Table 2.

Education in pharmacology and pharmacotherapy in Leiden [34]

Teaching clinical pharmacology and rational prescribing to medicine students requires an integrated approach that is consistently provided across the Leiden curriculum.

Basic principles of pharmacology (pharmacodynamics and pharmacokinetics) and pharmacotherapy are taught early in the curriculum at the beginning of year 2. Thereafter, students apply these basic concepts and learn the clinical pharmacology in all (mostly organ specific) courses. All the gained knowledge needs then to be applied by writing 6STEP therapeutic plans. Practicing 6STEPs occurs in very different ways during the preclinical years. 6STEP teaching methods include interactive (plenary) lectures, self-study assignments, small group discussions, and tutorials and assignments on our pharmacology E-Learning program (Teaching Resource Centre). Students write a 6STEP for all commonly occuring disease states discussed in year 2 to 4. At the end of year 4, the students are able to write a 6STEP therapeutic plan for a simple (virtual, paper-based) patient case with a common medical problem.

Assessment of the prescribing skills takes place with open questions, multiple choice or extended matching questions in the final exam of every course.

This pharmacotherapy programme is continued during the clinical phase of the study (clerkship, year 5 and 6) when the student interns write 6STEPs for real patients. The complexity of the cases increases, because the real patient often has more than one medical problem and a longer medication list. The emphasis is now directed towards a practical, clinical 6STEP instead of the more tutorial-directed 6STEPs in the preclinical phase. The format for information gathering in a 6STEP is used to perform the therapeutic consult of a patient and that can be practiced in a role play fashion.

Assessment of 6STEP writing skills during the rotations is done by feedback sessions with the supervisor, creation of a 6STEP portfolio and a pharmacotherapeutic exam.