992. Does voluntary e-learning on antibiotics improve medical students’ prescribing skills later on?
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
  • 20161020 E-learning IDweek Poster.pdf (1.9 MB)
  • Background:

    A fundamental basis for appropriate antimicrobial prescribing should be built during medical study, but teachers often cite lack of time as an obstacle. In addition, a common barrier to implement this subject in the medical curriculum is the emphasis on diagnostic rather than therapeutic competence (‘you will learn pharmacotherapy later in clinical practice’). We investigated whether the implementation of a voluntary e-learning module would have a long-term effect on antimicrobial prescribing competence.


    Prospective controlled intervention study of the long-term effects of an e-learning module on prescribing behavior of 4th year medical students in a Dutch university. We developed an interactive e-learning module on antimicrobial prescribing based on clinical cases (Figure 1). The e-learning was implemented as a voluntary module at the start of the first internship from September 2011 to August 2012. The intervention group consisted of students from this period, and they were granted access during 6 weeks. Students outside this period formed the control group. Six months later, all students underwent an objective structured clinical examination (OSCE) aimed at mimicking post-graduate prescribing. The OSCE included writing an antimicrobial prescription for a patient actor.

    Main outcomes: OSCE pass rate, overall grade, and knowledge and prescription quality subgrades. We used propensity scores to create equal comparisons.


    We included 81 students in the intervention group and 285 students in the control group. E-learning participation in the intervention group was 81%. In the intention to treat analysis, the pass percentage was 86% in the control group versus 97% in the intervention group (+11%, odds ratio 5.9, 95% confidence interval (CI) 1.7-20.0), while overall, knowledge and prescription quality grades (1-10) were also all significantly higher in the intervention group (differences +0.31, +0.31, and +0.51 respectively). 


    Introducing a voluntary e-learning module improves medical students’ antimicrobial prescribing quality, antimicrobial knowledge and overall performance on an antimicrobial therapeutic consultation, in a situation mimicking clinical practice six months later.

    SSD 500GB:Users:Jonne:Dropbox:Promotie:Manuscripten:P3 E-learning students:IDweek:20160516 Figure Screenshot.jpg

    Jonne Sikkens, MD MSc1, Martine Caris, MD MSc2, Jelle Tichelaar, MSc3, Tim Schutte, MD MSc3, Mark Kramer, MD PhD4 and Michiel Van Agtmael, MD PhD4, (1)Internal Medicine, VU University Medical Center, Amsterdam, Netherlands, (2)VU University medical center, Amsterdam, Netherlands, (3)Internal Medicine, VU University medical center, Amsterdam, Netherlands, (4)VU University Medical Center, Amsterdam, Netherlands


    J. Sikkens, None

    M. Caris, None

    J. Tichelaar, None

    T. Schutte, None

    M. Kramer, None

    M. Van Agtmael, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.