MacDougall Conan, Schwartz Brian S, Kim Lisa, Nanamori Mari, Shekarchian Sharmin, Chin-Hong Peter V
Department of Clinical Pharmacy, University of California, San Francisco School of Pharmacy.
Department of Medicine, University of California, San Francisco School of Medicine.
Open Forum Infect Dis. 2017 Jan 31;4(1):ofw225. doi: 10.1093/ofid/ofw225. eCollection 2017 Winter.
Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare.
We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ and tests and mixed-effects logistic regression.
Analysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, < .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, < .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, < .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%).
A curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students.
不恰当的抗菌药物使用会威胁患者安全，是医生和药剂师抗菌药物管理协作团队关注的焦点。然而，医学或药学院课程中并未全面教授抗菌药物管理内容。弥补这一不足既能传授一个重要概念，又能为跨专业医疗保健树立典范。
我们创建了一个抗菌药物管理课程，包括一个在线学习模块和研讨会，将医学和药学专业的学生以及两个专业的教师结合在一起。学习者通过与适当抗菌药物使用相关的交互式、分支逻辑临床病例进行学习。我们在课程前后对参与者进行了调查，使用经过验证的问题来评估他们对抗菌药物管理和跨专业协作的知识和态度。结果采用配对χ检验和t检验以及混合效应逻辑回归进行分析。
对3年中完成课程前和课程后调查的745名学生（425名医学生，320名药学学生）进行了分析。完成课程后，明显更多的学生认为他们能够描述每个专业在适当抗菌药物使用中的作用（34%对82%，P<.001），以一种能让跨专业团队参与的方式进行沟通（75%对94%，P<.001），并描述适当抗菌药物使用的协作方法（49%对92%，P<.001）。学生对在线学习模块（85%）和小组研讨会（93%）的满意度很高。
一个由自主学习和跨专业研讨会组成的抗菌药物管理课程显著提高了临床前医学生和药学学生对协作抗菌药物管理的知识和态度。
