Implementation and Assessment of a New Longitudinal Antibiotics Curriculum for Third Year Medical Students

Background: Inappropriate use and knowledge of antibiotics is linked to the emergence of multidrug resistant bacteria, adverse side effects, and emergence of diseases such as C. difficile colitis. Antibiotics are taught in a fragmented manner in medical school curricula. A survey of graduating UCSF medical students in 2013 showed significant demand for more comprehensive antibiotics teaching during the third year of medical school, consistent with published literature. We aimed to develop, implement and assess a multipronged antibiotics curriculum.

Methods: The curriculum consists of the following components: 1) A two-part lecture at beginning of third year open to all students, and 2) An optional learning module and a mandatory one hour jeopardy-style didactic session on antibiotics use which occurred during three alternating blocks of the internal medicine core clerkship. The class of 2015 served as the historical control. Students who were in a clerkship block when the learning module and jeopardy game were not offered served as an additional control group. All students completed a 25-item antibiotics knowledge test at the end of their third-year. Mean test scores were calculated for each group and differences between the groups were analyzed using t-tests.

Results: Students in the historical control group (n=70) had a mean exam score of 11.06+/-3.09. Students in the control group (n=56) had a mean exam score of 11.36+/-3.23. Students in the intervention group (n=27) had a mean exam score of 11.78+/-3.34. There were no statistically significant differences in the exam scores between groups.

Conclusion: We were able to successfully introduce a longitudinal antibiotics curriculum at UCSF. The interactive antibiotics curriculum itself did not significantly improve exam scores. Possible explanations include difficulty in controlling for antibiotics teaching in clinical setting, the optional nature of the two-part lecture and the module, the difficulty level of the test, and relative brief nature of the curriculum. Next steps include incorporation of the curriculum in additional clerkships as well as making the learning module required. We hypothesize that with incorporation of game-based learning in a curriculum that allows for spaced learning and spiral education, there could be improvement in antibiotics knowledge.