Helpful if “Medication took up more space in the course!” – a mixed methods study about pharmacotherapeutic knowledge and digital quizzes for learning and assessment in the medical programme

BACKGROUND: Pharmacotherapy and prescribing are core skills for physicians, and all medical graduates must master the basics. From a medical education perspective, it is important to understand factors that help students attain sufficient skills for safe and effective prescribing. In this study, we evaluated autograded pharmacotherapeutic quizzes for practice and summative assessments in two undergraduate clinical courses and explored medical students' views on educational components they considered helpful in learning to treat patients with medications. METHODS: Pharmacotherapeutic quizzes were implemented in two steps across two course instances for two clinical courses (Psychiatry and Neurology, seventh semester in the medical programme at the University of Gothenburg, Gothenburg, Sweden). In step I, voluntary practice quizzes and a summative assessment test were introduced. In step II, clinical contexts for the quiz questions were provided, and the summative test was expanded. The students' achieved level of knowledge post-course was investigated before and after each step, using an anonymous voluntary knowledge evaluation test including 20 case-based single best answer (SBA) questions. Based on free-text replies to a concurrent questionnaire on students' views on learning pharmacotherapy, a manifest content analysis was performed, guided by the research question "What in their education do medical students consider important in enabling them to treat patients with medications?" Meaning units were extracted, and emergent categories and themes identified. RESULTS: In total, 274 out of 404 course participants took the knowledge evaluation test and completed the questionnaire (response rate: 68%; 56% women; 66% ≤24 years old). Compared with pre-quiz results (median correct answers out of 20 SBA questions = 10 (lower to upper quartile 9-13)), no difference was seen after step I (11 (8-13) correct answers; P = 0.88) but a clear improvement was seen after step II (14 (12-16); P < 0.0001). In the qualitative analysis, four themes emerged: Curriculum, Clinical placement, Theoretical teaching and Student responsibility. The second theme, including the categories Preparation, Participation and Performance, was particularly prominent. CONCLUSIONS: Elaborated quizzes about medications, for practice and summative assessment, may increase pharmacotherapeutic knowledge in medical students. The four emergent themes regarding what students consider important can guide future course developments.