IMPACT OF A SHORT-COURSE IN PHARMACOTHERAPY FOR UNDERGRADUATE MEDICAL-STUDENTS - AN INTERNATIONAL RANDOMIZED CONTROLLED-STUDY

Irrational prescribing is a habit which is difficult to cure. However, prevention is possible and for this reason the WHO Action Programme o n Essential Drugs aims to improve the teaching of pharmacotherapy to m edical students. The impact of a short problem-based training course i n pharmacotherapy, using a WHO manual on the principles of rational pr escribing, was measured in an international multi-centre controlled st udy of 219 undergraduate students in (Netherlands), Kathmandu (Nepal), Lagos Newcastle (Australia), New Delhi (India), San Francisco (USA), and Yogyakarta (Japan). The manual and the course presented the studen ts, who were about to enter the clinical phase of their studies, with a normative model for pharmacotherapeutic reasoning in which they were taught to generate a ''standard'' pharmacotherapeutic approach to com mon disorders, resulting in a set of first-choice drugs called P(erson al)-drugs. The students were then taught how to apply this set of P-dr ugs to specific patient problems on the symptomatic treatment of pain, using a six-step problem-solving routine. The impact of the course wa s measured by tests before training, immediately after, and six months later. After the course, students from the study group performed sign ificantly better than controls in all patient problems presented (p<0. 05). The students not only remembered how to solve old problems, but t hey could also apply their shills to new problems. Both retention and transfer effect were maintained at least six months after the training session in all seven medical schools. In view of the impossibiity of teaching students all basic knowledge on the thousands of drugs availa ble, this approach seems to be an efficient way of teaching rational p rescribing. However, the method should be accompanied by a change in t eaching methods away from the habit of transferring knowledge about th e drugs towards problem-based leaching of therapeutic reasoning.