Exploring UK medical schools' perception and intent for teaching on antimicrobial resistance and stewardship

探究英国医学院校对抗菌素耐药性和管理教学的认知和意图

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Abstract

BACKGROUND: Antimicrobial resistance (AMR) is a key global public health threat. Developing healthcare worker awareness and knowledge in AMR and antimicrobial stewardship (AMS) are UK national action plan targets. Competency frameworks have been developed to support improved undergraduate teaching, but their uptake is unclear. METHODS: A targeted survey was sent to all UK medical schools to determine curriculum learning objectives (LOs) on AMR/AMS and distribution of teaching opportunities across courses. Replies were mapped to the six McMaster competency framework domains to identify areas of strength and potential gaps in undergraduate teaching models. RESULTS: Replies were received from 50/52 (96.2%) medical schools. AMR/AMS teaching through dedicated teaching sessions was offered by 32/50 (64.0%), whereas 11/50 (22.0%) had fully integrated courses and 7/50 (14.0%) were unable to identify any LOs. Data on dedicated teaching provision (mean 7.7 h/course, IQR 3.0-10.5) were provided by 32/50 (64.0%). Evidence for mapping to the McMaster competencies was highly variable, ranging from 1/50 (2.0%) to 35/50 (70.0%) across the six key domains. Where identified, mapping to knowledge-based competencies was observed to be significantly greater than to practical-based competencies (OR 3.2, 95% CI 2.5-4.1, P < 0.0001). Ten of 50 (20.0%) highlighted learning opportunities in clinical years were opportunistic, variable, indirect or incidental. CONCLUSIONS: Current approaches to UK undergraduate AMR/AMS medical education appear limited, with greater focus on knowledge-based competencies and less focus on practical skills. Reliance on opportunistic teaching in clinical years presents challenges for programme assurance and impact assessment. Minimizing unwanted variability in medical school teaching and learning in AMR/AMS should be pursued, and inclusion in the UK Medical Licensing Assessment content map may provide such an opportunity.

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