Transcript INNOVATIVE LEARNING METHODS FOR

INNOVATIVE LEARNING METHODS FOR
RATIONAL DRUGS PRESCRIBING.
ITTHIPANICPONG C.,CHOMPOOTAWEEP S., CHONGTRAKUL P.,
NANTAWAN P., THAMAREE S., WITTAYALERTPANYA S.,
LIMPANASITHIKUL W., LILITKARNTAKUL P. and WANGSATURAKA D.
Department of Pharmacology, Faculty of Medicine, Chulalongkorn University.
Bangkok 10330, THAILAND
ABSTRACT
This study was designed to use innovative learning methods in rational
drug prescribing in the third year medical students in the 2002 academic year who
attended the three weeks block of Degeneration and Diseases of Aging. A
modified problem-based learning (PBL) was the main educational strategy in this
module. Three key problems were ‘polyuria’, ‘knee pain’, and ‘dyspnea’. For each
problem, students met in tutorial groups to identify their learning objectives. After
the tutorial sessions, students attended a lecture and adviced on a self-directed
learning (SDL) period. They would then meet in groups to summarise what they
had learned and discussed what drugs were most appropriate for the patient with
the problem according to the principles of rational drug use. Students were also
asked to submit a prescription for the patient in each of the cases. To promote
students’ use of information technology in their SDL, we created a web site
(www.sdl.academic.chula.ac.th. ), named ‘PBL RDU EBM Web Based
Instruction’. We designed it as a gateway to other relevant electronic sources in
pharmacology and medicine. Multiple choice questions (MCQ) were used for the
assessment of the students’ conceptual knowledge. An individual structured report
was designed for prescription writing skills and attitude assessment.
Most students (79.60%) received good marks for their MCQ examination
and structured reports (87.56%). They also demonstrated positive attitudes towards
the course’s learning outcome.
Problem statement :
Irrational drug prescribing causes a high
healthcare expenditure each year. It also
affects individual in term of getting
unnecessary drugs which sometime harmful
to them. There is a need for medical schools to
create new physicians who possess conceptual
knowledge, skill and attitude in rational drug
prescribing.
Educational strategies
MODIFIED PROBLEM-BASED LEARNING
10 groups of 3rd year medical students with 20 students in each group
case scenarios
(polyuria, knee pain and dyspnea)
formulate learning
objective
Self-directed
learning
2 facilitators in each group
A set of learning objective was developed by students in the group.
The students were asked to write prescription in each scenario.
I students search through provided learning resources
• Textbooks, literatures, articles
• Online textbook, journals and medical databases
• Web-Based Instruction in Pharmacology
(WWW.SDL.ACADEMIC.CHULA.AC.TH)
(PBL RDU EBM Web Based Instruction)
II Meet resource persons
Concept
formulation
• Presentation of the acquired information
• Discussion on rational prescribing for management of
the patient. (RDU) using evidence-based medicine.
• Conclusion
PBL = Problem-based learning, RDU = Rational drug use, EBM = Evidence-based medicine
Learning outcomes of the course
Rational drug prescribing
Evidence-Based Medicine
Written communication
Holistic approach
Roles of doctor
Basic and clinical science
Medical ethics
Leadership and teamwork
Professional and personal development
Student assessment
Educational outcomes
Assessment
Rational
Evidence-
methods
drug
based
prescribing
medicine
Written examination
(MCQ 5 choices and
Written
Holistic
communication approach
Roles of
Basic and
doctor
clinical
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/
(5 points)
Structured report
on rational
drug prescribing
/
/
and personal
teamwork
development
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Professional
and
ethics
science
short essay)
Rating scale
Medical Leadership
Components of a structured report
1) Diagnosis
2) Indication
3) Prescription writing (rational prescribing)
3.1) Efficacy
3.2) Risk
3.3) Cost
4) Underpinning prescription writing
5) Duration of treatment and follow up period
6) Patient education
7) Conclusion
8) References
Structured report grade distribution
MCQ grade distribution
32%
18%
30%
A+B++B = 87.56%
A+B++B = 79.60%
Students’ attitude towards the achievement of
course learning outcomes :
Learning Outcomes
• problem solving ability
• apply concept of evidence-based medicine
• utilize information technology for
information searching
• rational drug prescribing
• holistic mind
• basic and clinical science knowledge
• ethics
• self-directed learning
• attitude towards working in healthcare team
Total score 5
4.10
4.03
4.09
4.20
4.03
3.85
3.65
4.07
3.84
Conclusion
Innovation of the learning method for rational drug
prescribing was a modified problem-based
learning using the created web-based instruction in
Pharmacology (WWW.SDL.ACADEMIC.CHULA.AC.TH)
( PBL, RDU, EBM Web Based Instruction) as one of the
learning resources and utilize structured report for authentic
assessment in addition to conventional assessment methods.
The result demonstrated good conceptual knowledge and
practice in rational drug prescribing.To maintain the student
competency in rational drug prescribing, the process has
to be repeated and continued through the whole curriculum.
References
1) Outcome-Based Education. AMEE Education Guide
no.14 1999
2) Wangsaturaka D. Wiwanitkit V. An evaluation of
prescription writing and rational prescribing in
Third-Year Medical Students, Faculty of Medicine,
Chulalongkorn University. Thai J Pharmacol 2000
May-Aug; 22(2): 115-20.