A review of antimicrobial stewardship training in medical education

Abstract

ObjectivesWe reviewed the published literature on antimicrobial stewardship training in undergraduate and postgraduate medical education to determine which interventions have been implemented, the extent to which they have been evaluated, and to understand which are most effective. MethodsWe searched Ovid MEDLINE and EMBASE from inception to December 2016. Four thousand three hundred eighty-five (4385) articles were identified and underwent title and abstract review. Only those articles that addressed antimicrobial stewardship interventions for medical trainees were included in the final review. We employed Kirkpatrick’s four levels of evaluation (reaction, learning, behaviour, results) to categorize intervention evaluations. ResultsOur review included 48 articles. The types of intervention varied widely amongst studies worldwide. Didactic teaching was used heavily in all settings, while student-specific feedback was used primarily in the postgraduate setting. The high-level evaluation was sparse, with 22.9% reporting a Kirkpatrick Level 3 evaluation; seventeen reported no evaluation. All but one article reported positive results from the intervention. No articles evaluated the impact of an intervention on undergraduate trainees’ prescribing behaviour after graduation. ConclusionsThis study enhances our understanding of the extent of antimicrobial stewardship in the context of medical education. While our study demonstrates that medical schools are implementing antimicrobial stewardship interventions, rigorous evaluation of programs to determine whether such efforts are effective is lacking. We encourage more robust evaluation to establish effective, evidence-based approaches to training prescribers in light of the global challenge of antimicrobial resistance.

Knowledge regarding antibiotic use among students of three medical schools in Medellin, Colombia: a cross-sectional study

“…This method, suggested by the WHO [34] has successfully been applied in different countries such as Nepal [35] and Japan [36]. Similarly, Silverberg et al [37] conducted a review of recent literature in which they identified 48 articles, distributed worldwide, with different teaching methodologies on antibiotic administration in undergraduate and postgraduate medical education, and although that study showed that medical schools worldwide are implementing interventions on this topic, a rigorous evaluation of interventions is required to determine if such efforts have indeed been effective. Such interventions and evaluation could provide a basis on which to focus micro-and macrocurricular academic changes for local universities.…”

Perspective of Key Healthcare Professionals on Antimicrobial Resistance and Stewardship Programs: A Multicenter Cross-Sectional Study From Pakistan

“…Healthcare professionals (HCPs) working in hospitals should have adequate knowledge and awareness of AMR, its triggering factors, and strategies required to cope with AMR (Labi et al, 2018;Nicholson et al, 2018;Hayat et al, 2019a;Kalungia et al, 2019). Different professionals will have different views which could affect the functioning of hospital ASPs (Venugopalan et al, 2016;Salsgiver et al, 2018). Furthermore, the success of implementing ASPs in hospitals is highly dependent on the joint efforts of HCPs, including ID physicians, pharmacists, and nurses.…”

Knowledge regarding antibiotic use among students of three medical schools in Medellin, Colombia: A cross-sectional study

“…This method, suggested by the WHO [34] has successfully been applied in different countries such as Nepal [35] and Japan [36]. Similarly, Silverberg et al [37] conducted a review of recent literature in which they identified 48 articles, distributed worldwide, with different teaching methodologies on antibiotic administration in undergraduate and postgraduate medical education, and although that study showed that medical schools worldwide are implementing interventions on this topic, a rigorous evaluation of interventions is required to determine if such efforts have indeed been effective. Such interventions and evaluation could provide a basis on which to focus micro-and macro-curricular academic changes for local universities.…”