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Context Conflicts of interest (CoIs) are considered to be ubiquitous in health care and biomedicine. The disclosure of relevant interests is a first step in managing conflicts, although its usefulness is contested. Although several countries have mandated the public disclosure of doctors' financial relationships with the pharmaceutical industry, little is known about medical students' understanding of mandatory public disclosure. Methods Six 90-minute focus groups were conducted with medical students in New South Wales, Australia. Participants ranged from first- to final-year students. Students were asked about their understanding and experiences of CoIs and, more specifically, for their views on and experiences of disclosure in medical education, mandatory disclosure and public registers. Qualitative data analysis was based on a framework approach. Results Participants were generally not supportive of mandatory public disclosure of financial relationships with industry, principally because of concerns about privacy, control over disclosure, and others' (mis)interpretations of disclosures. Further, they did not know how to assess the disclosures presented to them as part of their medical education and described a wide range of reactions to disclosed information. Conclusions This study suggests that students are currently not well prepared for mandatory public disclosure of CoIs. The subsequent discussion draws on Bourdieu's doxa to highlight assumptions of altruism in medicine, assumptions that are potentially in tension with recent events that have exposed doctors to moral scrutiny by the public. Medical students could be better prepared for future obligations by encouraging disclosures, and contextualising and helping students to interpret them. Disclosure as a box-ticking exercise is unlikely to achieve goals implied by transparency, but a more reflective approach may assist both scrutinisers and the scrutinised. [ABSTRACT FROM AUTHOR]

Conflicts of interest ( COI) are considered ubiquitous in many healthcare arrangements,1 but there is disagreement on how COI should be defined, whether non-financial conflicts deserve attention and the relationship between COI and harm. We conducted a study of Australian healthcare professionals and students to gain a better understanding of the way that COI are understood in practice. In this paper, we outline an empirically derived taxonomy of the understanding of, and attitudes towards, COI. We carried out 25 semistructured interviews with clinicians working in several fields across Australia and held six focus group discussions with medical students in New South Wales. Interviewees and focus groups followed similar question routes investigating participants' understanding of COI and views of management. All data were compared and analysed using a matrix of pre-determined questions. There were, broadly, two views of COI: that COI were potentially harmful and morally compromising and another that saw COI as less serious and easily managed through existing structures. Definitions of COI varied widely and were both financial and non-financial. Causes of COI were, variously, systemic, individual and/or relational. Some participants associated COI with moral wrongdoing, and a variety of potential harms was identified. Views on how COI should be managed were similarly varied. We found considerable heterogeneity in how COI are understood in practice. This has implications for management systems that are currently in place, and we suggest a more sophisticated system for considering and mitigating COI. [ABSTRACT FROM AUTHOR]

Background UK medical students' confidence in their prescribing skills is low, and a significant proportion of prescriptions written by foundation year 1 (FY1) doctors contain errors. The Prescribing Safety Assessment ( PSA) is a new national examination aimed at ensuring prescribing competence in undergraduates, but few PSA-specific preparatory resources are available to students. Methods A needs analysis was performed and an online e-tutorial (Prepare for the PSA) was designed. The e-tutorial consists mainly of a practise exam that closely mirrors the format of the PSA itself. After completing each question the user receives personalised feedback, and is given the opportunity to further their knowledge using interactive learning activities. A facility for users to contribute their own questions is included, and the e-tutorial also explains the rationale underlying the PSA and directs users to further learning resources. Numerous attempts were made to encourage the use of the e-tutorial amongst UK medical students and educators. A total of 248 final-year students at a UK medical school were asked to evaluate the e-tutorial and rate their prescribing confidence before and after completing it. Results The response rate in the evaluation was 72.7-73.9 per cent. The results show that completing the e-tutorial is associated with highly significant (p < 0.0001) increases in confidence across all prescribing skills. Discussion Our e-tutorial is effective and meets the needs of medical students. Once the e-tutorial is disseminated more widely and is expanded by user-contributed questions, we hope that it will become established as a national platform for collaborative prescribing education. [ABSTRACT FROM AUTHOR]