Context and setting Learning clinical pharmacology and therapeutics can be very challenging as students find it difficult to apply their pharmacological knowledge to individual patients in a clinical setting. The Family Medicine Department in the International Medical School, Malaysia has developed a structured and organised learning programme on clinical therapeutics for Semester 8 students.
Why the idea was necessary There are concerns among faculty members that clinical students find it difficult to apply their knowledge of pharmacology when it comes to drug treatment for patients. Surveys of students also indicate that they feel learning clinical pharmacology is dull and boring. In the Semester 8 Family Medicine posting, students are required to learn pharmacotherapy relevant to chronic diseases such as hypertension, diabetes mellitus and dyslipidaemia. An innovative method of learning clinical pharmacotherapy by role-play was initiated on a cohort of 90 students.
What was done A programme was devised in which students are given a task of reading up on the pharmacotherapy of dyslipidaemia. During the subsequent 2-hour discussion session, the teacher provides clinical scenarios involving four different patients. In each scenario, the teacher role-plays as the patient and the student takes the role of the doctor. The ‘patient’ begins the session by asking the ‘doctor’ for the most appropriate drug and for information on its mechanism of action, side-effects, monitoring and follow-up based on the current best evidence. The ‘doctor’ must answer all the queries posed by the ‘patient’. Group members are then invited to comment and provide feedback. Finally, the teacher provides constructive feedback on the factual content and the communication skills required to ensure patient involvement and compliance.
Evaluation of results and impact This method of learning was commenced in September 2008 and to date 90 students have participated. All the students have given positive feedback with regard to their ability to use these newly acquired skills in the future application of therapeutics in real-life clinical settings in which they will have to deal with patients’ queries. There was a significant improvement in the end-of-posting examination using short-answer questions on the management of dyslipidaemia. The mean score for the cohort of students exposed to this innovative learning method was 7.8 out of 10. The mean score of students from previous groups tested before this method was initiated was 5.5 out of 10. The difference is statistically significant (P = 0.003).
Learning clinical therapeutics allows students to consolidate their basic knowledge in pharmacology and teaches them to apply it effectively in clinical situations. The use of role-play creates greater awareness of the importance of patient-centred management and evidence-based medicine. Students also perceive this method as innovative and are able to retain the knowledge they acquire on clinical pharmacology for longer. This method also incorporates practice of the communication skills required to ensure the patient’s agreement to and continued compliance with therapy.