TY - JOUR T1 - Medical students' confidence and competence with prescribing in ST-elevation myocardial infarction: a mixed-methods study AU - Angkananard, T. AU - Issarasenarak, P. AU - Teerawattananon, P. AU - Kosulawath, M. AU - Samrejphol, V. AU - Okanurak, K. KW - confidence KW - prescription KW - antiplatelets KW - fibrinolytic agents KW - stemi KW - PY - 2022/07/29 Y1 - 2022/07/04 VL - 13 N1 - doi: 10.5116/ijme.62c2.c33c DO - 10.5116/ijme.62c2.c33c M3 - doi: 10.5116/ijme.62c2.c33c JO - Int J Med Educ SP - 187 EP - 197 PB - IJME SN - 2042-6372 UR - http://www.ijme.net/archive/13/prescribing-in-st-elevation-myocardial-infarction/ L1 - http://www.ijme.net/archive/13/prescribing-in-st-elevation-myocardial-infarction.pdf N2 - Objectives: To explore factors associated with prescribing confidence and competence of final-year medical students for prescribing antiplatelet and fibrinolytic agents in ST-segment elevation myocardial infarction (STEMI). Methods: The study was conducted among final-year medical students with a triangular convergent mixed-methods approach. First, an online survey was conducted using a voluntary sampling method with concurrent in-depth interviews performed. The survey data was analysed using descriptive statistics and paired t-tests, while survey factors were compared using the chi-squared or Fisher's exact test. The interview data were coded and analysed thematically. The relations between the qualitative and quantitative findings were finally described. Results: Totally 92 validly replied to the questionnaire, and 20 participated in the interviews. The quantitative analysis indicated that they had high competence in the diagnosis of STEMI and prescribing antiplatelet and fibrinolytic agents. The mean confidence score of prescribing for both was medium and was significantly lower in fibrinolytic agents. (M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t=5.39, p<0.01). Their experience, knowledge, and mentoring were accounted for, considering the prescribing confidence factors in both approaches. Besides, providing guidelines and standing orders were derived from the interview data. Conclusions: This study has demonstrated that final-year medical students have a high ability to diagnose and prescribe essential medications in STEMI but tend to have low confidence in prescribing fibrinolytic agents. Experiential learning, mentorship and providing guidelines can help them, especially in emergency settings to prescribe confidently and safely. Further multicenter studies on undergraduate and graduate medical students’ confidence and perspective of prescribing are required, especially for high-alert medications. ER -