Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
Pharmacy Department, Prince of Wales Hospital, Sydney, Australia.
J Glob Antimicrob Resist. 2020 Sep;22:226-230. doi: 10.1016/j.jgar.2020.02.008. Epub 2020 Feb 19.
Inappropriate antimicrobial prescribing may harm patients and drive antimicrobial resistance. Junior doctors' knowledge of infectious diseases and antimicrobial prescribing is inadequate. Online spaced case-based learning can improve knowledge.
To develop infectious diseases and antimicrobial prescribing course content for online spaced education and assess its effectiveness and feasibility for junior doctors.
Infectious diseases and antimicrobial course content was developed for an online spaced education platform (Qstream Inc., Burlington, MA). Junior doctors (postgraduate years 1-3) at two tertiary teaching hospitals in Sydney participated in the study. Course content was provided with Qstream at one hospital and at the other hospital via two face-to-face (FTF) tutorials from August to October 2017. Knowledge and self-confidence were compared before and after training within and between both cohorts.
Participation in the course was higher in the Qstream cohort with 48/127 (37.8%) completing the course compared with 44/110 (40%) attending one or both FTF sessions, of whom 22/110 (20%) attended both. Improvement in mean knowledge score from 69.7% to 81.5% in the Qstream cohort was significantly greater than the FTF cohort's minimal improvement from 67.6% to 67.9% (95% CI 2.79-20.33; P=0.01). In the Qstream cohort mean confidence rating (0-10) improvement from 5.14 to 6.55 was greater than the FTF group improvement from 5.37 to 5.85 (95% CI 0.132-1.171; P=0.02). Qstream feedback was very positive.
Online spaced education in infectious diseases and antimicrobial prescribing was feasible, acceptable and effective for junior doctors. It has potential to reduce inappropriate antimicrobial prescribing and warrants further investigation.
不适当的抗菌药物处方可能会危害患者并推动抗菌药物耐药性的产生。初级医生对抗感染和抗菌药物处方的了解不足。在线间隔基于案例的学习可以提高知识。
为在线间隔教育开发传染病和抗菌药物处方课程内容，并评估其对初级医生的有效性和可行性。
为在线间隔教育平台（Qstream Inc.，马萨诸塞州伯灵顿）开发了传染病和抗菌药物课程内容。悉尼的两家三级教学医院的初级医生（研究生 1-3 年级）参与了这项研究。2017 年 8 月至 10 月，一家医院通过 Qstream 提供课程内容，另一家医院通过两次面对面（FTF）教程提供课程内容。在培训前后，在两个队列内和队列间比较了知识和自我信心。
在 Qstream 队列中，有 48/127（37.8%）完成了课程，而在参加一次或两次 FTF 课程的 44/110（40%）中，有 22/110（20%）参加了两次，这表明 Qstream 队列的参与度更高。Qstream 队列的平均知识得分从 69.7%提高到 81.5%，显著大于 FTF 队列从 67.6%提高到 67.9%（95%置信区间 2.79-20.33；P=0.01）。在 Qstream 队列中，平均信心评分（0-10）从 5.14 提高到 6.55 的幅度大于 FTF 组从 5.37 提高到 5.85（95%置信区间 0.132-1.171；P=0.02）。Qstream 的反馈非常积极。
传染病和抗菌药物处方的在线间隔教育对初级医生来说是可行、可接受和有效的。它有可能减少不适当的抗菌药物处方，值得进一步研究。
