{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:53:53Z","timestamp":1789768433120,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The WHO Global Patient Safety Challenge \u201cMedication Without Harm\u201d emphasizes the need to improve doctors\u2019 prescribing competence. Junior doctors are particularly at risk of prescribing errors due to inadequate training. To address this, the European Prescribing Exam was developed to standardize and improve clinical pharmacology and therapeutics (CPT) education across Europe. This study describes the development and quality analysis of the first two pilot examinations. Based on European consensus studies and the Dutch National Pharmacotherapy Assessment, an assessment blueprint was developed. Two pilot examinations, each with 36 knowledge\u2010based and 11 skills\u2010based questions, were administered between 2020 and 2023 at 16 medical schools in 11 countries. We assessed exam quality through reliability (standard error of measurement, Cronbach\u2019s alpha, item\u2010rest correlations (R\n                    <jats:sub>ir<\/jats:sub>\n                    \u2010value), difficulty index (DI)), and content validity (content validity ratio\u2019s (CVR)). Questions with a negative R\n                    <jats:sub>ir<\/jats:sub>\n                    or CVR, or DI &lt;\u20090.44 were flagged as potential lower quality. In addition, students\u2019 scores (% of maximum) and differences between schools and curricula were evaluated. A total of 3109 students participated (Examination 1: 1371; Examination 2: 1745). Most questions were of high quality; 20\/94 (21.3%) were flagged. Median scores on the examinations were 66.2% (IQR 55.4\u201374.3) and 58.9% (IQR 52.1\u201365.8) for pilot 1 and 2, respectively. Students from schools with problem\u2010based learning or a national prescribing examination scored significantly higher (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). In conclusion, this study demonstrates the feasibility of a standardized European Prescribing Exam. However, the wide variation and generally low median scores highlight the need to improve and harmonize CPT education across Europe.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70063","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T08:20:05Z","timestamp":1758010805000},"page":"190-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Feasibility and Quality of the European Prescribing Exam: An International Multicenter Pilot Study Among 3109 Medical Students From 16 Medical Schools"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8169-0714","authenticated-orcid":false,"given":"Erik M.","family":"Donker","sequence":"first","affiliation":[{"name":"Section Pharmacotherapy, Department of Internal Medicine Amsterdam UMC, Location VUmc  Amsterdam The Netherlands"},{"name":"Research and Expertise Centre in Pharmacotherapy Education (RECIPE)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7380-4876","authenticated-orcid":false,"given":"Joost D.","family":"Pi\u00ebt","sequence":"additional","affiliation":[{"name":"Section Pharmacotherapy, Department of Internal Medicine Amsterdam UMC, Location VUmc  Amsterdam The Netherlands"},{"name":"Research and Expertise Centre in Pharmacotherapy Education (RECIPE)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3816-6375","authenticated-orcid":false,"given":"David J.","family":"Brinkman","sequence":"additional","affiliation":[{"name":"Section Pharmacotherapy, Department of Internal Medicine Amsterdam UMC, Location VUmc  Amsterdam The Netherlands"},{"name":"Research and Expertise Centre in Pharmacotherapy Education (RECIPE)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-083X","authenticated-orcid":false,"given":"Milan C.","family":"Richir","sequence":"additional","affiliation":[{"name":"Section Pharmacotherapy, Department of Internal Medicine Amsterdam UMC, Location VUmc  Amsterdam The Netherlands"},{"name":"Research and Expertise Centre in Pharmacotherapy Education (RECIPE)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8880-0288","authenticated-orcid":false,"given":"Paraskevi","family":"Papaioannidou","sequence":"additional","affiliation":[{"name":"1st Department of Pharmacology School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki  Thessaloniki 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Ghent University  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-4921","authenticated-orcid":false,"given":"Jo\u00e3o N.","family":"Costa","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0367-9595","authenticated-orcid":false,"given":"Fabrizio","family":"De Ponti","sequence":"additional","affiliation":[{"name":"Pharmacology Unit, Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3364-5767","authenticated-orcid":false,"given":"Ylva","family":"B\u00f6ttiger","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Clinical Pharmacology Link\u00f6ping University Hospital  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5398-6414","authenticated-orcid":false,"given":"Cornelis","family":"Kramers","sequence":"additional","affiliation":[{"name":"Department of Pharmacology\u2010Toxicology Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-6934","authenticated-orcid":false,"given":"Michiel A.","family":"van Agtmael","sequence":"additional","affiliation":[{"name":"Section Pharmacotherapy, Department of Internal Medicine Amsterdam UMC, Location VUmc  Amsterdam The Netherlands"},{"name":"Research and Expertise Centre in Pharmacotherapy Education (RECIPE)  Amsterdam The 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