Pharmacist Peer-Led Teaching Enhances Medical Undergraduate Prescribing: A Mixed-Methods Study

Abstract

Background: Prescribing is a high-stakes clinical task where newly qualified doctors frequently report low confidence, with national data highlighting persistent error rates. Medical schools face logistical and staffing barriers in delivering high-quality, simulation-based prescribing education. Peer-led, interprofessional teaching, particularly by pharmacists, may offer a scalable solution in this context. Approach: This is the first study to evaluate pharmacist peer-led prescribing education using a mixed-methods framework. We designed and implemented a pharmacist peer-led prescribing programme for final-year medical students at Warwick Medical School. Peer tutors were final-year medical students with pharmacy backgrounds. Participants were recruited from the final year cohort (n = 74) and were split randomly across two groups, receiving teaching in a crossover format at different intervals. Teaching focused on calculations, high-risk drugs and prescribing in clinical scenarios. Mixed-methods evaluation included simulated assessments, confidence questionnaires, national PSA performance and semi-structured interviews. Quantitative data were analysed using non-parametric tests, and qualitative data were thematically analysed using Braun and Clarke's framework. Evaluation: Seventy-four students participated. Simulated prescribing assessment scores significantly improved within both groups (p < 0.001), with large effect sizes and strong domain-level gains (e.g., calculations +38.1%, data interpretation +37.2%). PSA scores and pass rates were higher among participants. Confidence improved across all domains (p < 0.001). Thematic analysis revealed four key enablers: specialist peer insights, interactive delivery, psychological safety and curriculum alignment. Implications: This novel pharmacist-led, peer-teaching model improved prescribing skills, confidence and interprofessional awareness. Now adopted locally and nationally, it offers a transferable, low-cost framework for embedding peer-led simulation into prescribing education.