ArticleBMJ open2019
Trainee doctors' experiences of common problems in the antibiotic prescribing process: an activity theory analysis of narrative data from UK hospitals.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Understanding and mapping the antibiotic prescribing and administration process in assisted living facilities.Exploratory research in clinical and social pharmacy · 2025Article
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- Can a novel constructivist theory-informed feedback intervention reduce prescribing errors ? A pre-post study.BMC medical education · 2023Article
- Using cultural historical activity theory to reflect on the sociocultural complexities in OSCE examiners' judgements.Advances in health sciences education : theory and practice · 2023Article
- Organizational arrangements as a key to enhancing innovativeness and efficiency - analysis of a restructuring hospital in Finland.BMC health services research · 2022Article
- Article
- Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework.BMJ quality & safety · 2022Article
- Understanding the Potential for Pharmacy Expertise in Palliative Care: The Value of Stakeholder Engagement in a Theoretically Driven Mapping Process for Research.Pharmacy (Basel, Switzerland) · 2021Article
- Article
- 'It makes life so much easier'-experiences of users of the MicroGuide™ smartphone app for improving antibiotic prescribing behaviour in UK hospitals: an interview study.JAC-antimicrobial resistance · 2021Article
- Understanding the complexities of antibiotic prescribing behaviour in acute hospitals: a systematic review and meta-ethnography.Archives of public health = Archives belges de sante publique · 2021Article
- Understanding surgical antimicrobial prescribing behaviour in the hospital setting: a systematic review and meta-ethnography protocol.Systematic reviews · 2020Article
- Diagnosis Between Chaos and Control: Affect and Hospital Clinicians' and Older Adult Patients' Narratives of Urinary Tract Infections.Frontiers in sociology · 2020Article
- Article
- How to … use qualitative research to change practice.The clinical teacher · 2019Article
- Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPrescribing antibiotics is an error-prone activity and one of the more challenging responsibilities for doctors in training. The nature and extent of challenges experienced by them at different stages of the antibiotic prescribing process are not well described, meaning that interventions may not target the most problematic areas.
objectivesOur aim was to explore doctors in training experiences of common problems in the antibiotic prescribing process using cultural-historical activity theory (CHAT). Our research questions were as follows: What are the intended stages in the antibiotic prescribing process? What are the challenges and where in the prescribing process do these occur?
methodsWe developed a process model based on how antibiotic prescribing is intended to occur in a 'typical' National Health Service hospital in the UK. The model was first informed by literature and refined through consultation with practising healthcare professionals and medical educators. Then, drawing on CHAT, we analysed 33 doctors in training narratives of their antibiotic prescribing experiences to identify and interpret common problems in the process.
resultsOur analysis revealed five main disturbances commonly occurring during the antibiotic prescribing process: consultation challenges, lack of continuity, process variation, challenges in patient handover and partial loss of object. Our process model, with 31 stages and multiple practitioners, captures the complexity, inconsistency and unpredictability of the process. The model also highlights 'hot spots' in the process, which are the stages that doctors in training are most likely to have difficulty navigating.
conclusionsOur study widens the understanding of doctors in training prescribing experiences and development needs regarding the prescribing process. Our process model, identifying the common disturbances and hot spots in the process, can facilitate the development of antibiotic prescribing activities and the optimal design of interventions to support doctors in training.
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