81%. All the respondents graduated from universities in Nigeria. The ability of the interns to prescribe rationally (66, 81.4%) and safely (47, 58%) was provided by undergraduate CPT teaching. Forty two (51.8%) respondents had problems with prescription writing. The interns would likely prescribe antibiotics (71, 87.6%), nonsteroidal analgesics (66, 81.4%), diuretics (55, 67.9%), sedatives (52, 62.9%), and insulin and oral hypoglycaemics (43, 53%) with confidence and unsupervised. The higher the numbers of clinical rotations done, the more confident were the respondents to prescribe unsupervised (chi2 = 19.98, P < 0.001). Similarly, respondents who had rotated through the four major clinical rotations and at least a special posting (chi2 = 11.57, P < 0.001) or four major clinical rotations only (chi2 = 11.25, P < 0.001) were significantly more confident to prescribe drugs unsupervised.

Conclusion: Undergraduate CPT teaching in Nigeria appears to be deficient. Principles of rational prescribing, drug dose calculation in children and pharmacovigilance should be the focus of undergraduate CPT teaching and should be taught both theoretically and practically. Medical students and interns should be periodically assessed on prescribing knowledge and skills during their training as a means of minimizing prescribing errors.

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Suggested topics by the interns that should be well taught in undergraduate training.
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Figure 2: Suggested topics by the interns that should be well taught in undergraduate training.

Mentions: Retrospectively, the interns were asked to suggest topics in CPT that require wider coverage. Figure 2 shows that drug dose calculation in children (49, 60.8%) and medication errors (45, 55.9%) were the two most frequently suggested topics. However, drug information source (10) and how to take drug history (7) were the least suggested topics.


Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study.

Oshikoya KA, Senbanjo IO, Amole OO - BMC Med Educ (2009)

Suggested topics by the interns that should be well taught in undergraduate training.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2724475&req=5

Figure 2: Suggested topics by the interns that should be well taught in undergraduate training.
Mentions: Retrospectively, the interns were asked to suggest topics in CPT that require wider coverage. Figure 2 shows that drug dose calculation in children (49, 60.8%) and medication errors (45, 55.9%) were the two most frequently suggested topics. However, drug information source (10) and how to take drug history (7) were the least suggested topics.

Bottom Line: The effect of internship training on the prescribing ability of the interns was also sought.The ability of the interns to prescribe rationally (66, 81.4%) and safely (47, 58%) was provided by undergraduate CPT teaching.Similarly, respondents who had rotated through the four major clinical rotations and at least a special posting (chi2 = 11.57, P < 0.001) or four major clinical rotations only (chi2 = 11.25, P < 0.001) were significantly more confident to prescribe drugs unsupervised.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pharmacology Department, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. med_modhospital@yahoo.com

ABSTRACT

Background: A sound knowledge of pathophysiology of a disease and clinical pharmacology and therapeutics (CPT) of a drug is required for safe and rational prescribing. The aim of this study was therefore to assess how adequately the undergraduate CPT teaching had prepared interns in Nigeria for safe and rational prescribing and retrospectively, to know how they wanted the undergraduate curriculum to be modified so as to improve appropriate prescribing. The effect of internship training on the prescribing ability of the interns was also sought.

Methods: A total of 100 interns were randomly selected from the Lagos State University Teaching Hospital (LASUTH), Ikeja; Lagos University Teaching Hospital (LUTH), Idiaraba; General Hospital Lagos (GHL); the EKO Hospital, Ikeja; and Havana Specialist Hospital, Surulere. A structured questionnaire was the instrument of study. The questionnaire sought information about the demographics of the interns, their undergraduate CPT teaching, experience of adverse drug reactions (ADRs) and drug interactions since starting work, confidence in drug usage and, in retrospect; any perceived deficiencies in their undergraduate CPT teaching.

Results: The response rate was 81%. All the respondents graduated from universities in Nigeria. The ability of the interns to prescribe rationally (66, 81.4%) and safely (47, 58%) was provided by undergraduate CPT teaching. Forty two (51.8%) respondents had problems with prescription writing. The interns would likely prescribe antibiotics (71, 87.6%), nonsteroidal analgesics (66, 81.4%), diuretics (55, 67.9%), sedatives (52, 62.9%), and insulin and oral hypoglycaemics (43, 53%) with confidence and unsupervised. The higher the numbers of clinical rotations done, the more confident were the respondents to prescribe unsupervised (chi2 = 19.98, P < 0.001). Similarly, respondents who had rotated through the four major clinical rotations and at least a special posting (chi2 = 11.57, P < 0.001) or four major clinical rotations only (chi2 = 11.25, P < 0.001) were significantly more confident to prescribe drugs unsupervised.

Conclusion: Undergraduate CPT teaching in Nigeria appears to be deficient. Principles of rational prescribing, drug dose calculation in children and pharmacovigilance should be the focus of undergraduate CPT teaching and should be taught both theoretically and practically. Medical students and interns should be periodically assessed on prescribing knowledge and skills during their training as a means of minimizing prescribing errors.

Show MeSH
Related in: MedlinePlus