Developing Interactive Antimicrobial Stewardship and Infection Prevention Curricula for Diverse Learners: A Tailored Approach

Author:

Nori Priya1,Madaline Theresa1,Munjal Iona2,Bhar Shubha3,Guo Yi4,Seo Susan K.5,Porrovecchio Andrea6,Gancher Elizabeth7,Nosanchuk Joshua8,Pirofski Liise-anne8,Ostrowsky Belinda1

Affiliation:

1. Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York

2. Children’s Hospital at Montefiore, Division of Pediatric Emergency Medicine, Albert Einstein College of Medicine, Bronx, New York

3. Department of Medicine, Miami Veterans Affairs Hospital, University of Miami Health System, Miami, Florida

4. Department of Pharmacy, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York

5. Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York

6. Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York

7. Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania; and

8. Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York

Abstract

Abstract Background To impart principles of antimicrobial stewardship (AS) and infection prevention and control (IPC), we developed a curriculum tailored to the diverse aptitudes of learners at our medical center. Methods We integrated case-based modules, group learning activities, smartphone applications (apps), decision support tools, and prescription audit and feedback into curricula of the medical school, medicine residency program, infectious diseases (ID) fellowship program, and hospital medicine program operations. Interventions were implemented in 2012–2016 using a quasi-experimental before-and-after study design, and this was assessed using pre- and postintervention surveys or audit of antibiotic prescriptions. Results Over 180 medical students participated in the AS and IPC seminars. After smartphone app introduction, 69% reported using the app as their preferred source of antibiotic information. Approximately 70% of students felt comfortable prescribing antibiotics for a known infection compared with 40% at baseline (P = .02), and approximately 83% were able to identify the appropriate personal protective equipment for specific scenarios. Approximately 99% agreed that they have a role in promoting patient safety and preventing healthcare-associated infections as medical students. At 20 months, appropriateness of trainee antibiotic prescriptions increased by 20% (P < .01). Almost all ID fellows indicated that the AS and IPC seminar was a vital training supplement. Uptake of internist antibiotic recommendations using AS decision support tools was approximately 70%. Conclusions All 5 interventions addressed learning objectives and knowledge gaps and are applicable across a range of environments. Evaluating long-term impact of our curriculum is the focus of future study.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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