E-drug: Undergraduate pharmacotherapy teaching (cont'd)
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Professor Santanu K. Tripathi has asked an important question.
In Newcastle (NSW Australia) we have been teaching pharmacology
and clinical pharmacology within an integrated problem-based
curriculum since the late 1970s. It is not easy, but overall is worth it. I
think it is the best way for students to learn.
I am listing a few issues - but there are many more - hopefully others
will contribute. This is opinion rather than evidence, but I think our
experiences are representative.
In our experience the main issues are:
1) It is necessary to ensure that a list of all the main principles in
clinical pharmacology that need to be taught are agreed on. This
requires answers to questions like - how much receptor pharmacology
or pharmacokinetics do the students REALLY need to know? Once
these core issues are identified they need to be 'mapped' to the
content of the curriculum - which will probably be centered around a
series of working problems. This is an important opportunity to review
and refresh the present teaching provided in pharmacology/clinical
pharmacology. (In my view many departments still spend too much
time on basic pharmacology - of course some is needed- and not
nearly enough on drug selection and prescribing as professional skills).
2) The working problems will not have been chosen/written to
exemplify pharmacological or prescribing principles - so a certain
amount of flexibility and creatitivity is needed.
3) The teaching should 'evolve' over the years of the course. The
pharmacology learning goals can be centered on basic issues in the
early stages, whereas in later problems (for more experienced
students) they can be oriented more toward practical prescribing
issues, evidence-based medicine and prescribing practices and costs in
the community.
4) If you don't have many 'fixed resource sessions' (lectures to most
of us) you will need to consider what teaching material to make
available to the students tackling the working problems, and how to
keep it up to date. The work involved in doing it properly is hard. I
think there is an advantage if this supporting material can be made
Web-deliverable.
5) To make this work tutors have to make themselves available for
informal consultations - e-mail can help here.
6) It often means a move away from protected departmental teaching
hours, and as this can have financial implications it may seem
threatening to some large departments.
E-Druggers may be interested that the Australian medical schools
(now numbering 11) are collaborating in the development of a
problem-based 'prescribing curriculum' for students in the final 2 years
of their undergraduate course. This will extend into the first 2
postgraduate years, with the approval and active support of the
postgraduate medical councils in the different states. The course will
have a number of characteristics, including a strong representation of
the principles in the WHO guide to good prescribing. It is too early to
send material around or to comment on the chances of success, but it
has received great support from all of the faculties and there is a
genuine consensus on the need to change (and enhance) what we
teach to medical students.
David Henry
Professor of Clinical Pharmacology
School of Population Health Sciences
Faculty of Medicine and Health Sciences
The University of Newcastle
New South Wales
Australia
Phone +61 249 211856
Fax +61 249 602088
e-mail: mddah@mail.newcastle.edu.au
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