The Prescribing Safety Assessment (PSA) stands as a pivotal milestone in the journey of medical professionals, serving as a crucial evaluation of their competence in prescribing medications safely and effectively. Since 2017, it has been a mandatory part of the medical education curriculum, ensuring that junior doctors are equipped with the necessary knowledge and skills to make informed and safe prescription decisions. 


Recent developments have placed the PSA under a spotlight, as the findings of the independent Dacre Review have shed new light on its structure, content, and overall impact. In this blog, we delve deeper into the Prescribing Safety Assessment, exploring its significance in medical education, and examine the key takeaways from the Dacre Review. 


Unearthing insights: Why the Dacre Review was commissioned


In 2022, the British Pharmacological Society and the Medical Schools Council jointly commissioned an extensive review of the PSA. The goal was to evaluate the exam’s effectiveness and determine its future direction. The review was overseen by top representatives from across the NHS and medical education programme in the UK, who under the chair of Professor Dame Jane Dacre, have proposed a set of recommendations for the exam. 


Headlines from the Review


The findings from the review can be boiled down to some key themes, we’ve summarised them below; 


Support for the Prescribing Safety Assessment 


The consensus among stakeholders and echoed by the oversight group is that there is widespread support for the PSA. Many understand that prescribing has changed and will continue to change with the introduction of new medications coupled with prescribing in an ageing population, giving rise to complex challenges which junior doctors need to be prepared for. This is where the exam not only presents an opportunity for students to assess their prescribing skills but also build their knowledge and confidence in prescribing before advancing in their careers. 


Impact of the Prescribing Safety Assessment  


The review not only focused on the exam’s effectiveness, but also considered its impact on both students and patients. The data suggests that the PSA is a robust tool for assessing prescribing competency and that since its implementation there has been little difference in the performance between medical schools and regions across the UK, an indication of its reliability.


Aside from the direct impact on students, there is evidence to suggest that the PSA also has had a positive effect on the safety of patients. Since the PSA was made mandatory in 2017, the percentage of medication-related patient safety incidents has reduced year-on-year.  


The Future of the Prescribing Safety Assessment  


The recommendations put forth by the Dacre Review mark a pivotal turning point for the future of the PSA. Among others, it highlights the need for sustained and equitable funding to ensure the PSA’s accessibility and continued improvement. As well as, better regulation and a more robust governance structure to enhance transparency and accountability, bringing together key stakeholders to guide its development and delivery. 


These recommendations collectively represent a promising vision for the PSA’s future, one that prioritises fairness, quality, and sustainability in assessing the prescribing competence of future healthcare professionals. The PSA is poised to evolve into a more effective and reliable assessment tool, forming an integral part of the medical education curriculum within the UK that is better equipped to prepare healthcare practitioners for the challenges of modern medicine.

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