Faculty of Medical and Health Sciences
Department of Pharmacology & Clinical Pharmacology, University of Auckland
Faculty of Medical and Health Sciences
Department of Pharmacology & Clinical Pharmacology, University of Auckland

MBChB501 Clinical Pharmacology

Year 5 Clinical Pharmacology 2019

 

Module Coordinator

 

Prof Mark  McKeage

 
m.mckeage@auckland.ac.nz       

Module Administrator

 

Teresa Timo

 

t.timo@auckland.ac.nz

 

  

Please be sure to read the Asynchronous Learning, Synchronous Learning and Prescribing Safety Assessment sections (see below).

 

Introduction to Year 5 Clinical Pharmacology

 

Welcome to the Clinical Pharmacology module of the MBChB 501 course.

This module will build on your existing anatomy, physiology, genetics, and biochemistry knowledge. This module is designed to teach you the principles of clinical pharmacology and therapeutics that will underlie other aspects of your medical education and future medical practice.  Where we can, we will use specific clinical examples and patient scenarios to help you understand these basic principles. You should expect your learning from this module to integrate with your learning from other modules.

 

I hope that this module is informative, challenging and interesting. Good luck with the year.

 

Mark McKeage

 

Module Overview

The clinical pharmacology module is taught by a series of lectures and tutorials.

The lectures provide a structured introduction to the principles of clinical pharmacology and application to therapeutics.

The tutorials encourage students to reflect on the module content and apply principles of dose individualization.

The Clinical Pharmacology module consists of formal lectures, synchronous and asynchronous learning activities. In view of possible last minute change of venues and times, please refer to the MBChB Portal (http://medprog.fmhs.auckland.ac.nz/timetable/) for the latest timetable information.

Lectures will be given in lecture theatre 505-011 unless you are informed otherwise.

The notes and lecture slides provided cover key areas of interest as your lecturers see them, and guide you about the scope of what we expect you to learn. However, this is a university-level course, therefore, for some topics you will need to do your own reading outside of lectures and module resources. If unsure about anything please don’t hesitate to ask your lecturers for help.

If you are given reading material before any session or in this module manual, you are expected to have read and considered this prior to attending.

 

Medicines You Should Know About

 

Practicing doctors may prescribe from a large list of medicines in New Zealand. Typically, every doctor will be familiar with several hundred medicines. Clinicians at FMHS have compiled a list of medicines that they think all medical students should be aware of. A shorter list has been identified that should be familiar to year 6 medical students who may be asked to initiate a prescription. These lists are accessible on the MBChB Clinical Scenarios Medicines website.

 

The CP module will introduce you to medicines from these lists. As you continue in your medical training you will learn about a wider range of medicines.  You are expected to be familiar with the mechanism of action, primary indications and major adverse effects of all medicines that are referred to in the CP module.  This information will not necessarily be discussed by your teachers or appear in the course materials. You should learn to use online resources about medicines to complement and integrate the materials used in the CP module (see MBChB Clinical Scenarios Medicines website for further links).

 

Clinical Pharmacology Formal Learning

 

In Year 5 students will be introduced to a greater degree of complexity in the practice of prescribing, building upon the knowledge and practical skills acquired in Phase 1 and Year 4. 

Session one focuses on the prescriber working in a mindful way: considering the issues involved in detecting and preventing medication errors, the use of prescribing aids and the ethical issues involved in prescribing.

Session two reinforces the need to approach patients as individuals when prescribing, focusing on prescribing to three ‘special’ populations:  children, pregnant women and lactating women.

 

Clinical Pharmacology Synchronous Learning

 

Therapeutics is taught in the Synchronous Learning in Medicine teaching in Year 4. (For further information refer to Staff and Student Guide to Synchronous Learning in Year 4).

 

After completing Year 6, you should be able to formulate a basic management plan and identify medicines (and nonpharmacological approaches) that might be indicated for each therapeutic problem.



Clinical Pharmacology Asynchronous Learning


National Prescribing Centre Learning Modules

Please read the following instructions about the National Prescribing Centre modules. You are expected to use these modules to help improve your prescribing knowledge and skills. There are recommended modules for both Year 4 and Year 5 students. If you are a Year 5 student and have not taken the Year 4 modules then you are strongly encouraged to do so.

Australian National Prescribing Centre Modules

 

 

Prescribing Skills Assessment 2019

You are probably aware that the Prescribing Skills Assessment (PSA) test on 24  october 2018 had be abandoned due to a technical problem in UK preventing delivery of the online test.

Due to the structure of Year 6, you will be allocated to one of two dates to sit the test for the first time (February or July). Any student failing at their first attempt will be asked to take the test again in October with the 2019 Year 5 cohort. An oral assessment will take place prior to the MBChB6 Board of Examiners meeting for any student failing at the second attempt.

Prescribing Safety Assessment dates for 2019

Wednesday 20 February 2019, commencing at 8.30am (first cohort 2019 year 6)
Wednesday 3 July 2019, commencing at 8.30am (second cohort 2019 year 6)
Wednesday 30 October 2019, commencing at 8.30am (all 2019 year 5 plus any 2019 year 6 who have not passed)


What is the Prescribing Skills Assessment?

The Prescribing Skills Assessment (PSA) is a two hour online test designed to assess prescribing competence. 

The PSA test is used in all UK medical schools, all NZ medical schools and most Australian medical schools. The test you will sit was developed for use in New Zealand and Australia. All medicines and doses that might have been used in the test were checked by a large panel of clinicians and clinical pharmacists from New Zealand and Australia to see that they are consistent with both the New Zealand Formulary and the Australian Medicines Handbook. The same group participated in an extensive standard setting procedure to establish the pass mark for the test. The principle of the standard setting was based on the expected percentage of borderline students who would be able to get the correct answer. Each question was evaluated separately in order to set the standard. The use of a common standard for all PSA tests in New Zealand and Australia is important because of the ability of doctors to work in both countries.


Students who have taken this assessment in the past have commented very positively on its usefulness. You will get the most out of the assessment if you prepare yourself during the year by reading the following section on preparing for the test and making sure you understand the practice questions.

The PSA is a summative two hour online test which students are required to undertake in Year 5. From 2019, any Year 5 students who fail the PSA will be required to re-sit this test in Year 6. There will be three opportunities for students to demonstrate their prescribing competence. Students who fail the PSA in Year 5 will be provided with support in Year 6 to improve their prescribing competence prior to resitting the assessment.

Students who have not achieved a pass for the PSA in time for the Year 6 Board of Examiners will be required to undertake a remediation period before graduation.
 

The results of the test will provide you with an individualised indication of your preparedness to prescribe safely and highlight any areas that you need to address in Year 6 in order to feel confident to prescribe safely.  It is planned that you will be given further opportunities to demonstrate prescribing competence during Year 6, and this, together with the PSA, aims to help you prepare for independent prescribing in your PGY1 year.

In order to take the test you will need to be registered with the PSA. You will need to activate your PSA account. You will receive an email reminder in the second semester asking you to do this when the PSA site is ready for registration to start.  Once you have activated your account you will be able to access more detailed information about the PSA and be able to take the Practice Assessments. If you have difficulty accessing the "Preparing for the PSA event" video, a transcript of the information contained in the video will be available in the near future.

 

To activate your account go to Prescribing Skills Assessment and use your University of Auckland email address.  It is suggested that you use your  University password to register on  the  PSA  web  site so  that you  only have one password to remember. This is  especially  important on the day you take the test. After you have registered on the PSA site and if you  forget your PSA password you can request a password reset to be sent to your UoA email address. 

There is assistance available via the PSA website.  Alternatively you can contact the local PSA academic co-ordinator, Professor Nick Holford.

IMPORTANT: You must use the Australasian  PSA website link (https://prescribingskillsassessment.com). Do not try to use  www.prescribingsafetyassessment.ac.uk  which is for UK students.


Why do the Prescribing Skills Assessment?


http://careers.bmj.com/careers/advice/view-article.html?id=2018


 

PSA Test Format

The PSA is an on-line exam lasting two hours. The exam is divided into 8 stations and each station contains 6-8 questions. The competencies tested include writing new prescriptions, reviewing existing prescriptions, calculating drug doses, identifying and avoiding both adverse drug reactions and medication errors and amending prescribing to suit individual patient circumstances.  For more information you can look on the PSA website https://prescribingskillsassessment.com/aboutpsa.

Note that you will need to use the New Zealand Formulary (NZF) in place of the British National Formulary (BNF). The  NZF will be  available for  consultation during the test. It is the only on-line resource you are allowed to access during the test. Attempts to  look at other resources during the test is considered cheating.

 

Preparing for the Test

Sample questions are available and once you have activated your account you will have access to practice exams. Note that these  sample questions are  designed for  UK student use so you may find some  medicine names  are not those used in New Zealand.  Questions involving date and time format are designed for UK time. The actual test in Auckland will only  use New Zealand  specific medicines and date and time will be UK time.

Your clinical teachers are those primarily responsible for teaching you prescribing skills as they are for other clinical skills.

You can also prepare for the test by:
1. reviewing your Formal Learning in clinical pharmacology

2. participating in the Asynchronous Learning (the NPC online modules)

3. engaging in prescribing during your clinical attachments. 

You can practice by trying an unofficial “preparation” test designed by a UK medical school.