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Abstract
Aims To determine trainees’ perceived confidence and competence in practical prescribing skills and if this varies with level of training.
Methods A cross-sectional, prospective, questionnaire completed by ST1–8 paediatric trainees at regional teaching days in May–July 2015.
Results 100 questionnaires were completed comprising 27 junior trainees (ST1–3), 35 core trainees (ST4–5) and 38 senior trainees (ST6–8). A prescribing error had been experienced by 90% of trainees. One third had been involved in a prescribing related incident report, the frequency reducing with training grade (p = 0.02) (Figure 1). A reduction of recent errors was observed with increasing level of training (p = 0.0001) with 81%, 40% and 27% of junior, core and senior trainees respectively reporting an error within the last 3 months. The majority of prescription errors regardless of level of training were due to incorrect dose or therapy duration (Figure 2). Despite the frequency of errors, 84% of trainees felt very or reasonably confident in their prescribing skills. All groups reported less confidence when prescribing for renal, liver and haematology/oncology specialties. Less than a third of trainees felt that undergraduate and postgraduate training had adequately prepared them for paediatric prescribing. Almost 2/3rds had completed SCRIPT or RCPCH prescribing programmes with a majority feeling that they had a positive impact on prescribing practice. 80% of all trainees would support a paediatric specific online learning resource.
Percentage of trainees involved in a prescribing related incident report by level of training
Percentage breakdown of specific prescribing errors by trainee grade
Conclusions This study found prescribing errors to be common throughout the training grades, with confidence not necessarily translating to competence. Under/postgraduate paediatric prescribing training is felt to be insufficient and trainees felt an online resource would be beneficial in addressing the clear need for specific and targeted training. We have developed an online learning platform, Paediatric SCRIPT for exactly this purpose. Modules ranging from ‘basic principles’, to more specific ‘prescribing in paediatric renal disease’, will go live for local ST1–8 trainees in March 2016. We have inbuilt assessment methods and will monitor trainee prescribing errors and START assessment data. It will be important to repeat this survey to look at the impact of the modules on trainee prescribing competence, errors, near misses and episodes of patient harm.