"Hopefully, I will never forget that again" - sensitizing medical students for drug safety by working on cases and simulating doctor-patient communication.

Objective: This project is part of the "PJ-STArT-Block", a one-week course preparing 10th semester medical students for their final practical year. The focus is on sensitizing students to aspects of medication safety by becoming aware of their skills and their deficits in terms of application and communication of pharmacological knowledge. The modules were evaluated regarding feasibility, acceptance and possible effects. Furthermore, the areas in which students see their pharmacological deficits or learning successes were gathered. Methods: In simulated physician-patient conversations, the students are to identify drug-related problems such as medication errors, adverse drug events or interactions. Together with their fellow students and under medical or pharmaceutical moderation, they then have to find solutions for the identified problems and communicate these solutions to the patients. Based on paper cases, students practice, reflect, and discuss the research of reliable information about drugs and medication therapy. The written evaluation included the evaluation by school grades and the possibility of comments in free text. A content analysis of interviews with students at the beginning of the project aimed to identify areas of pharmacology in which they see their own deficits. Results: Evaluation results including the free text comments indicate students' acceptance of our pharmacology modules. According to this, the students realize the importance of aspects relevant for medication safety. The areas mentioned in 35 interviews in which students localize deficits, correspond to the topics that were intended when conceiving the modules and which are important for medication safety (e.g. interactions, adverse drug effects, dosages). Conclusion: Implementation of context-based, application-oriented teaching formats as recently claimed for pharmacological education to improve the quality of prescriptions, is possible, as the Cologne example shows. The student evaluation turns out positively and indicates a critical self-reflection. The students identified various pharmacological deficits in themselves, which have since been confirmed and quantified in another study.

Development of perceived pharmacological deficits of medical students and alumni supports claim for continuous and more application-oriented education.

Medical students' prescribing competencies are insufficient. So far, surveys focused on final-year students. Knowledge and confidence seem important, but their development during medical studies are unclear. This study investigated whether students perceived deficits in pharmacological knowledge change during medical studies. Alumni were included to look for changes occurring after graduation. Medical students at different stages of their studies were invited to fill in paper-and-pencil (6th-, 8th-, 9th- and 10th-term students) or online questionnaires (final-year students and alumni) regarding their self-assessed deficits in pharmacology. Questionnaires have been developed based on previous interviews with 10th-term students. We differentiated between declarative and application-oriented knowledge. In total, data from 816 participants could be analysed. Self-assessment regarding declarative knowledge changed during medical studies, being more sceptical in terms without pharmacology courses. Of note, self-assessment of application-oriented knowledge remained constantly low throughout, although our pharmacology courses use problem-based learning. Tenth-term students were most sceptical, perhaps influenced by an obligatory, formative, simulation-based, 1-week course, preparing students for their final practical year. Compared to students, alumni were significantly less sceptical regarding application-oriented knowledge. Students' self-assessment of deficits in pharmacological knowledge changes throughout their studies, presumably in association with pharmacology courses. Overall, students are rather sceptical, especially with regard to application-oriented knowledge. Our data further substantiate the European Association for Clinical Pharmacology and Therapeutics (EACPT) recommendations to improve pharmacology education throughout the entire medical curriculum, e.g. by providing more training in simulated and clinical environments.