Survey: European medical students want more education on antibiotic use
A survey of final-year medical students in Europe has found that most feel they still need more education on antibiotic use, a team of European researchers report today in the Journal of Antimicrobial Chemotherapy.
The cross-sectional web-based survey, developed by the ESCMID Study Group for Antimicrobial Stewardship (ESGAP), sought to assess how prepared final-year medical students felt to prescribe antibiotics according to commonly accepted principles of prudent use, with the intention of providing data to support targeted national and international improvement efforts. The 47-item questionnaire included questions on demographics, self-reported preparedness on 27 curriculum topics on prudent antibiotic use, and perceived need for further education.
A preparedness score was calculated for each student, and mean scores were compared at medical schools and country levels. In addition, comparisons were made with national-level data on resistance among four common bacterial pathogens.
Overall, 7,328 responses from 179 medical schools in 29 European countries were included in the analysis. Country global preparedness scores, representing the proportion of curriculum topics that students felt at least sufficiently prepared on, ranged from 54.8% in Portugal to 84.8% in Latvia, with a mean of 71.2%. The proportion of students wanting more education on prudent antibiotic use or general antibiotic use ranged from 20.3% (Sweden) to 94.3% (Slovakia), with a mean of 66.1%, and was strongly inversely correlated with global preparedness scores (Spearman's rho = −0.72, n = 29, P < 0.001). Higher prevalence rates of antibiotic-non-susceptible bacteria were associated with lower preparedness scores and higher self-reported needs for further education (P < 0.01).
"In conclusion, many final-year European medical students do not feel sufficiently prepared to prescribe antibiotics responsibly and we have identified areas for improvement," the authors write. "Further research is needed to understand how students' self-reported preparedness reflects observed preparedness and how this in turn translates into clinical practice."
May 9 J Antimicrob Chemother study
E-learning intervention helps improve medical students' prescribing
In another study today in the Journal of Antimicrobial Chemotherapy, Dutch researchers report that an e-learning module significantly improved medical students' performance during a simulated antimicrobial therapeutic consultation.
The e-learning module on antimicrobial prescribing was introduced to medical students in their fourth year at VU University Medical Centre in Amsterdam from September 2011 through August 2012, and was temporarily implemented as a non-compulsory course over a 6-week period. The module was based on the World Health Organization's guide to good prescribing. Six months later, students who took the course underwent an infectious disease-based objective structured clinical examination (OSCE) aimed at simulating postgraduate prescribing. Their results were compared against a control group of students from a period before the e-learning module was implemented.
The results showed that the OSCE pass percentage among the 71 students in the intervention group was 97%, compared with 86% for the 285 students in the control group (+11 percentage points, odds ratio, 5.9). OSCE overall, knowledge, and drug choice grades were also significantly higher in the intervention group (differences +0.31, +0.31, and +0.51, respectively). When questioned on their confidence in prescribing antimicrobial therapy in clinical practice prior to and subsequent to the e-learning module, the percentage of students indicating insecurity or severe insecurity decreased from 74% to 37%.
"In order to shape future antimicrobial prescriber behaviour, it is very important to identify resource-effective tools that can improve undergraduates' prescribing competence, rather than at a later stage when physicians have already begun clinical practice," the authors write. "Our results suggest that e-learning may be just that."
May 9 J Antimicrob Chemother study