Evidence map›Paper›PMID 31978199›Full record

ArticlePloS one2020

Readiness to prescribe: Using educational design to untie the Gordian Knot.

Ciara Lee, Richard McCrory, Mary P Tully, Angela Carrington, Rosie Donnelly, Tim Dornan

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Ciara LeeCentre for Medical Education, Queen's University Belfast, Belfast, United Kingdom.ORCID 0000-0002-2296-7867
Richard McCroryCentre for Medical Education, Queen's University Belfast, Belfast, United Kingdom.
Mary P TullyDivision of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom.ORCID 0000-0003-2100-3983
Angela CarringtonBelfast Health and Social Care Trust, Belfast, United Kingdom.
Rosie DonnellySouth-Eastern Health and Social Care Trust, Belfast, United Kingdom.
Tim DornanCentre for Medical Education, Queen's University Belfast, Belfast, United Kingdom.ORCID 0000-0001-5497-3412
Queen's University Belfast · GBBelfast Health and Social Care Trust · GBSouth Eastern Health and Social Care Trust · GBUniversity of Manchester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionJunior residents routinely prescribe medications for hospitalised patients with only arms-length supervision, which compromises patient safety. A cardinal example is insulin prescribing, which is commonplace, routinely delegated to very junior doctors, difficult, potentially very dangerous, and getting no better. Our aim was to operationalise the concept of 'readiness to prescribe' by validating an instrument to quality-improve residents' workplace prescribing education.

methodsGuided by theories of behaviour change, implementation, and error, and by empirical evidence, we developed and refined a mixed-methods 24-item evaluation instrument, and analysed numerical responses from Foundation Trainees (junior residents) in Northern Ireland, UK using principal axis factoring, and conducted a framework analysis of participants' free-text responses.

results255 trainees participated, 54% women and 46% men, 80% of whom were in the second foundation year. The analysis converged on a 4-factor solution explaining 57% of the variance. Participants rated their capability to prescribe higher (79%) than their capability to learn to prescribe (69%; p<0.001) and rated the support to their prescribing education lower still (43%; p<0.001). The findings were similar in men and women, first and second year trainees, and in different hospitals. Free text responses described an unreflective type of learning from experience in which participants tended to 'get by' when faced with complex problems. DISCUSSION: Operationalising readiness to prescribe as a duality, comprising residents' capability and the fitness of their educational environments, demonstrated room for improvement in both. We offer the instrument to help clinical educators improve the two in tandem.

Indexed as

Patient SafetyDrug PrescriptionsEducation, MedicalFemaleHumansInsulinLearningMaleMedical RecordsMedical Staff, HospitalPatientsPharmacistsPhysiciansSurveys and QuestionnairesInsulin

Identifiers

PMID31978199
PMCPMC6980548
OpenAlexW2999241620

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.