Improvement in Drug Prescription Skills Among Medical Students in Peru: A Quasi-Experimental Study Using In-Person and Remote Simulated Interviews

Pharmacology learning plays a key role in medical education as the basis for prescribing and therapeutics, with direct implications for patients' health. Studies have found deficiencies in medical students' prescribing skills and a scarcity of pharmacology learning in the clinical context. The development of good prescribing skills requires innovative educational approaches. This quasi-experimental study aimed to determine the effects of simulated clinical interviews on the improvement of drug prescribing skills among medical students in Peru. In 2020, we led a research team from three local medical schools with competency-based curricula and an initial stage of simulation development. Using an expert-validated instrument constructed from the World Health Organization (WHO) Guide to Good Prescribing, we assessed students' prescribing skills during three simulated interviews: baseline, pre-, and post-intervention. The educational intervention took place between Interviews 2 and 3, consisting of simulated interview (Interview 2), plus debriefing (after Interview 2), and pre-briefing (before Interview 3) simulation strategies focused on prescribing skills. We assessed its effects on students' performance during Interview 3. Eligible participants were students from each institution who had taken pharmacology in the previous semester (pharmacokinetics, pharmacodynamics, and case studies). We sought their voluntary participation through social media, considering their availability of four hours over two days. Participants received the WHO Guide to Good Prescribing and information about the drugs to be used the following week in the simulated clinical interviews. We had to conduct the three interviews, to which participants were randomly assigned, in two groups-in-person in the first batch and remotely in the second batch-due to mandatory social distancing during the COVID-19 pandemic. Participants' prescribing skills and knowledge significantly improved over the three interviews only when participants experienced all phases of the intervention: pre-briefing, debriefing, and feedback. Pharmacology learning may benefit from the implementation of remote and in-person simulated clinical interviews aimed at developing good prescribing skills. The logical sequence of the WHO Guide for Good Prescribing may facilitate skill assessment and acquisition.