The National Prescribing Curriculum (NPC) modules are a series of case-based modules which mirror the decision-making process outlined in the World Health Organisation's Guide to Good Prescribing. These stages include: setting therapeutic goals for a particular patient; deciding on a therapeutic approach (including considering non-drug options); if a drug is needed, choosing and checking the effectiveness, safety and appropriateness of the preferred agent for that individual patient; writing a prescription (if necessary); monitoring treatment of the patient; and providing the patient with information, instructions and warnings. The WHO guidelines focus on the process of prescribing and at its centre is the development of a personal formulary. The rationale is that emerging prescribers will develop a limited set of drugs which they will use confidently and appropriately for specific indications. The NPC modules commenced as a joint initiative of NPS and the Australasian Society for Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT). After a period of development and pilot testing, the first series of online modules were made available to all Australian medical schools in 2001. Since its inception, the NPC has expanded both in terms of number of modules, as well as number and types of learners; the technology used to deliver the modules has been updated and refined; and there are continuing efforts to evaluate its usefulness and effectiveness. Currently, the modules are used by most Australian medical schools, and a growing number of pharmacy, dental, and nurse practitioner schools. The modules are also used by some interns and other practising health professionals.

The original set of module topics was chosen based on a needs analysis conducted with medical interns; these interns were asked to suggest topics which they felt were most relevant to the intern year and in which they would have liked more competence. Additional modules were added based on need, relevance to the expanding audience, and synergy with NPS therapeutic topics.

Content creation
We engage internal and external clinical experts to write the content of the NPC modules. Once the authors are identified, the team sends 3 Microsoft Word templates to writers along with instructions on how to complete them.

When finished, the author returns the completed templates and an educational designer reviews the author's work from an educational perspective i.e. whether the content is in the right places, if there is too much/ too little content for a particular activity etc. This is an iterative process and the templates may go back and forth between author and educational designer several times.

When all content is in order, the team manager provides a broad-brushed review of the material.

Build
One or more educational designers work on building and implementing the actual module e.g. creating the Flash objects that will be imbedded in the module, and adding the drug classes and preferred drugs to the online database. Once the module is placed online, the module author is invited to view the module online and give feedback.

Review
All modules are reviewed by at least two reviewers from a panel of internal and external reviewers chosen for their expertise, including a subject matter expert, clinical pharmacologist, academic pharmacist, academic nurse practitioner, and several NPS staff members from the health professionals program.

Feedback from reviewers is addressed or incorporated in the module by an educational designer, the team manager or the module author, depending on its nature and complexity.

Release
The new module is put online and all administrators (main NPC contact points for universities and organisations) are notified.

Update
All external links in the NPC modules are documented on a spreadsheet and updated once a year. Module content is reviewed every two years.

Interested universities or administrators contact the Educational Design and Support team (ph: 02 8217 8642) and request for groups to be set up. Monitoring rights can be given to interested staff to enable them to monitor their students’ progress.

Once the groups are set up, learners access the NPC modules through a self-registration page, making it easy for them to enrol in the NPC at any time and keep track of their own login information.

The NPC Curriculum promotes and encourages the use of evidence-based drug and therapeutic information resources. Links to material from the Australian Medicines Handbook, Therapeutic Guidelines, Australian Prescriber, Cochrane Collaboration, NPS publications, and a number of scientific journals and other useful evidence-based sites have been provided throughout the modules.

Learners don’t have to read all the additional resources to complete the modules but they are encouraged to be familiar with the types of content, layout and use of such resources. This knowledge will serve them well as they embark on their professional careers and require rapid access to up-to-date evidence-based materials to guide their everyday practice.

There are 25 medical modules and 3 dental modules available to learners, each one based on a specific therapeutic topic. The following table briefly describes the content of each activity in a typical module.

The following are some of the design values that influenced our learning design for the NPC modules.

Greater levels of feedback for learners
Learners are increasingly being asked to take more responsibility for their own learning and to act as self-directed learners. Given that most of our learners use the NPC modules in a self-paced mode with little input from tutors, built-in mechanisms for feedback were vital in the development of the NPC. At various points throughout a module, learners receive expert feedback. There are visual clues to indicate that the model answer is expert feedback.

Peer feedback
Learning is social, and higher order thinking skills are fostered through discussion. We have therefore looked for ways to promote connections for learners with each other. In a number of points in a module we used the question and answer tool in the learning management system. Learners are asked a question, and they type their response into a space provided. On the following screen they then see their peers' responses before going on to receive expert feedback. This provides students with the opportunity to not only learn from their peers, but to reflect and assess how their responses compared to others.

Active and authentic tasks
Learners should be given complex, real world tasks to complete. They learn best when they are actively engaged in the learning process, and they can make a meaningful connection between what they are learning and how they can apply it in their daily practice.

The 'write prescription' activity is one example of authentic task design. Learners follow a process where they search for drugs in their formulary, select drugs for the prescription, enter doctor, patient and drug details into the prescription, preview and print the prescription (if desired) and get feedback from an expert on the correct prescription. The prescription types have the same fields and look very similar to real-life prescriptions used in Australian public hospitals and general practice.