Comparison of medical doctors and pharmacists' assessments of medical intern prescribing: a descriptive pilot study

Abstract Background Entrustable Professional Activities (EPA) are units of professional practice that can be entrusted once competence is demonstrated. Although widely used across health professions, evidence on interprofessional EPA assessments, where one profession evaluates another, is limited. Aim This study aimed to provide insights into the assessment practices of pharmacists and supervising doctors evaluating medical interns undertaking prescribing assessments in clinical practice. Method This pilot study evaluated an interprofessional EPA assessment model for medical intern prescribing across an Australian multi‐site hospital network where pharmacists, consultants, and registrars acted as assessors. Data were collected on the specific prescribing tasks assessed, entrustment decisions, case complexity, and assessment duration and frequency. This project was exempt due to the local policy requirements that constitute research by the Monash Health Research Office (Reference no: RES‐24‐0000‐166Q). The justification for this exemption was as follows: the study conforms with the National Health and Medical Research Council Ethical considerations in quality assurance and evaluation activities and while the addition of pharmacist assessors was new, the study utilised only routinely collected data. Informed consent was obtained from all participants via the distribution of project information indicating participation was voluntary. Participants provided their consent by participating in EPA assessments. Results From June–October 2024, 114 prescribing EPA assessments were conducted: 28 (25%) were conducted by pharmacists, 16 (14%) by consultants, and 70 (61%) by registrars. There were no differences between assessor groups in prescribing tasks (p = 0.408) and case complexity (p = 0.071). Entrustment decisions varied significantly (p < 0.001), with pharmacists (67.8%) and registrars (80.0%) selecting the highest trust level more frequently than consultants (31.3%). Assessment duration also varied (p < 0.001), with median (interquartile range IQR Q1, Q3) durations of 12.5 (10, 15) min for pharmacists, 10 (5, 15) min for consultants, and 6.5 (5, 10) min for registrars. Median (IQR) assessment frequency per assessor over the five‐month study period was 1.5 (1, 4.75) for pharmacists, 1 (1, 1) for consultants, and 1 (1, 2) for registrars. Conclusion Pharmacists, alongside supervising doctors, can serve as assessors for medical interns prescribing EPA assessments. The longer assessment duration observed with pharmacists offers new insights into interprofessional assessment practices.