Study On Education To Promote Medical Students' Prescribing Behavior Of Rational Drug Use

Objectives:The study is to evaluate medical students' rational drug use knowledge, awareness and behavior levels in specific stage, to evaluate medical students' prescribing behavior effects induced by patients expectations and their response to patients expectations and to evaluate the effect of rational drug use propaganda intervention on them, also to establish the corresponding theoretical model. Thereby,to explore viable and effective suggestions and strategies to improve the medical students' ability on rational drug use and correctly facing the patients expectations.Methods:The method in the study includes:literature research, which means primarily gathering related information about this study and then sort and aggregate them according to the nature of. Expert consultation, which is to consult experts intervention design, contents of promotional materials and investigation item in questionnaire. Field intervention method (quasi-experimental method), which means selecting 300 4-Semester undergraduate students who major in five-year clinical medicine first, and then dividing them randomly into three groups and use experts lectures intervention, group discussions intervention and comprehensive intervention to each group respectively. Field investigation,which means investigating to the students by the designed questionnaire one week before the intervention, one to two weeks after the intervention and three months after the intervention respectively.Results and conclusions:The level of medical students' rational drug use knowledge is worried, the level of awareness in rational drug use is general,the level of rational drug use behavior is general and patient expectations' impact on the prescribing behavior is general, medical students are open to patient expectations, accept neither more nor less and explain very much.As far as the interventions to improve the rational use of medical students knowledge of rational drug use, they are valid regardless of the long term or short term. In the short term, part intervention is better than full intervention, in the long term, full intervention is better than part intervention. There are no differences between expert lecture and problem-group discussion, which are also better than comprehensive intervention in the short term, there is no differences between comprehensive Intervention and problem-based group discussion, which are also better than expert lecture in the long term.As far as the interventions to improve the level of medical students'awareness of rational drug use, each method has some effect, but no one is very good. Part intervention is better than full intervention but not so significant in the short and long term, problem-based group discussion and comprehensive intervention are better than expert lecture intervention, in which their difference is not significant in the short and long termAs far as the interventions to improve the level of medical students'behavior rational of drug use, each method has some effect, but no one is very good. In the short term, there is no difference full and partial intervention, in the long term, full intervention is better than part intervention, in the short term, experts lecture is better than the problem-group discussion and comprehensive intervention, problem-group discussion and comprehensive intervention made no difference for the effect; in the long term, expert lecture is better than the problem-group discussion and comprehensive intervention, comprehensive intervention is better than problem-group discussion.As far as the interventions to reduce the impact of patient expectations to medical students' prescribing behavior, each method has some effect, but none is very good. There is no difference between full intervention and part intervention in the short term. Part intervention is more effective in reducing the impact from patient expectations in the long term. In reducing the impact from patient expectations, the methods from good to bad is as follows:problem-group discussion method, comprehensive intervention and expert lecture.As far as the interventions to improve the level of medical students'response to patient expectations, each method has some effect, but no one is very good. There is no difference between full intervention and part intervention in the short term but in the long term full intervention is better. The Effect of the methods from good to bad is as follows:expert lecture, comprehensive intervention and problem-group discussion in the short term and the long term.The score of medical students' rational drug use knowledge correlates to the investigation stage, educational intervention, gender, family income assessment and evaluation of practice prescribing frequency positively and at the same time correlates to intervention group and the quality evaluation of their instructor's practice guide negatively. The score of medical students'rational drug use behavior correlates to the investigation stage, educational intervention, student's area, the family whether to participate in urban workers medical insurance or not, the family whether to participate in commercial health insurance or not, self-assessment of health status, the frequency evaluation of instructor's practice guidance, academic quality evaluation of internship instructor guide and medical course positively, also correlates to intervention groups, family health insurance category and rational drug use of knowledge score negatively. Patient expectations impact on medical students' prescribing behavior correlates to educational intervention, student's area, the family whether to participate in free medical care or not, the family whether to participate in medical insurance for urban workers not, the evaluation of frequency to hospital, score of rational drug use knowledge, score of awareness of rational drug use behavior and score of behavior of rational drug use positively, also correlates to intervention group, family health insurance type and number of family members with medical background negatively. The score of medical students' response to patient expectations correlates to educational intervention, assessment of family income, family whether to participate in medical insurance for urban workers or not, medical courses' assessment and score of rational drug use behavior, also correlates to intervention group and the frequency to hospital.The model about the relation between medical students' rational drug use knowledge and awareness is:Y=2.799+0.346 X-0.043X2+0.002X3,The model about the relation between medical students' rational drug use knowledge and behavior is Y=3.052-0.169X+0.020X2-0.001X3' The model about the relation between medical students'rational drug use awareness and behavior is Y=0.227+1.490 X-0.220X2。Suggestions:Strengthening medical students'rational drug use knowledge, including establishing rational drug use knowledge curriculum, reasonable arrangements for rational use of knowledge in medical education and attaching importance to evaluation of rational drug use courses. Besides this, we must attach importance to bring up students'awareness of rational drug use, including developing rational drug awareness education programs throughout the higher medical education, putting drug awareness education throughout the construction of the campus culture and putting training of rational use of drug awareness as an important target of clinical practice. Also, medical students'rational drug use behavior should be reinforced, which includes correcting medication practice behavior of doctors at frist, improving the level of practice teachers' rational use drug, strengthening the guidance of rational drug use behavior to medical students' in clinical practice. The rest, strengthening the guidance about medical students' correctly handling the patient expectations need in treatment, including putting clinical practice in a more important location, giving more opportunity to students to contact with patients and strengthening guidance to students about dealing with patient expectationsInnovations and limits:The innovations of this study is as follows:Firstly,the intervention objects selected is a breakthrough and evaluate the level of medical students' rational drug use knowledge, awareness and behavior quantitatively, which is of great significance for our higher medical education. Secondly, this study give qualitative analysis of impact about doctors' prescribing behavior from patient expectations and doctor's response to patient expectations from the perspective of health services supply, which is of great significance. Thirdly, this study made a systematic and comprehensive comparison on effect of different educational interventions designed, which can give reference to related study of educational intervention later on. The corresponding theoretical model by multiple linear regression and curving estimation has important applications and academic values. Surely, this study has some limits, such as there is a gap between designed intervention programs and its implement. Besides this, the analysis on doctors prescribing behavior from patient expectations' impact and doctors'response to it, is just from the perspective of health services supply, not from the perspective of health services demand, which is not comprehensive enough.