Applying the Plan-Do-Study-Act cycle in medical education to refine an antibiotics therapy active learning session

Abstract

Background Appropriate antibiotic utilization is an important topic in medical education, given the public health implications of antibiotic stewardship. One approach to integrating this content includes active learning / gaming, which may improve learner engagement and knowledge retention, with curricular enhancement further guided by solicitation of feedback from learners. Methods Guided by the Plan-Do-Study-Act framework, between February 2017 and July 2019, we developed, implemented, and revised an active learning session for medical students, focused on appropriate utilization of antibiotics during their Internal Medicine clerkship. Results Across twelve sessions, 367 students (75.2%) completed the post-evaluation survey. Although baseline ratings were high (97% of respondents enjoyed the “active learning” format), constructive comments informed iterative improvements to the session, such as modifying session timing, handouts and organization of the gaming component. Intervention 3, the last improvement cycle, resulted in more favorable ratings for the active learning format (p = 0.015) improvement in understanding antibiotics and their clinical application (p = 0.001) compared to Baseline ratings. Conclusions This intervention suggests that active learning and gaming was effective in achieving high student engagement in an Internal Medicine core clerkship session on antibiotic therapy. Interventions to streamline session content and format, such as providing a completed antibiotic reference table and answer choices for each case, further improved student receptivity and perceived educational value. The study findings have potential implications for medical education, and suggest that the use of gaming and active learning, combined with regular incorporation of student feedback vis a vis a PDSA cycle, are useful tools for curriculum develop in antibiotic stewardship.