Medical students' confidence and competence with prescribing in ST-elevation myocardial infarction: a mixed-methods study
Issued Date
2022-07-29
Resource Type
eISSN
20426372
Scopus ID
2-s2.0-85135216173
Pubmed ID
35909350
Journal Title
International journal of medical education
Volume
13
Start Page
187
End Page
197
Rights Holder(s)
SCOPUS
Bibliographic Citation
International journal of medical education Vol.13 (2022) , 187-197
Suggested Citation
Angkananard T., Issarasenarak P., Teerawattananon P., Kosulawath M., Samrejphol V., Okanurak K. Medical students' confidence and competence with prescribing in ST-elevation myocardial infarction: a mixed-methods study. International journal of medical education Vol.13 (2022) , 187-197. 197. doi:10.5116/ijme.62c2.c33c Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85704
Title
Medical students' confidence and competence with prescribing in ST-elevation myocardial infarction: a mixed-methods study
Author's Affiliation
Other Contributor(s)
Abstract
Objectives: To explore factors associated with prescribing confidence and competence of final-year medical students for prescribing antiplatelet and fibrinolytic agents in ST-segment elevation myocardial infarction (STEMI). Methods: The study was conducted among final-year medical students with a triangular convergent mixed-methods approach. First, an online survey was conducted using a voluntary sampling method with concurrent in-depth interviews performed. The survey data was analysed using descriptive statistics and paired t-tests, while survey factors were compared using the chi-squared or Fisher's exact test. The interview data were coded and analysed thematically. The relations between the qualitative and quantitative findings were finally described. Results: Totally 92 validly replied to the questionnaire, and 20 participated in the interviews. The quantitative analysis indicated that they had high competence in the diagnosis of STEMI and prescribing antiplatelet and fibrinolytic agents. The mean confidence score of prescribing for both was medium and was significantly lower in fibrinolytic agents. (M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t(91)=5.39, p<0.01). Their experience, knowledge, and mentoring were accounted for, considering the prescribing confidence factors in both approaches. Besides, providing guidelines and standing orders were derived from the interview data. Conclusions: This study has demonstrated that final-year medical students have a high ability to diagnose and prescribe essential medications in STEMI but tend to have low confidence in prescribing fibrinolytic agents. Experiential learning, mentorship and providing guidelines can help them, especially in emergency settings to prescribe confidently and safely. Further multicenter studies on undergraduate and graduate medical students' confidence and perspective of prescribing are required, especially for high-alert medications.