Portal de Periódicos da CAPES

Junior doctors' perceptions of their self‐efficacy in prescribing, their prescribing errors and the possible causes of errors

2013; Wiley; Volume: 76; Issue: 6 Linguagem: Inglês

10.1111/bcp.12154

1365-2125

Cristín Ryan, Sarah Ross, Peter Davey, Eilidh Duncan, Shona Fielding, Jill Francis, Marie Johnston, Jean Ker, Amanda Lee, Mary Joan MacLeod, Simon Maxwell, Gerard McKay, James S. McLay, David J. Webb, Christine Bond,

Clinical Reasoning and Diagnostic Skills

Aims The aim of the study was to explore and compare junior doctors' perceptions of their self‐efficacy in prescribing, their prescribing errors and the possible causes of those errors. Methods A cross‐sectional questionnaire study was distributed to foundation doctors throughout S cotland, based on B andura's S ocial C ognitive T heory and H uman E rror T heory ( HET ). Results Five hundred and forty‐eight questionnaires were completed (35.0% of the national cohort). F 1s estimated a higher daytime error rate [median 6.7 ( IQR 2–12.4)] than F 2s [4.0 IQR (0–10) ( P = 0.002)], calculated based on the total number of medicines prescribed. The majority of self‐reported errors (250, 49.2%) resulted from unintentional actions. Interruptions and pressure from other staff were commonly cited causes of errors. F 1s were more likely to report insufficient prescribing skills as a potential cause of error than F 2s ( P = 0.002). The prescribers did not believe that the outcomes of their errors were serious. F 2s reported higher self‐efficacy scores than F 1s in most aspects of prescribing ( P < 0.001). Conclusion Foundation doctors were aware of their prescribing errors, yet were confident in their prescribing skills and apparently complacent about the potential consequences of prescribing errors. Error causation is multi‐factorial often due to environmental factors, but with lack of knowledge also contributing. Therefore interventions are needed at all levels, including environmental changes, improving knowledge, providing feedback and changing attitudes towards the role of prescribing as a major influence on patient outcome.