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WPBA: Prescribing assessments

Publication date: 19 January 2024

Prescribing is an integral part of a GP’s work. In 2017 the GMC published a document describing Generic Professional Competences which every speciality trainee needs to achieve before the end of training and included prescribing as one of their key areas. The RCGP subsequently worked with a team from the University of Nottingham to create an assessment suitable for GPs in training that was based on the PRACtlCe study and REVISiT intervention.

The assessment is a formative exercise to reflect on prescribing practice, which should highlight trends and learning needs within your prescribing. By reflecting on the errors identified it will enable learning plans to be put in place to improve your prescribing in the future.

Summary

  1. The trainee searches on their last 50 retrospective prescriptions
  2. Using the prescribing manual, the trainee reviews these prescriptions and maps them against potential prescribing errors
  3. The GP trainer / Supervisor reviews 20 of these prescriptions, maps these against potential errors and adds these to the spreadsheet 
  4. The trainee completes the trainee reflection form in the ePortfolio and in particular reflects on their prescribing using the GP prescribing proficiencies
  5. The trainee and GP trainer / Supervisor complete the assessment using the GP trainer/ Supervisor assessment form found in the ePortfolio
  6. The trainee uploads the anonymised spreadsheet to their learning log
  7. Supporting documents which outline the assessment in detail can be found below

Documents required to complete the assessment

How to search for prescription items

You are required to collect the data for 50 prescriptions. Many of you will be able to use the created searches below to help facilitate the gathering of the data.

Some of you will unfortunately not be able to use this functionality, either because of the system you are using or because of how you are set up as a user on the system. If that is the case then you will need to complete this assessment by looking through all of your consultations backwards, from a particular date and identifying when you have prescribed a medication. You will then need to manually enter the information onto the spreadsheet.

Training resources for TPDs, trainees and trainers

We will continue to try and work with the PMSs to provide as many trainees with an automated search but we are aware that there will be many of you who will not be able to take advantage of this and will therefore have to return to the default position of manually gathering the data.

This resource has four components to it and is designed to be used by trainees and trainers and ideally both together to discuss the results.

Full details of the prescribing assessment and how to complete it are below, and should be used in conjunction with this resource.

The four resource components

  1. 14 Consultation details with added Past Medical History (PMH) and other medications (DOCX file, 29 KB)
  2. Trainee / Trainer assessment form/ spread sheet with the 14 prescriptions included and blank areas for the assessment (this is also presented as a one-page PDF or a two page larger printable version for use as paper copy for workshops) (XLSX file, 24 KB)
  3. Completed example of an anonymised trainee assessment form for the 14 prescriptions (XLSX file, 26 KB)
  4. Completed example of an anonymised trainee assessment form with additional comments from the Nottingham team on how they would have expected it to have been evaluated for the 14 prescriptions (XLSX file, 29 KB)
1. 14 Consultation details
  • These are copies of the electronic records for the patients, a random selection of consultations from a full 50 consultations reviewed
  • Though based on real patients’ various elements and characteristics have been changed to aid anonymity and enhance the educational experience
  • These have some past medical history (PMH) added and some other medication the patient is already on to model the information available in the real patient records
2. Trainee/Trainer assessment form / spreadsheet
  • This is a copy of the prescribing assessment spreadsheet with the patient’s consultation and medication details inputted and the various elements that need assessing left blank for the trainee or trainer to add their assessments to
  • It is designed to be used with the consultation records and the supporting evidence such as the BNF, NICE guidelines etc to evaluate each prescription and assess it using the Right Drug, Right Dose etc detailed in the Prescribing Assessment Manual
  • Printer-friendly versions:
3. Completed trainee assessment form
  • To be used as a guide and provide an example of the sorts of assessments and comments a trainee may make with regard to their prescribing review
  • This will help trainees see how to use the form
  • This will provide a trainee assessment form for the trainer to compare their findings with and provide supportive meaningful feedback as if this was their trainees self-assessment
4. Completed trainee assessment with Nottingham comments
  • This is to provide feedback to the trainee, on the form they completed, and to see how well this matched with the ideal review of prescribing
  • It provides feedback to the trainer to use, as a comparison with their own assessment, to review how they may have evaluated the trainee themselves or what feedback they may have given to the trainee had the completed assessment form been their own trainee’s self-assessment
  • We would like to thank the 'medicines safety and effective healthcare research team from the University of Nottingham, working in partnership with the NIHR GMPSTRC' for their work on this resource

Instructions for trainees, trainers, programme leaders and large groups

Instructions for trainee

  1. Look at the consultation records (form 1) and for each prescription complete the trainee/ trainer self-assessment form (form 2) using the Prescribing Manual on the website to explain what each area and types of error is and the examples in the appendix to help
  2. Use BNF and other resources to check that correct prescribing happened and make suggestions for improvement and pick out examples of good prescribing as well
  3. Complete the assessment form 2 for all prescriptions using all consultations
  4. Compare your responses with the completed trainee form 3 and form 4 (Nottingham feedback)
  5. Think if there are any trends or specific learning points to take away and complete the trainee assessment form with all areas that you could complete as if the assessment was based on your own prescribing
  6. Discuss with your trainer / programme director

Instructions for trainer

  1. Look at the consultation records (form 1) and for each prescription complete the trainee/ trainer self-assessment form (form 2) using the Prescribing Manual on the website to explain what each area and types of error is and the examples in the appendix to help
  2. Use BNF and other resources to check that correct prescribing happened and make suggestions for improvement and pick out examples of good prescribing as well
  3. Complete the assessment form 2 for all prescriptions using all consultations
  4. Compare your responses with the completed trainee form 3 and form 4 (Nottingham feedback)
  5. Decide what feedback you would give to your trainee if this had been their self-assessment
  6. Think if there are any trends or specific learning points you would want your trainee to take away and complete the trainer assessment form with all areas that you could complete as if the assessment was based on your own trainees prescribing
  7. If your trainee has also done this exercise discuss the results with them and complete any additional areas in the assessment forms to familiarise yourself with them

Instructions to Programme directors and large group leaders

  1. Use the prescribing PowerPoint presentation (PPT file, 3 MB) to explain the new assessment as a large group, making as interactive as possible
  2. Use the instructions above relevant to the group you are teaching to explain how to use the resources
  3. Get all the delegates to complete the assessments either individually or in small groups and discuss their results
  4. Share the results with the larger group and benchmark
  5. Discuss any problems, concerns using the FAQs on the website to help
  6. Summarise the main learning points from the sessions and remind all where they can find further resources to help