Improved junior paediatric prescribing skills after a short e-learning intervention: a randomised controlled trial

Abstract

OBJECTIVE: Medication errors are common, with junior doctors accounting for the majority in acute healthcare. Paediatrics is uniquely challenging, but the evidence base to guide prescribing education is limited. The authors set out to develop a short, educationally sound, low cost e-learning resource for paediatric prescribing to improve junior doctors' prescribing skills and to evaluate its effectiveness. DESIGN: A non-blinded randomised controlled trial. SETTING: North Western Deanery Foundation School, UK. PARTICIPANTS: 162 volunteer foundation (junior) doctors randomised into control (86) and intervention (76) groups. INTERVENTIONS: On study entry, participants were assessed on prescribing skill, prescribing habits and confidence. The intervention group completed the e-learning course designed for the study, which took 1-2 h. At 1 and 3 months after the intervention, both groups were assessed on similar prescribing assessments, habits and confidence. MAIN OUTCOME MEASURES: Total score (expressed as a percentage) on prescribing assessments, confidence and satisfaction scores. RESULTS: There were no preintervention differences in prescribing assessments (67% vs 67%, p=0.56). Postintervention, the e-learning group scored significantly higher than the control group (63% vs 79%, p<0.0001). At 3 months, the e-learning group still scored significantly higher (69% vs 79%, p<0.0001), with improved confidence scores (p<0.0001). CONCLUSIONS: This short e-learning resource significantly improved the paediatric prescribing skills of junior doctors. Outcomes were maintained at 3 months, suggesting the utility of low cost, low fidelity, educationally sound e-learning interventions. However, the direct impact on patient outcomes following this intervention has yet to be determined.

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