Methods: We designed a spiral antimicrobial stewardship curriculum (defined as revisiting the same concept but with increasing complexity) for medical students in years 2-4. Data provided by the Graduation Questionnaire (GQ) administered by the U.S. Association of American Colleges were used. We compared student responses during the curriculum rollout in 2013-15 between students at our institution and other schools. We also surveyed graduating seniors in 2015 about antimicrobial stewardship training.
Results: Using GQ data for the class of 2013 (pre-intervention), a similar proportion of UCSF medical students compared to other US medical students rated microbiology clinical preparation as excellent (43.6% vs. 45.1%, P>0.20). For the 2014 class, we developed interactive case-based sessions at the beginning of years 3 and 4. After this first intervention, a higher proportion of UCSF students rated the microbiology clinical preparation as excellent (51.3%) compared to responses at all schools (39.8%, odds ratio [OR] 1.59, 95% confidence interval [CI] 1.1-2.3, P=0.013). For the class of 2015, we added content during the medicine clerkship and 1 week before graduation. For the 2015 class, an even higher proportion of UCSF students rated microbiology preparation as excellent (57.6%), compared to all schools (41.2%, OR 2.23, 95% CI 1.54-3.22, P<0.0001). From our survey, 88% were very or extremely satisfied with antimicrobial stewardship training.
Conclusion: A spiral curriculum focusing on antimicrobial stewardship and infectious diseases increases student perception of clinical preparation prior to graduation. As the curriculum was incrementally introduced, students’ knowledge increased indicating a dose-response pattern. Based on these positive results, we plan to introduce more content throughout UME, and link to curriculum for GME and practicing clinicians.
D. Irby, None
B. Schwartz, None