Assessment and evaluation of prescribing competences: A systematic review and recommendations

John C. McLachlan*, Asa Auta, Aderonke Ajiboye

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Aims: Since assessment of prescribing competence is a key promoter of student learning and achievement, we aim to summarize existing national‐level approaches, provide a systematic review of current literature, indicate the frequency of various methodologies, and make recommendations to promote and extend existing practice. Methods: Regulatory body websites were accessed for details of national examinations. PubMed, Embase, the Allied and Complementary Medicine, and CINAHL databases were systematically searched in August 2023 for studies in English from Europe, North America, Australia and New Zealand reporting assessment of prescribing competencies among students/practitioners. Additional articles were identified through citation tracking. Results: National approaches are described for several jurisdictions. A total of 20 514 articles were retrieved, of which 54 met the inclusion criteria. Most articles came from the UK, with medical students and qualified doctors most frequently featured. Multiple choice formats were most common, with short answer questions, calculations and scenario‐based skills tests also featured. Direct observations of skills through Objective Structured Clinical Examinations and similar methods were less commonly described. Test reliability generally employed Classical Test Theory. Costs of developing and delivering assessments, differential attainment by demographics, and predictive validity were not indicated. Conclusion: We recommend measurement of the predictive validity of prescribing competence assessments, the routine inclusion of performance by demographic characteristics, extension of competence assessments to professions other than medicine, and structured reporting of methods and findings, including costs and cost‐effectiveness. Situational judgement tests would be a valuable addition to assessment practices.
Original languageEnglish
Pages (from-to)1-19
Number of pages19
JournalBritish Journal of Clinical Pharmacology
Early online date14 Mar 2024
DOIs
Publication statusE-pub ahead of print - 14 Mar 2024

Keywords

  • reliability
  • assessment
  • competence predictive
  • validity
  • utility
  • prescribing

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