Australia and New Zealand Prescribing Skills Assessment (ANZ-PSA)
What is the ANZ Prescribing Skills Assessment (ANZ-PSA)?
The ANZ-PSA exam is a regional modification of UK Prescribing Safety Assessment (UK PSA). The exam was piloted in 2015 and by 2024 had been successfully implemented to over 20,000 final year medical students at 13 medical schools (~60% of all ANZ medical schools).
The ANZ-PSA exam;
- Is a standardised, 2 hour exam for medical students and internationally trained doctors to test prescribing competency prior to practice
- Is an open-book exam with access to the national formulary (New Zealand Formulary or Australian Medicines Handbook)
- Covers at standard for internship – prescription writing, prescription review, planning management, clinical data interpretation and therapeutic decision making, identification of adverse drug reactions, dose calculations, drug monitoring, patient communication
- Covers the breadth of intern-level prescribing including medical, surgical and community scenarios
- Focuses on important medicines in ANZ practice – those that are most prescribed, high risk, high error
The PSA was evaluated in the 2023 Independent review into the UK Prescribing Safety Assessment. The review found ‘consensus that there should be appropriate and dedicated assessment of prescribing competence, and that assessment should be mandatory’. Stakeholders universally acknowledged the importance of the PSA in preparing junior doctors for prescribing and that ‘prescribing was safer now’. The exam was found to be reliable and improvements in patient safety were noted since its implementation. Over 70,000 medical students in the UK have passed the PSA over the last decade. The UK PSA exam is part of the national medical licensing exam and passing is a requirement for practice.
A full evaluation of the ANZ-PSA exam Pilot Implementation was conducted in 2023 by an Australasian academic team (Chin P, Charles K et al British Journal of Clinical Pharmacology, 2023). The passing rates for the ANZ-PSA exam are comparative to the UK PSA, with 85-89% of students meeting prescribing competency requirements for practice. Further remediation and re-testing are provided for students to attain competency.
Governance
The governance of the ANZ-PSA exam is supported by ASCEPT in partnership with BPS Assessment. The assessment is developed through a cycle of the following four workstreams.
- The PSA Executive Board – responsible for the strategic direction of the PSA.
- The PSA Assessment Committee – responsible for item and test development and standard setting.
- The PSA Stakeholder Advisory Group – enables effective engagement and feedback with representatives of key stakeholders including medical students, medical schools, professional organisations, regulators and state and federal health departments.
Organisational chart
Co-Chairs - Executive Board
Professor Sarah Hilmer
Professor Sarah Hilmer AM FAHMS, is a nationally and internationally recognised clinical pharmacologist and geriatrician. Sarah co-led the expansion and evaluation of ANZ-PSA across Australia. Leadership positions in quality use of medicines include Chair of the International Union of Basic and Clinical Pharmacology (IUPHAR) Clinical and Translational Section and its Geriatric Committee, Chair of the NSW Therapeutic Advisory Group and Chair of the Drug and Therapeutics Committee for the Local Health District that she works in. Her translational research program in geriatric pharmacology applies basic pharmacology, clinical trials and implementation methods, including development of clinical decision support and educational interventions, to improve prescribing for older people.
Associate Professor Matt Doogue
A/Professor Matt Doogue is a clinical pharmacologist involved in teaching and assessment from medical students to specialists for over 20 years. He has held several senior leadership roles in medicines governance in Australia and New Zealand. He has established systems for monitoring medicines use and providing clinical decision support in prescribing systems focused on junior doctor prescribing. He is a physician in a busy general medicine service in a tertiary hospital and supporting a small rural hospital.
Co-Chairs - Assessment Committee
Associate Professor Kellie Charles
A/Professor Kellie Charles is an educator and pharmacologist. She successfully led the preclinical curriculum review for post-graduate medicine at the University of Sydney, is the current Therapeutics Academic lead at Sydney, and is chair elect of the ASCEPT Education Forum. She has led standard setting, question development and evaluation of ANZ-PSA. She is a world-class educator as recognised by Senior Fellowship of Higher Education Academy and being awarded the ASCEPT Outstanding excellence in teaching Award in 2020.
Dr Paul Chin
Dr Paul Chin is a clinical pharmacologist and senior lecturer. He has taught and assessed clinical pharmacology with medical students for over 10 years, and been involved with standard setting, question development and evaluation of ANZ-PSA for over 6 years. He was awarded the ASCEPT Elizabeth Davis Teaching Excellence Award in 2023.
Membership of ANZ-PSA Committees
Members are selected for the breadth of expertise to achieve the tasks of each group. This includes expertise in assessment, medicines use, and the learning and work environments. Members are predominantly drawn from the academic and clinical staff of the participating medical schools and health services.
- Co-Chair (Australia) – Sarah Hilmer, Royal North Shore Hospital & University of Sydney
- Co-Chair (New Zealand) – Matthew Doogue, University of Otago & Canterbury District Health Board
- Content & Sector Expert – Anne Tonkin, University of Adelaide
- Content & Sector Expert – Ric Day, UNSW & St Vincent’s Hospital
- Expert in Medical Education & Health Services Research – Danny Liew, University of Adelaide
- Health Economist – Kirsten Howard, University of Sydney
- QLD Representative – Joel Iedema, Metro South Health & Redland Hospital
- SA Representative – Arduino Mangoni, Flinders University
- VIC Representative – David Liew, Austin Health
- WA Representative – Christopher Etherton-Beer, University of Western Australia
- President, ASCEPT Board – Bridin Murnion, St Vincent’s Hospital Sydney & University of New South Wales
- ASCEPT Representative – Carl Kirkpatrick, Monash University
- ACT Representative – Karlee Johnston, Australian National University
- Co-Chair & NSW Representative – Kellie Charles, University of Sydney
- Co-Chair & NZ Representative – Paul Chin, University of Otago
- Content & Delivery Expert – Claire Harrison, Monash University
- CP Lead – Jonathan Brett, St Vincent’s Hospital
- NZ Representative – Chris Cameron, University of Otago
- QLD Representative – Peter Donovan, Royal Brisbane and Women’s Hospital
- SA Representative – Tilenka Thynne, Flinders Medical Centre
- TAS & NPC Representative – Gregory Peterson, University of Tasmania
- VIC Representative – Barb Kemp-Harper, Monash University
- Advanced Trainee Member – Benedict Tan, Path West Laboratory Medicine
- Australian National University – Karlee Johnston
- Bond University – Treasure McGuire
- Charles Sturt University – Brendan Cantwell
- Curtin University – Alexandra Seewan-Gaitatzas, Denise Findlay & Lauren White
- Deakin University (Medical School) – Karen D’Souza, Melissa Oxley, Susan Day & Sue Garner
- Flinders University – Michal Wozniak & Tilenka Thynne
- Griffith University – Niru Nirthanan
- Macquarie Medical School – Clement Loy
- Monash University – Julia Harrison
- University of Adelaide – Jo Thomas
- University of Auckland – Jeff Harrison
- University of Melbourne – Louisa Ng
- University of Newcastle – Catherine Lucas
- University of New England – Anna Barwick
- University of New South Wales – Gary Velan & Ric Day
- University of Otago – David Reith & Paul Chin
- University of Sydney – Kellie Charles
- University of Tasmania – Pankti Shastri
- University of Western Australia – Benedict Tan
- University of Wollongong – Natalie Bailey
Australia
- Australian Commission on Safety and Quality in Health Care
- Australian Health Practitioner Regulation Agency
- Australian Medical Association
- Australian Medical Students Association
- Australian Medicines Handbook
- Pharmaceutical Society of Australia
- Royal Australian College of General Practitioners
- Therapeutic Guidelines
- Health Ministers
- Australian Federal Health Minister
- QLD Health Minister
- NSW Health Minister
- ACT Health Minister
- VIC Health Minister
- WA Health Minister
- NT Health Minister
New Zealand
- Medical Council of New Zealand
- Medsafe
- National Medicines Steering Group
- New Zealand Medical Students Association
- Pharmac
- Te Whatu Ora Health New Zealand
- The New Zealand Formulary
Key publications
Australian Prescriber – Harrison and Hilmer – The Prescribing Skills Assessment: a step towards safer prescribing
BJCP – Chin, Charles et al – Evaluation of the Prescribing Skills Assessment implementation, performance and medical student experience in Australia and New Zealand
For all ANZ-PSA enquiries, please contact: ascept@ascept.org