Assessment of prescribing competencies among final year medical students in Gezira State, Sudan

Abstract

Prescribing medications is a critical part of medical practice, yet evidence indicates prevalent issues with errors and inadequate training among clinicians, particularly junior doctors. Newly graduated doctors in countries like Sudan are often expected to write most hospital prescriptions and prescribe multiple times per day on hospital drug charts. This study investigated the prescribing competencies of final-year medical students in Gezira State, Sudan, aiming to identify gaps in knowledge, skills, and students’ self- assessment of their preparedness. A descriptive cross-sectional study was conducted in 2022. Four medical schools (two governmental, two private) participated, and 162 of 213 eligible students completed the assessment (76% response rate). The validated assessment tool included 55 multiple-choice questions (weighted to 60 points), covering pharmacology, clinical pharmacology, and pharmacotherapy (CPT). Student performance was classified using a criterion-referenced system: Excellent (50–60), Very Good (40–49), Good (30–39), Poor (< 30). The study revealed a significant deficiency in essential prescribing competencies. Only 17% of students achieved a score of 50% or above in the assessment. The average clinical pharmacology and therapeutics (CPT) knowledge score of students was 22 (± 7.5) out of 60. The students’ performance was lowest in the domains of drug-drug interactions, drug-disease interactions, and identification of prescribing errors with students scoring an average percent 18, 31, and 18%, respectively. Students obtained an average percent score of 36, 40, and 48% regarding drug indications, drug-related side effects, and mechanism of action, respectively. Many students (48%) expressed low confidence in their prescribing skills and dissatisfaction with the amount and quality of undergraduate teaching in (CPT). Our results suggest that undergraduate teaching of CPT is inadequate in these schools potentially leading to unsafe prescribing. We recommend that CPT curricula should be reviewed and developed under the supervision of qualified clinical pharmacologists to achieve competency-based outcomes. Moreover, we recommend that medical schools should test prescribing competencies of their students prior to graduation.