Teaching Rational Prescribing in Medical Education: Knowledge, Attitude and Practice of Pharmacology and Community Medicine Among Final-Year MBBS Students in Karachi

Abstract

Background: Rational prescribing is a fundamental clinical competency that ensures the safe, effective, and economical use of medicines. Prescribing knowledge, attitudes and clinical decision-making skills are important areas of undergraduate medical education. Pharmacology and Community Medicine help in understanding the choice of proper drugs, patient safety and rational use of drugs.

Objective: To assess knowledge, attitudes, and practices regarding rational prescribing among final-year MBBS students in Karachi and examine their association with previous educational exposure to Pharmacology and Community Medicine.

Materials and Methods: A cross sectional descriptive study was done on 151 students from the final year MBBS in Karachi from January 2023 to June 2023. The structured questionnaire was used to measure the knowledge of rational prescribing, attitudes towards medicine use, self-reported prescribing practices and demographic characteristics. The assessment of knowledge was carried out with 10 questions and 5-point Likert scales were used for the assessment of attitudes and practices. In the proposed analytical framework descriptive statistics, group comparisons and Spearmann correlation analyses were used, and the statistical significance was set at p<0,05.

Results: Among 151 students, the mean age was 23.65 ± 1.23 years, and 61.6% were female. Good knowledge of rational prescribing was demonstrated by 27.2%, while 46.4% had moderate knowledge and 26.5% had poor knowledge. Positive attitudes were observed in 26.5%, neutral attitudes in 60.9%, and negative attitudes in 12.6%. Good prescribing practices were identified in 7.3%, fair practices in 37.1%, and poor practices in 55.6%. Previous rational prescribing training was associated with higher knowledge (p=0.003) and practice scores (p=0.010). Knowledge showed a positive correlation with prescribing practices (ρ=0.486, p<0.001).

Conclusion: The analysis demonstrates a potential gap between theoretical understanding and practical prescribing competency among final-year MBBS students. Integrated teaching, structured prescription-writing exercises, case-based learning, and supervised clinical training may strengthen rational prescribing education.

Keywords: Rational Prescribing; Pharmacology; Community Medicine; Knowledge; Attitude; Practice; Medical Education; MBBS Students.