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Prescribing Safety Assessment

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Prescribing Safety Assessment
NamePrescribing Safety Assessment
Established1990s
Administered byBritish Pharmacological Society;Medical Schools Council;General Medical Council
PurposeAssessment of clinical pharmacology, therapeutics, and prescribing
CountryUnited Kingdom

Prescribing Safety Assessment The Prescribing Safety Assessment is a high‑stakes clinical competency examination used in the United Kingdom to evaluate the prescribing abilities of medical graduates and junior doctors. It is taken by candidates from institutions such as University of Oxford, University of Cambridge, King's College London, and University College London and is recognised by regulators like the General Medical Council and professional bodies including the British Pharmacological Society and the Royal College of Physicians. The assessment interfaces with undergraduate curricula at schools such as Imperial College London and University of Edinburgh and aligns with postgraduate training pathways overseen by organizations like Health Education England and the NHS Education for Scotland.

Overview

The assessment examines candidate competence in safe and effective prescribing across common clinical areas encountered in settings such as St Thomas' Hospital, Addenbrooke's Hospital, Royal London Hospital, and Great Ormond Street Hospital. It covers medication choices aligned with formularies including the British National Formulary and policies influenced by bodies like the National Institute for Health and Care Excellence and Medicines and Healthcare products Regulatory Agency. Stakeholders include universities such as Queen Mary University of London, regulatory authorities such as the General Pharmaceutical Council, and training programmes run by institutions like Guy's and St Thomas' NHS Foundation Trust.

History and Development

Origins trace to curriculum reforms at institutions including University of Birmingham and University of Manchester in response to reports from panels convened by the General Medical Council and the British Medical Association. Development involved collaborations among academic departments at University of Bristol, University of Glasgow, and University of Southampton together with professional societies such as the Royal College of General Practitioners and the Royal Pharmaceutical Society. External influences included patient safety initiatives following incidents reviewed by the Shipman Inquiry and policy recommendations from the Department of Health and Social Care and the Academy of Medical Royal Colleges.

Format and Content

The exam employs electronic stations modelled on clinical scenarios familiar from wards at centres like Royal Infirmary of Edinburgh and Manchester Royal Infirmary, and includes tasks comparable to assessments used by organisations such as Medical Schools Council Assessment Alliance. Items require selection of drug, dose, route, and monitoring consistent with guidance from the British Thoracic Society, British Cardiac Society, and other specialist bodies including the Royal College of Paediatrics and Child Health. Content domains reflect overlaps with curricula from University of Leeds, Newcastle University, and University of Liverpool and incorporate case types relevant to settings such as St Bartholomew's Hospital and Chelsea and Westminster Hospital.

Administration and Scoring

Administration is coordinated centrally with delivery at test centres associated with universities like University of Leicester and centres accredited by organisations such as Pearson VUE and local hospital trusts including Birmingham Women's and Children's NHS Foundation Trust. Scoring uses objective marking rubrics and standard setting methods comparable to processes used by the Membership of the Royal Colleges of Physicians of the United Kingdom examinations and assessments governed by the Quality Assurance Agency for Higher Education. Results inform progression decisions made by medical schools such as University of Exeter and postgraduate programme directors within Health Education England regions.

Preparation and Educational Impact

Preparation resources are provided by academic units at St George's, University of London, student groups at University of Glasgow and commercial providers with materials analogous to guides from the Royal College of Surgeons of England. The assessment has driven curricular changes at institutions like University of Aberdeen and Cardiff University and prompted pedagogic innovations similar to initiatives from the Wellcome Trust and the Higher Education Academy. It influences learning in clinical placements at hospitals such as Royal Free Hospital and shapes teaching by departments led by figures from King's College Hospital and Barts and The London School of Medicine and Dentistry.

International Use and Recognition

Although rooted in UK practice, the assessment format has been referenced by medical schools internationally including University of Sydney, University of Auckland, McMaster University, and University of Toronto and cited in collaborations with bodies like the World Health Organization and the Commonwealth Medical Association. Elements of the assessment have informed competency frameworks adopted by organisations such as the Australian Medical Council and the Medical Council of Canada and have been discussed at conferences hosted by institutions like Harvard Medical School and Johns Hopkins University.

Criticisms and Controversies

Critiques have been raised by student bodies at universities such as University of Nottingham and University of Sheffield concerning access, cost, and alignment with local prescribing practices specific to trusts like Cambridge University Hospitals NHS Foundation Trust and Leeds Teaching Hospitals NHS Trust. Clinical educators from centres including Oxford University Hospitals and University Hospitals Birmingham have debated the fidelity of scenarios to rare but serious events discussed in inquiries like the Francis Report and the balance between summative assessment and workplace‑based supervision advocated by the Care Quality Commission.

Category:Medical assessments Category:Pharmacology