The integration of the British Pharmacological Society's prescription safety assessment into the WHO 6-step model of rational pharmacotherapy in a Turkish medical school.

Aims: At Koç University School of Medicine, a one-week rational pharmacotherapy (RPHM) programme, modelled after WHO 6-step, has been introduced in the fourth-year curriculum to improve prescription skills. For efficient problem-based learning (PBL) sessions on a prespecified topic, students need to brush up on basic pharmacology knowledge, so we implemented the British Pharmacological Society (BPS)-Prescribing Safety Assessment (PSA) related to prescription skills in eight competencies. A survey-based study was initiated to evaluate students' self-confidence.

Methods: The study included 101 medical students in two groups (respiratory tract infections, urinary infections/sexually transmitted diseases) in 2020-2023. Students were required to take BPS-PSA, prepare personal formularies and prove their ability to manage simulated patients in objective structured clinical examinations (OSCE) settings. A 15-item PSA-invigilated paper with an eight-item practice paper was explicitly prepared by BPS to match indications, tailored according to local formularies and regulations. Self-efficacy surveys were filled out before, during and after completion of the programme. Survey results were analysed concurrently with OSCE and BPS-PSA performances.

Results: The number of students and gender distributions were similar in all groups. Average final grades ranged from 74-82 points for OSCE, and 43-59 for BPS-PSA. All groups did well in OSCE (92.1% aggregate pass rate). Survey results showed significant increase in self-efficacy levels measured at different task categories as the training progressed. The highest scores in PSA were for dose calculation (88.3%) and lowest for communication (33.01%).

Conclusions: Implementing the PSA to WHO 6-step model provided complete assessment of learning environment and student progress. The new teaching programme supports students in developing their prescribing skills, allowing benchmarking in an international setting.