Study On Participatory Training Promoting Rational Use Of Drug Among The Medical Students

ObjectivesBased on the result analysis of the practice of participatory training promoting rational use of drugs both at home and abroad, the study aimed at:To evaluate the effect of the drug use among the medical students.To discuss the soundness of the related theories that support the intervention strategy of participatory training activities implemented to enhance the rational use of drugs.To make suggestion and provide theoretical support to the promotion of the intervention strategy of participatory training activities aiming to enhance the rational use of drugs.Content1. The study of the practice of participatory training both at home and aboard aiming at promoting rational use of drug. 2. Theoretical study of participatory training aiming at promoting rational use of drug. 3. The study of the practice of intervention participatory training designed to increase the rational use of drugs among the medical students.Methods1. Literature review: Summarizing the theories and intervention experience both at home and aboard of participatory training promoting rational use of drug.2. DELPHI: by inviting expert commenting the design of the intervention study and questionnaires, the feasibility and rightness of the study was ensured.3. The strategy on carrying out the intervention study (1) Objects: Sophomores and juniors majoring in clinical medicine, pharmacology and preventive medicine were selected.(2) Intervention plan: Two methods, participatory training and common training, were carried out. The process study was divided into three periods: first, by free bidding of the mini research to the students, the students who directly participated in the mini study of rational use of drugs were determined. Then, the determined students were assisted to finish the mini research about the RUD. The result would be summarized and discussed. At last, the direct participants would be guided to execute intervention of RUD on the behavior of the experimental group.(3) Data collection and analysis: A questionnaire survey was adopted to evaluate the intervention effects. Objects were chosen by random sampling. 119 students were randomly sampled at the baseline survey. According to the baseline condition, 38 students in participatory mode and 59 students in common mode were randomly surveyed at the ending of the participatory training. 45 students in participatory mode and 62 students in common mode were randomly surveyed one month after the ending of the participatory training.Descriptive statistics method was used in describing the knowledge, attitude, practice of the RUD of the objects, the score difference in the knowledge between the participatory mode and the common mode at the same period were tested by two independent t-test, the difference among all the three periods of each of them were tested by variance analysis.For the indicators of attitude and practice, the score difference between the participatory mode and the common mode at the same period were tested by Wilcoxon rank sum t-test, the difference among all the three periods of each of them were tested by H-test.Results and ConclusionsBefore and after the intervention, the questionnaire surveys were carried out to evaluate the effect of the intervention. The results show that:In the aspect of the knowledge of RUD, before the intervention, the mean score of the participatory mode and the common mode were 15.48 and 14.79, indicating no significant difference between them(t=1.653,P=0.102). At the ending of the intervention, the mean score of the participatory mode and the common mode, were 15.91 and 15.76, indicating no significant difference between them(t=0.466,P=0.642). However, one month after the ending of the intervention, the mean score of the two modes were 16.06 and 15.07, demonstrating significant difference between them(t=2.102,P=0.038). It showed that: In the aspect of the knowledge of RUD, intervention effect of the participatory mode would last longer than the common mode.In the aspect of the attitude of RUD, no significant difference was found between the participatory mode and the common mode at the ending of the intervention. But one month after the ending of the intervention, there was significant difference between the participatory mode and the common mode at the item A17"the effect could be absolutely different with difference of one word", which was about the hazard of the drug (Z=2.036, P=0.042) and item A25"If some drug can be oral, you had better not take them by injection", which was about the taking-method (Z=2.531, P=0.011). No significant differences were found in all the other items. The result revealled the fact that: Comparing to the common mode, the awareness of the drug hazard and the taking-method of the participatory mode had improved after the intervention.In the aspect of the practice of RUD, there was no significant difference between the participatory mode and the common mode before and at the ending of the intervention. But one month after the ending of the intervention, there was significant difference between the participatory mode and the common mode at the item P35"If someone point out that your irrational use of drug, are you willing to accept?"which concerned the will of accepting the others'advice of RUD (Z=2.560, P=0.010). It can be concluded from the result that: after the intervention, the medical students taking the participatory training were more willing to accept the others'advice of RUD.Generally speaking, participatory training method showed edges over the common training method in training outcome. The difference in training outcome was substantial after a long period, especially in the aspect of the knowledge of RUD. Also, there was significant change in certain aspects of the attitude and practice of RUD, such as the awareness of the drug hazard, accepting the others'advice of RUD.Suggestions 1. Adding the RUD education to the current course system.The study found that the awareness, attitude and behavior of the RUD of medical students had fallen well below the requirements of the RUD. The blame was taken primary on the lacking of the RUD courses in the curriculum portfolios.Also, without a sustainable and institutionalized education plan of the RUD, it was unlikely to obtain the major goals such as boost the knowledge, increase the awareness and better the behavior of the RUD.2. Deepening the practice and study of the participatory training on the RUD:(1) Using the intervention experience of relevant aspect for reference to boost the use of the participatory training.(2) Enlarging the range of the intervention, especially strengthen the intervention on the demander of the health service.(3) Further the discussions of the key influencing factors in the research circumstances.(4) Rigorously designed research method.(5) Enhancing the promotion of the achievement obtained in participatory training and ensuring the outcome with related measures.Innovations in this Study1. Having introduced a new training method, the participatory training in the RUD education. 2. The study focused on particular demanders of the health service (the medical students), who are likely to be the health service providers in the future. The intervention has helped them establish the concept of RUD during the period of the medicine education. The great effect will gradually take place as they become health service personnel.However, some drawback was unavoidable in the study: the experiment lasted only 1.5 months, not long enough to observe the full attitude and behavior transitions of the participants. Besides, some item concerning in the questionnaire may not be easy to detect.