DEVELOPMENT AND VALIDATION OF THE MCMASTER PRESCRIBING COMPETENCY ASSESSMENT FOR MEDICAL TRAINEES (MacPCA)

Main Article Content

Vincent Wu
Oscar Chan
Simon R. Maxwell
Mitchell A. Levine
Dan Perri
Rolf J. Sebaldt
Bandar Baw
Anne Holbrook

Keywords

Prescribing, medical students, clinical pharmacology, competency, validation

Abstract

Background


Prescribing is an essential skill for all physicians, built on knowledge of clinical pharmacology, therapeutics and toxicology across the life cycle. The decline in organized clinical pharmacology training in medical schools, combined with an expanding pharmacopeia and increasing complexity of patient care, makes prescribing competency difficult for medical students to master.


Objectives


To develop and validate the McMaster Prescribing Competency Assessment (MacPCA), an online tool suitable for evaluating clinical pharmacology knowledge and prescribing skills of medical trainees in Canada.


Methods


The MacPCA was developed using an online examination platform scalable to multiple sites across Canada. Questions represented 8 domains of safe and effective prescribing with level of difficulty aimed at a final year medical student. Validation assessment concentrated on face and construct validity.


Results


58 participants ( 7, 12 and 21 medical students in Years 1, 2, and 3, respectively and 8 undergraduate controls) were recruited. Mean scores were 31 % (SD 13.6) , 46% (SD 14.9), 75% (SD 8.3) and 81% (SD 10.5) for the controls, Year 1, Year 2, and Year 3 (final year) students, respectively. Combined Year 2/ Year 3 scores were significantly better than control /Year 1 scores (p<0.0001). Final year student feedback indicated the test was fair, clear and unambiguous, aimed at the right level, with sufficient time for completion.


Conclusions


The MacPCA demonstrated good face validity and successfully discriminated between upper year medical students and their junior colleagues. Further expansion of testing and validation is warranted.

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