Studies reveal insufficient preparedness among European medical students and junior doctors in safe and responsible prescribing, reflected in poor examination scores and prescribing errors. Problem-based curricula are more effective than traditional teaching methods. However, a European survey showed that most universities still use traditional teaching, making a shift to problem-based learning challenging. The European Open Platform for Prescribing Education (EurOP²E) aims to address this by sharing online resources. The COVID-19 pandemic intensified the need for high-quality online materials, leading to this study, which sought to determine the types of resources international CPT teachers desire for the EurOP²E platform.

Previous research highlights the inadequacy of current prescribing education in Europe, with students lacking sufficient preparation. Studies have shown that problem-based learning significantly improves student preparedness compared to traditional methods. However, the transition to problem-based learning has been difficult for many universities. Existing online resources are often underutilized due to a lack of sharing and collaboration amongst educators. The EurOP²E platform seeks to improve this collaborative aspect of sharing and developing online learning resources. Existing studies also indicate the effectiveness of online resources in teaching the knowledge, skills, and attitudes necessary for safe and effective prescribing.

This study employed a nominal group technique (NGT) combined with thematic analysis. Twenty CPT teachers from 15 countries participated in four online meetings (4-6 participants per meeting). The NGT involved four phases: (1) individual brainstorming, (2) round-robin idea presentation, (3) group discussion and refinement, and (4) anonymous ranking of ideas. Researchers recorded all ideas and discussions. Thematic analysis was used to identify overarching themes within the suggestions. The COREQ checklist guided reporting. The study used purposive sampling, inviting active teachers in teaching innovation within NOTIP. Three researchers were present at all meetings, one hosting, one providing technical support, and one observing. Meetings were recorded and transcribed verbatim. MAXQDA software was used for coding and thematic analysis, with independent review and consensus on themes amongst researchers. Member checking by participant-authors ensured internal validity, while external validation was done by other authors.

The 20 participating teachers generated and ranked 35 teaching resources. Three major themes emerged: 1. **Learning Outcomes for CPT:** The top-ranked resource was prescribing scenarios, focusing on common diseases and essential drugs. Other important outcomes included knowledge materials (video clips, podcasts), addressing topical issues not found in textbooks (e.g., antimicrobial resistance, eco-pharmacostewardship, interactions with the pharmaceutical industry), personalized and evidence-based medicine (considering patient context, drug reimbursement), and deprescribing. 2. **Format of Teaching:** Interactive and gamified resources were highly ranked, including virtual patients with realistic responses and feedback. Online, transnational case discussions were suggested to foster interprofessional collaboration and awareness of international differences. Decision support systems and electronic prescribing systems were also suggested for practical training. 3. **Resource and Faculty Development:** A repository of exam questions, reusable materials, and harmonized formularies were considered crucial. Teach-the-teacher materials on problem-based learning and addressing the digital readiness of teachers were prioritized, acknowledging the time-intensive nature of this approach and resistance to change among some teachers. The specific rankings for each suggestion varied across the meetings but overall the three themes were consistently prioritized.

The findings address the research question by identifying specific, prioritized resources for the EurOP²E platform. The results highlight the need for a multifaceted approach to improving CPT education, encompassing diverse learning outcomes, teaching formats, and faculty development. The emphasis on personalized medicine, ethical considerations (e.g., planetary health), and addressing the digital literacy of teachers reflects current trends in medical education. The study's identification of the need for teach-the-teacher materials addresses the challenges of transitioning to problem-based learning. The findings emphasize not only creating new resources, but also making existing high-quality resources more readily available through a collaborative platform. This collaborative aspect is vital to addressing the previously identified lack of sharing among educators.

This study provides a prioritized list of online problem-based teaching resources for CPT education, categorized by learning outcomes, teaching format, and faculty development. The findings highlight the importance of collaborative resource creation and sharing within the EurOP²E platform. Future work will involve collaboratively developing and disseminating these resources, with a particular focus on addressing the newly identified need to integrate the impact of pharmaceuticals on planetary health into the curriculum.

The study's limitations include a response rate of approximately 50%, resulting in underrepresentation from some larger EU countries. The limited time allocated per meeting (90 minutes) may have slightly rushed the idea-generation phase, though this was mitigated by allowing participants to add crucial suggestions later. The possibility of priming effects due to prior study participation among some participants is acknowledged. Despite these limitations, the study provides a valuable starting point for developing a comprehensive resource platform for CPT education.