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  1. Article ; Online: Bridging the gap between clinical pharmacology and rational drug prescribing 2.0: An up-date after 30 years.

    Donker, Erik M / Bakkum, Michiel J / Richir, Milan C / Tichelaar, Jelle

    British journal of clinical pharmacology

    2024  

    Language English
    Publishing date 2024-03-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.16051
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  2. Article ; Online: Using artificial intelligence to create diverse and inclusive medical case vignettes for education.

    Bakkum, Michiel J / Hartjes, Mariëlle G / Piët, Joost D / Donker, Erik M / Likic, Robert / Sanz, Emilio / de Ponti, Fabrizio / Verdonk, Petra / Richir, Milan C / van Agtmael, Michiel A / Tichelaar, Jelle

    British journal of clinical pharmacology

    2024  Volume 90, Issue 3, Page(s) 640–648

    Abstract: Aims: Medical case vignettes play a crucial role in medical education, yet they often fail to authentically represent diverse patients. Moreover, these vignettes tend to oversimplify the complex relationship between patient characteristics and medical ... ...

    Abstract Aims: Medical case vignettes play a crucial role in medical education, yet they often fail to authentically represent diverse patients. Moreover, these vignettes tend to oversimplify the complex relationship between patient characteristics and medical conditions, leading to biased and potentially harmful perspectives among students. Displaying aspects of patient diversity, such as ethnicity, in written cases proves challenging. Additionally, creating these cases places a significant burden on teachers in terms of labour and time. Our objective is to explore the potential of artificial intelligence (AI)-assisted computer-generated clinical cases to expedite case creation and enhance diversity, along with AI-generated patient photographs for more lifelike portrayal.
    Methods: In this study, we employed ChatGPT (OpenAI, GPT 3.5) to develop diverse and inclusive medical case vignettes. We evaluated various approaches and identified a set of eight consecutive prompts that can be readily customized to accommodate local contexts and specific assignments. To enhance visual representation, we utilized Adobe Firefly beta for image generation.
    Results: Using the described prompts, we consistently generated cases for various assignments, producing sets of 30 cases at a time. We ensured the inclusion of mandatory checks and formatting, completing the process within approximately 60 min per set.
    Conclusions: Our approach significantly accelerated case creation and improved diversity, although prioritizing maximum diversity compromised representativeness to some extent. While the optimized prompts are easily reusable, the process itself demands computer skills not all educators possess. To address this, we aim to share all created patients as open educational resources, empowering educators to create cases independently.
    MeSH term(s) Humans ; Artificial Intelligence ; Education, Medical ; Ethnicity
    Language English
    Publishing date 2024-01-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15977
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  3. Article ; Online: Educational value of international and intercultural differences in prescribing: the international and interprofessional student-run clinic project.

    Bakkum, Michiel J / Donker, Erik M / Spitaleri Timpone, Pietro / Hagen, Charlotte A M / Richir, Milan C / van Agtmael, Michiel A / De Ponti, Fabrizio / Tichelaar, Jelle

    European journal of clinical pharmacology

    2023  Volume 79, Issue 4, Page(s) 571–574

    MeSH term(s) Humans ; Interprofessional Relations ; Students, Health Occupations ; Student Run Clinic ; Cooperative Behavior
    Language English
    Publishing date 2023-02-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 121960-1
    ISSN 1432-1041 ; 0031-6970
    ISSN (online) 1432-1041
    ISSN 0031-6970
    DOI 10.1007/s00228-023-03465-9
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  4. Article ; Online: The European List of Key Medicines for Medical Education: A Modified Delphi Study.

    Donker, Erik M / Spitaleri Timpone, Pietro / Brinkman, David J / Richir, Milan C / Papaioannidou, Paraskevi / Likic, Robert / Sanz, Emilio J / Christiaens, Thierry / Costa, João N / De Ponti, Fabrizio / Gatti, Milo / Böttiger, Ylva / Kramers, Cornelis / Pandit, Rahul / van Agtmael, Michiel A / Tichelaar, Jelle

    Clinical pharmacology and therapeutics

    2023  Volume 115, Issue 3, Page(s) 515–524

    Abstract: Rational prescribing is essential for the quality of health care. However, many final-year medical students and junior doctors lack prescribing competence to perform this task. The availability of a list of medicines that a junior doctor working in ... ...

    Abstract Rational prescribing is essential for the quality of health care. However, many final-year medical students and junior doctors lack prescribing competence to perform this task. The availability of a list of medicines that a junior doctor working in Europe should be able to independently prescribe safely and effectively without supervision could support and harmonize teaching and training in clinical pharmacology and therapeutics (CPT) in Europe. Therefore, our aim was to achieve consensus on such a list of medicines that are widely accessible in Europe. For this, we used a modified Delphi study method consisting of three parts. In part one, we created an initial list based on a literature search. In part two, a group of 64 coordinators in CPT education, selected via the Network of Teachers in Pharmacotherapy of the European Association for Clinical Pharmacology and Therapeutics, evaluated the accessibility of each medicine in his or her country, and provided a diverse group of experts willing to participate in the Delphi part. In part three, 463 experts from 24 European countries were invited to participate in a 2-round Delphi study. In total, 187 experts (40%) from 24 countries completed both rounds and evaluated 416 medicines, 98 of which were included in the final list. The top three Anatomical Therapeutic Chemical code groups were (1) cardiovascular system (n = 23), (2) anti-infective (n = 21), and (3) musculoskeletal system (n = 11). This European List of Key Medicines for Medical Education could be a starting point for country-specific lists and could be used for the training and assessment of CPT.
    MeSH term(s) Humans ; Female ; Male ; Delphi Technique ; Education, Medical ; Europe ; Curriculum ; Educational Status ; Clinical Competence
    Language English
    Publishing date 2023-12-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 123793-7
    ISSN 1532-6535 ; 0009-9236
    ISSN (online) 1532-6535
    ISSN 0009-9236
    DOI 10.1002/cpt.3132
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  5. Article ; Online: Estimation of glomerular filtration rate for drug dosing in patients with very high or low body mass index.

    Donker, Erik M / Bet, Pierre / Nurmohamed, Azam / Serné, Erik / Burchell, George Louis / Friedman, Allon N / Bouquegneau, Antoine / Lemoine, Sandrine / Ebert, Natalie / Cirillo, Massimo / van Agtmael, Michiel A / Bartelink, Imke H

    Clinical and translational science

    2022  Volume 15, Issue 9, Page(s) 2206–2217

    Abstract: An accurate estimated glomerular filtration rate (eGFR) is essential in drug dosing. This study demonstrates the limitations of indexed (ml/min/1.73 ... ...

    Abstract An accurate estimated glomerular filtration rate (eGFR) is essential in drug dosing. This study demonstrates the limitations of indexed (ml/min/1.73 m
    MeSH term(s) Body Mass Index ; Creatinine ; Glomerular Filtration Rate ; Humans ; Obesity/complications ; Obesity/diagnosis ; Renal Insufficiency, Chronic/diagnosis ; Thinness/diagnosis
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2022-07-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2433157-0
    ISSN 1752-8062 ; 1752-8054
    ISSN (online) 1752-8062
    ISSN 1752-8054
    DOI 10.1111/cts.13354
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  6. Article ; Online: The European Prescribing Exam: assessing whether European medical students can prescribe rationally and safely.

    Donker, Erik M / Brinkman, David J / Richir, Milan C / Papaioannidou, Paraskevi / Likic, Robert / Sanz, Emilio J / Christiaens, Thierry / Costa, João N / De Ponti, Fabrizio / Böttiger, Ylva / Kramers, Cornelis / van Agtmael, Michiel A / Tichelaar, Jelle

    European journal of clinical pharmacology

    2022  Volume 78, Issue 6, Page(s) 1049–1051

    MeSH term(s) Clinical Competence ; Education, Medical, Undergraduate ; Humans ; Students, Medical
    Language English
    Publishing date 2022-03-03
    Publishing country Germany
    Document type Letter
    ZDB-ID 121960-1
    ISSN 1432-1041 ; 0031-6970
    ISSN (online) 1432-1041
    ISSN 0031-6970
    DOI 10.1007/s00228-022-03301-6
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  7. Article ; Online: The Dutch list of essential drugs for undergraduate medical education: A modified Delphi study.

    Donker, Erik M / Pandit, Rahul / Poleij, Merel C S / Brinkman, David J / van Agtmael, Michiel A / van Rosse, Floor / Dumont, Glenn / Kramers, Cornelis / Atiqi, Roya / Richir, Milan C / van Smeden, Jeroen / Hessel, Marleen H M / Janssen, Ben J / Knol, Wilma / Tichelaar, Jelle

    British journal of clinical pharmacology

    2022  Volume 89, Issue 4, Page(s) 1431–1451

    Abstract: Aims: Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate ... ...

    Abstract Aims: Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate medical curriculum. To support CP&T education, it is important to determine which drugs medical undergraduates should be able to prescribe safely and effectively without direct supervision by the time they graduate. Currently, there is no such list with broad-based consensus. Therefore, the aim was to reach consensus on a list of essential drugs for undergraduate medical education in the Netherlands.
    Methods: A two-round modified Delphi study was conducted among pharmacists, medical specialists, junior doctors and pharmacotherapy teachers from all eight Dutch academic hospitals. Participants were asked to indicate whether it was essential that medical graduates could prescribe specific drugs included on a preliminary list. Drugs for which ≥80% of all respondents agreed or strongly agreed were included in the final list.
    Results: In all, 42 (65%) participants completed the two Delphi rounds. A total of 132 drugs (39%) from the preliminary list and two (3%) newly proposed drugs were included.
    Conclusions: This is the first Delphi consensus study to identify the drugs that Dutch junior doctors should be able to prescribe safely and effectively without direct supervision. This list can be used to harmonize and support the teaching and assessment of CP&T. Moreover, this study shows that a Delphi method is suitable to reach consensus on such a list, and could be used for a European list.
    MeSH term(s) Humans ; Education, Medical, Undergraduate/methods ; Drugs, Essential ; Delphi Technique ; Clinical Competence ; Curriculum
    Chemical Substances Drugs, Essential
    Language English
    Publishing date 2022-12-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15606
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  8. Article ; Online: The impact of a summative national prescribing assessment and curriculum type on the development of the prescribing competence of junior doctors.

    Donker, Erik M / Osmani, Hayaudin / Brinkman, David J / van Rosse, Floor / Janssen, Ben / Knol, Wilma / Dumont, Glenn / Jorens, Philippe G / Dupont, Alain / Christiaens, Thierry / van Smeden, Jeroen / de Waard-Siebinga, Itte / Peeters, Laura E J / Goorden, Ronald / Hessel, Marleen / Lissenberg-Witte, Birgit I / Richir, Milan C / van Agtmael, Michiel A / Kramers, Cornelis /
    Tichelaar, Jelle

    European journal of clinical pharmacology

    2023  Volume 79, Issue 12, Page(s) 1613–1621

    Abstract: Purpose: The primary aim of this study was to investigate the effect of including the Dutch National Pharmacotherapy Assessment (DNPA) in the medical curriculum on the level and development of prescribing knowledge and skills of junior doctors. The ... ...

    Abstract Purpose: The primary aim of this study was to investigate the effect of including the Dutch National Pharmacotherapy Assessment (DNPA) in the medical curriculum on the level and development of prescribing knowledge and skills of junior doctors. The secondary aim was to evaluate the relationship between the curriculum type and the prescribing competence of junior doctors.
    Methods: We re-analysed the data of a longitudinal study conducted in 2016 involving recently graduated junior doctors from 11 medical schools across the Netherlands and Belgium. Participants completed three assessments during the first year after graduation (around graduation (+ / - 4 weeks), and 6 months, and 1 year after graduation), each of which contained 35 multiple choice questions (MCQs) assessing knowledge and three clinical case scenarios assessing skills. Only one medical school used the DNPA in its medical curriculum; the other medical schools used conventional means to assess prescribing knowledge and skills. Five medical schools were classified as providing solely theoretical clinical pharmacology and therapeutics (CPT) education; the others provided both theoretical and practical CPT education (mixed curriculum).
    Results: Of the 1584 invited junior doctors, 556 (35.1%) participated, 326 (58.6%) completed the MCQs and 325 (58.5%) the clinical case scenarios in all three assessments. Junior doctors whose medical curriculum included the DNPA had higher knowledge scores than other junior doctors (76.7% [SD 12.5] vs. 67.8% [SD 12.6], 81.8% [SD 11.1] vs. 76.1% [SD 11.1], 77.0% [12.1] vs. 70.6% [SD 14.0], p < 0.05 for all three assessments, respectively). There was no difference in skills scores at the moment of graduation (p = 0.110), but after 6 and 12 months junior doctors whose medical curriculum included the DNPA had higher skills scores (both p < 0.001). Junior doctors educated with a mixed curriculum had significantly higher scores for both knowledge and skills than did junior doctors educated with a theoretical curriculum (p < 0.05 in all assessments).
    Conclusion: Our findings suggest that the inclusion of the knowledge focused DNPA in the medical curriculum improves the prescribing knowledge, but not the skills, of junior doctors at the moment of graduation. However, after 6 and 12 months, both the knowledge and skills were higher in the junior doctors whose medical curriculum included the DNPA. A curriculum that provides both theoretical and practical education seems to improve both prescribing knowledge and skills relative to a solely theoretical curriculum.
    MeSH term(s) Humans ; Longitudinal Studies ; Curriculum ; Education, Medical ; Netherlands ; Medical Staff, Hospital/education ; Clinical Competence
    Language English
    Publishing date 2023-09-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 121960-1
    ISSN 1432-1041 ; 0031-6970
    ISSN (online) 1432-1041
    ISSN 0031-6970
    DOI 10.1007/s00228-023-03567-4
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  9. Article ; Online: Do we become better prescribers after graduation: A 1-year international follow-up study among junior doctors.

    Donker, Erik M / Brinkman, David J / van Rosse, Floor / Janssen, Ben / Knol, Wilma / Dumont, Glenn / Jorens, Philippe G / Dupont, Alain / Christiaens, Thierry / van Smeden, Jeroen / de Waard-Siebinga, Itte / Peeters, Laura E J / Goorden, Ronald / Hessel, Marleen / Lissenberg-Witte, Birgit / Richir, Milan / van Agtmael, Michiel A / Kramers, Cornelis / Tichelaar, Jelle

    British journal of clinical pharmacology

    2022  Volume 88, Issue 12, Page(s) 5218–5226

    Abstract: Aim: The aim of this study was to investigate how the prescribing knowledge and skills of junior doctors in the Netherlands and Belgium develop in the year after graduation. We also analysed differences in knowledge and skills between surgical and ... ...

    Abstract Aim: The aim of this study was to investigate how the prescribing knowledge and skills of junior doctors in the Netherlands and Belgium develop in the year after graduation. We also analysed differences in knowledge and skills between surgical and nonsurgical junior doctors.
    Methods: This international, multicentre (n = 11), longitudinal study analysed the learning curves of junior doctors working in various specialties via three validated assessments at about the time of graduation, and 6 months and 1 year after graduation. Each assessment contained 35 multiple choice questions (MCQs) on medication safety (passing grade ≥85%) and three clinical scenarios.
    Results: In total, 556 junior doctors participated, 326 (58.6%) of whom completed the MCQs and 325 (58.5%) the clinical case scenarios of all three assessments. Mean prescribing knowledge was stable in the year after graduation, with 69% (SD 13) correctly answering questions at assessment 1 and 71% (SD 14) at assessment 3, whereas prescribing skills decreased: 63% of treatment plans were considered adequate at assessment 1 but only 40% at assessment 3 (P < .001). While nonsurgical doctors had similar learning curves for knowledge and skills as surgical doctors (P = .53 and P = .56 respectively), their overall level was higher at all three assessments (all P < .05).
    Conclusion: These results show that junior doctors' prescribing knowledge and skills did not improve while they were working in clinical practice. Moreover, their level was under the predefined passing grade. As this might adversely affect patient safety, educational interventions should be introduced to improve the prescribing competence of junior doctors.
    MeSH term(s) Humans ; Clinical Competence/statistics & numerical data ; Follow-Up Studies ; Longitudinal Studies ; Medical Staff, Hospital ; Practice Patterns, Physicians'
    Language English
    Publishing date 2022-07-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15443
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