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Aims: The United Kingdom (UK) Prescribing Safety Assessment (PSA) is a 2‐h online assessment of basic competence to prescribe and supervise the use of medicines. It has been undertaken by students and doctors in UK medical and foundation schools for the past decade. This study describes the academic characteristics and performance of the assessment; longitudinal performance of candidates and schools; stakeholder feedback; and surrogate markers of prescribing safety in UK healthcare practice. Methods: We reviewed the performance data generated by over 70 000 medical students and 3700 foundation doctors who have participated in the PSA since its inception in 2013. These data were supplemented by Likert scale and free text feedback from candidates and a variety of stakeholder groups. Further data on medication incidents, collected by national reporting systems and the regulatory body, are reported, with permission. Results: We demonstrate the feasibility, high quality and reliability of an online prescribing assessment, uniquely providing a measure of prescribing competence against a national standard. Over 90% of candidates pass the PSA on their first attempt, while a minority are identified for further training and assessment. The pass rate shows some variation between different institutions and between undergraduate and foundation cohorts. Most responders to a national survey agreed that the PSA is a useful instrument for assessing prescribing competence, and an independent review has recommended adding the PSA to the Medical Licensing Assessment. Surrogate markers suggest there has been improvement in prescribing safety in practice, temporally associated with the introduction of the PSA but other factors could be influential too. Conclusions: The PSA is a practical and cost‐effective way of delivering a reliable national assessment of prescribing competence that has educational impact and is supported by the majority of stakeholders. There is a need to develop national systems to identify and report prescribing errors and the harm they cause, enabling the impact of educational interventions to be measured. [ABSTRACT FROM AUTHOR]

Though a diverse array of teaching methods is now available, bedside teaching is arguably the most favoured. Students like it because it is patient-centred, and it includes a high proportion of relevant skills. It is on the decline, coinciding with declining clinical skills of junior doctors. Several factors might account for this: busier hospitals, broader roles of clinicians, competing teaching modalities, and the limited training of clinicians as medical educators. However, bedside teaching offers unique benefits. Students gain first-hand experience of the doctor patient relationship. They see the process of interacting with patients, investigative yet sensitive, demystified. Certain clinical skills, like the recognition of the tactile sensation of hepatosplenomegaly cannot be simulated elsewhere. We advocate the preservation of bedside learning experience. Teaching guidelines should be written to minimise disruption to ward work, and to ensure the preservation of patient autonomy. Greater emphasis should be placed on bedside skills in the undergraduate curriculum. For teachers, training in teaching methodology should begin at undergraduate level, with subsequent protected teaching time in job plans. This would increase not just the quantity, but also the quality of bedside teaching.

Authors felt the opportunity to use the PSA platform for local teaching would make the PSA relevant to all years of the medical school, not only those in final year. Lastly, aligning the PSA governance models with other national assessments, such as the MLA, will ensure that assessment has active oversight and robust quality assurance methods moving forward. The Prescribing Safety Assessment (PSA) is a high-stakes exam sat by approximately 8000 final-year UK medical students each year.[1] All doctors joining the NHS in foundation year 1 (FY1) are required to pass this assessment to progress through to their second year of foundation training.[2] The PSA has been a very successful initiative; since being first piloted in 2012, it has been adopted by every UK medical school, won awards, and attracted attention internationally. [Extracted from the article]