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The Feasibility and Quality of the European Prescribing Exam: An International Multicenter Pilot Study Among 3109 Medical Students From 16 Medical Schools

Title: The Feasibility and Quality of the European Prescribing Exam: An International Multicenter Pilot Study Among 3109 Medical Students From 16 Medical Schools
Authors: Donker, Erik M; Piët, Joost D; 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
Contributors: Erasmus+ consortium EuroPE+ and the EACPT Education Working Group; Sanz, Emilio; Sans, Carla; van Leeuwen, Ellen; Chtioui, Haithem; Costa, Joao; Rychlickova, Jitka; Dima, Lorena; Maciulaitis, Romaldas; Labriffe, Marc; Tamba, Bogdan; van Agtmael, Michiel; Donker, Erik
Publication Year: 2026
Collection: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Subject Terms: Pilot Projects; Humans; Europe; Students; Medical; statistics & numerical data; Clinical Competence; standards; Educational Measurement; methods; Schools; Feasibility Studies; Curriculum; Reproducibility of Results; Pharmacology; Clinical; education; Drug Prescriptions; Undergraduate
Description: The WHO Global Patient Safety Challenge "Medication Without Harm" emphasizes the need to improve doctors' prescribing competence. Junior doctors are particularly at risk of prescribing errors due to inadequate training. To address this, the European Prescribing Exam was developed to standardize and improve clinical pharmacology and therapeutics (CPT) education across Europe. This study describes the development and quality analysis of the first two pilot examinations. Based on European consensus studies and the Dutch National Pharmacotherapy Assessment, an assessment blueprint was developed. Two pilot examinations, each with 36 knowledge-based and 11 skills-based questions, were administered between 2020 and 2023 at 16 medical schools in 11 countries. We assessed exam quality through reliability (standard error of measurement, Cronbach's alpha, item-rest correlations (R ir -value), difficulty index (DI)), and content validity (content validity ratio's (CVR)). Questions with a negative R ir or CVR, or DI < 0.44 were flagged as potential lower quality. In addition, students' scores (% of maximum) and differences between schools and curricula were evaluated. A total of 3109 students participated (Examination 1: 1371; Examination 2: 1745). Most questions were of high quality; 20/94 (21.3%) were flagged. Median scores on the examinations were 66.2% (IQR 55.4-74.3) and 58.9% (IQR 52.1-65.8) for pilot 1 and 2, respectively. Students from schools with problem-based learning or a national prescribing examination scored significantly higher (P < 0.001). In conclusion, this study demonstrates the feasibility of a standardized European Prescribing Exam. However, the wide variation and generally low median scores highlight the need to improve and harmonize CPT education across Europe. © 2025 The Author(s). Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 0009-9236; 40955478
Relation: International Journal of Clinical Pharmacology and Therapeutics; https://iris.unil.ch/handle/iris/279574; 001573268400001
DOI: 10.1002/cpt.70063
Availability: https://iris.unil.ch/handle/iris/279574; https://doi.org/10.1002/cpt.70063
Accession Number: edsbas.47D9751
Database: BASE