Curricular Intervention to Teach Antimicrobial Pharmacology at an Allopathic Medical School
Authors: Athauda Gagani , Toonkel Rebecca L , Kashan Sanaz B 
Published: June 2021

Introduction

Students at Herbert Wertheim College of Medicine (HWCOM) expressed low confidence in antimicrobial pharmacology. Visual tools to support learning about antimicrobial spectrum of activity are not widely available. Also, despite widespread use of case based learning (CBL), CBL has not been explored for teaching antimicrobials. We studied the combined use of a visual tool for antimicrobial spectrum with team based CBL (TB‐CBL, a large group CBL method) to strengthen medical student knowledge and confidence in antimicrobial pharmacology.

Methods

In 2017, HWCOM transitioned from didactics to a flipped classroom approach for antimicrobial pharmacology. Students view 16 short videos prior to 2 TB‐CBL sessions in the 1st year pharmacology course and 5 across the 2nd year. The investigators developed a visual tool for the sessions using colored bars to show activity spectrum of commonly used drugs and/or drugs used for serious infections. A pocket version was provided to students prior to clerkships. Knowledge was assessed by a voluntary 20 question MCQ quiz administered to CO 2020 (intervention) and CO 2019 (control) prior to clerkships. Satisfaction/confidence was assessed by a voluntary 6 question survey (5 point Likert scale) contiguous with the quiz. Another 6 question survey was administered to CO 2019 after clerkships.

Results

Knowledge assessment participation was 100% (n=119) for CO 2019 and 99.2% (n=125) for CO 2020. The mean score for CO 2019 was 58.6% (SD 15.92) vs. 75.5% (SD 14.24) for CO 2020 (p<0.0001). Survey participation was 89% (n=106) for CO 2019 and 98% (n=124) for CO 2020. For CO 2019, 20.8% agreed/strongly (A/SA) to confidence about mechanism of action of commonly prescribed antibiotics (mean 2.28, SD 1.17) vs. 58.9% for CO 2020 (mean 3.66, SD 1.03). For CO 2019,14.2% A/SA to confidence about spectrum of commonly prescribed antibiotics (mean 2.08, SD 1.18) vs. 31.5% for CO 2020 (mean 2.95, SD 1.14). For CO 2019, 17% A/SA to confidence about common/serious adverse effects of commonly prescribed antibiotics (mean 2.27, SD 1.17) vs. 52.4% for CO 2020 (mean 3.56, SD 1.01). For CO 2019, 14.2% A/SA to confidence about resistance mechanisms against commonly prescribed antibiotics (mean 2.27, SD 1.08) vs. 63.7% for CO 2020 (mean 3.70, SD 0.95). For CO 2019, 9.4% A/SA to confidence in using a rational approach to choosing empiric antibiotic coverage (mean 2.09, SD 1.08) vs. 42.7% for CO 2020 (mean 3.40, SD 0.97). For CO 2019, 14.2% A/SA to having sufficient foundational knowledge in the treatment of infectious diseases prior to clerkships (mean=2.19, SD=1.15) vs. 43.5% for CO 2020 (mean 3.34, SD 1.03). 40.34% (n=48) of students in CO2019 responded to the end of 3rd year survey. 83.33% A/SA that the pocket card helped in the rational approach to antibiotic selection.

Conclusion

The implemented intervention improved student knowledge and confidence in antimicrobial pharmacology. The visual learning tool aided in the clinical application of antimicrobial pharmacology knowledge.

Future Directions

Analysis of question by question performance is underway to identify areas for improvement. The curriculum will be modified to improve identified deficiencies.

Support or Funding Information

This study was not supported by a grant.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.