Year 5 and Year 6 Clinical Pharmacology

 

Module Coordinator  Dr Catherine Han  c.han@auckland.ac.nz

Module Administrator  Teresa Timo  t.timo@auckland.ac.nz

 

  

Please be sure to read the Asynchronous Learning, Synchronous Learning and Prescribing Safety Assessment sections (see below).

 

Introduction to Year 5 Clinical Pharmacology

 

Welcome to the Clinical Pharmacology module of the MBChB 501 course.

This module will build on your existing anatomy, physiology, genetics, and biochemistry knowledge. This module is designed to teach you the principles of clinical pharmacology and therapeutics that will underlie other aspects of your medical education and future medical practice.  Where we can, we will use specific clinical examples and patient scenarios to help you understand these basic principles. You should expect your learning from this module to integrate with your learning from other modules. 

I hope that this module is informative, challenging and interesting. Good luck with the year.

 

Catherine Han

 

Module Overview

 

The clinical pharmacology module is taught by a series of lectures and eLearning resources.

The lectures provide a structured introduction to the principles of clinical pharmacology and application to therapeutics.

The eLearning modules encourage students to reflect on the module content and apply principles of good prescribing.

The Clinical Pharmacology module consists of formal lectures, synchronous and asynchronous learning activities. In view of possible last minute change of venues and times, please refer to the MBChB Portal (http://medprog.fmhs.auckland.ac.nz/timetable/) for the latest timetable information.

Lectures will be given in lecture theatre 505-011 unless you are informed otherwise.

The notes and lecture slides provided cover key areas of interest as your lecturers see them, and guide you about the scope of what we expect you to learn. However, this is a university-level course, therefore, for some topics you will need to do your own reading outside of lectures and module resources. If unsure about anything please do not hesitate to ask your lecturers for help.

If you are given reading material before any session or in this module manual, you are expected to have read and considered this prior to attending.

 

Medicines You Should Know About

 

Practicing doctors may prescribe from a large list of medicines in New Zealand. Typically, every doctor will be familiar with several hundred medicines. Clinicians at FMHS have compiled a list of medicines that they think all medical students should be aware of. A shorter list has been identified that should be familiar to year 6 medical students who may be asked to initiate a prescription. These lists are accessible on the MBChB Clinical Scenarios Medicines website.

 

The CP module will introduce you to medicines from these lists. As you continue in your medical training you will learn about a wider range of medicines.  You are expected to be familiar with the mechanism of action, primary indications and major adverse effects of all medicines that are referred to in the CP module.  This information will not necessarily be discussed by your teachers or appear in the course materials. You should learn to use online resources about medicines such as the New Zealand Formulary (https://nzf.org.nz/) to complement and integrate the materials used in the CP module (see MBChB Clinical Scenarios Medicines website for further links).

 

Clinical Pharmacology Formal Learning

 

In Year 5 students will be introduced to a greater degree of complexity in the practice of prescribing, building upon the knowledge and practical skills acquired in Phase 1 and Year 4. 

Year 5 Clinical Pharmacology Formal Learning lectures reinforce the need to approach patients as individuals when prescribing, focusing on prescribing to three special populations:  elderly, children, and pregnant or lactating women. There will also be a lecture about Prescribing Skills Assessment (PSA), which is a mandatory exam you will be sitting at the end of Year 5 - see below for further information. We will go through some example questions.

 

Clinical Pharmacology Synchronous Learning

 

Therapeutics is taught in the Synchronous Learning in Medicine teaching in Year 5. (For further information refer to Staff and Student Guide to Synchronous Learning in Year 5).

 

After completing Year 6, you should be able to formulate a basic management plan and identify medicines (and non‐pharmacological approaches) that might be indicated for each therapeutic problem.

Clinical Pharmacology Asynchronous Learning

 

National Prescribing Centre Learning Modules

Please read the following instructions about the National Prescribing Centre modules. You are expected to use these modules to help improve your prescribing knowledge and skills. There are recommended modules for both Year 4 and Year 5 students. If you are a Year 5 student and have not taken the Year 4 modules, then you are strongly encouraged to do so.

 
Australian National Prescribing Service Modules

 

 

Medical Deans of Australia and New Zealand Core Competencies

The core competencies document is provided to help you understand the competencies expected of medical students in the later stages of their training.

 MDANZ 2020 May Core Competencies

Prescribing Skills Assessment 2024 - Years 5 and 6

 

The PSA is a summative two-hour online test which students are required to undertake in Year 5. Any Year 5 cohort students who fail the PSA will be required to re-sit this test in Year 6. There will be three opportunities for students to demonstrate their prescribing competence (two attempts at the online PSA test and an oral examination).

Students who fail the PSA in Year 5 will be provided with support in Year 6 to improve their prescribing competence prior to resitting the assessment.

 

All 6th year students resitting the online PSA test must prepare themselves to be available for an oral exam in case they do not pass the online test. The exact date and time of the oral exam for each student will be communicated after the online test.

Year 6 Students who have not achieved a pass in time for the Year 6 Board of Examiners meeting in November may be required to undertake a remediation period before graduation.

 

Prescribing Skills Assessment dates for 2024

Wednesday 28^th August 2024, commencing at 8:30 am (resit test for year 6 students who failed in 2023)

Wednesday 22^nd October 2023, commencing at 8:30 am (all 2024 year 5 students)

 

Activation of PSA Account

All 5^th year students who are required to take the PSA test have been registered on the PSA site. You must activate your account using your UNIVERSITY EMAIL ADDRESS on the PSA website BEFORE the PSA test.

 

 

What is the Prescribing Skills Assessment?

 

The Prescribing Skills Assessment (PSA) is a two-hour online test designed to assess prescribing competence. 

The PSA test is used in all UK medical schools, all NZ medical schools and most Australian medical schools. The test you will sit was developed for use in New Zealand and Australia. All medicines and doses that might have been used in the test were checked by a large review group of clinicians and clinical pharmacists from New Zealand and Australia to see that they are consistent with both the New Zealand Formulary and the Australian Medicines Handbook.

 

Because of the Australasian nature of the test some medicines may not appear in University of Auckland lists of medicines (e.g. https://medprog.fmhs.auckland.ac.nz/scenarios/index.php/medicine/index) but are described in the New Zealand Formulary.

 

The review group participated in an extensive standard setting procedure to establish the pass mark for the test. The principle of the standard setting was based on the expected percentage of borderline students who would be able to get the correct answer. Each question was evaluated separately in order to set the standard. The use of a common standard for all PSA tests in New Zealand and Australia is important because of the ability of doctors to work in both countries.

 

Students who have taken this assessment in the past have commented very positively on its usefulness. You will get the most out of the assessment if you prepare yourself during the year by reading the following section on preparing for the test and making sure you understand the practice questions.

 

The results of the test will provide you with an individualised indication of your preparedness to prescribe safely and highlight any areas that you need to address in Year 6 in order to feel confident to prescribe safely.  It is planned that you will be given further opportunities to demonstrate prescribing competence during Year 6, and this, together with the PSA, aims to help you prepare for independent prescribing in your PGY1 year.

In order to take the test, you will need to be registered with the PSA. You will need to activate your PSA account. Fifth year students will receive an email reminder in the second semester asking you to do this when the PSA site is ready for registration to start.  Sixth year students will be contacted in the first semester.

 

Once you have activated your account you will be able to access more detailed information about the PSA and be able to take the Practice Assessments. If you have difficulty accessing the "Preparing for the PSA event" video, a transcript of the information contained in the video will be available in the near future.

 

Please do not try to activate your account before you have been notified by email. To activate your account go to the PSA website and use your University of Auckland email address.  It is suggested that you use your University password to register on the PSA web site so that you only have one password to remember.  After you have registered on the PSA site and if you forget your PSA password you can request a password reset to be sent to your UoA email address. 

There is assistance available via the PSA website. Alternatively, you can contact the local PSA academic lead.

IMPORTANT: You must use the Australasian PSA website link.  Do not try to use  www.prescribingsafetyassessment.ac.uk  which is for UK students.

 

Why do the Prescribing Skills Assessment?

 

http://careers.bmj.com/careers/advice/view-article.html?id=2018

 

 

PSA Test Format

The PSA is an on-line exam lasting two hours. The exam is divided into 8 stations and each station contains 6-8 questions. The competencies tested include writing new prescriptions, reviewing existing prescriptions, calculating drug doses, identifying and avoiding both adverse drug reactions and medication errors and amending prescribing to suit individual patient circumstances.

 

Note that you will need to learn to use the New Zealand Formulary (NZF). The NZF will be available for consultation during the PSA test. You should practice using the NZF so that you can quickly find information about specific medicines, adverse effects, diseases and treatment options. This will help you both in your clinical training and in taking the PSA test.

It is the only on-line resource you are allowed to access during the test. You are allowed to use links that exist in the NZF but attempts to look at other resources during the test is considered cheating.

 

 

Preparing for the Test

Knowing your email address and PSA password is especially important on the day you take the test. You are responsible for knowing these in order to login. You will not be given extra time to find these details if you are unable to provide the email address and password that was used to activate your account.

 

Once you have activated your account you will have access to practice exams and eLearning modules. You are strongly recommended to utilise these well in advance to help you prepare for the PSA test.

 

Your clinical teachers are those primarily responsible for teaching you prescribing skills (as they are for other clinical skills).

 

You can also prepare for the test by:
1. reviewing your Formal Learning in clinical pharmacology

2. using eLearning modules on PSA webpage (University of Auckland pays for the subscription therefore you have access) – these modules are highly relevant to the PSA exam.

3. participating in the Asynchronous Learning (the NPC online modules)

4. engaging in prescribing during your clinical attachments. 

 

You can also try the following websites:

 

Prepare for the PSA (unofficial site designed by a UK medical school) 

Question Browser (payment for access)

Pastest (payment for access)

“Pass the PSA” is an unofficial textbook for PSA which has useful information and practice questions. You can purchase on Amazon as hardcopy or electronic copy.