E-Learning versus Face-to-Face Methodology for Learning Antimicrobial Resistance and Prescription Practice in a Tertiary Hospital of a Middle-Income Country

• Published in: Antibiotics (Basel) 2022-12, Vol.11 (12), p.1829
• Main Authors: Armas Freire, Paulina Isabel, Gaspar, Gilberto Gambero, Zurita, Jeannete, Salazar, Grace, Velez, Jorge Washington, Bollela, Valdes Roberto
• Format: Article
• Language: English
• Subjects: Antibiotics; Antimicrobial agents; antimicrobial prescription; Antimicrobial resistance; Attitudes; Bacteremia; Bacterial pneumonia; Clinical medicine; Comparative analysis; continuous professional development; Distance learning; Drug resistance; Drug resistance in microorganisms; E-learning; Empirical analysis; Employee development; Health services; Hospitals; Infections; Infectious diseases; Learning; Medical personnel; Medical records; Medical research; Medicine, Experimental; Methods; Online education; Online instruction; Perception; Physicians; Pneumonia; Professional development; Soft tissues; Statistical analysis; Teaching methods; Training; Urinary tract; Urinary tract diseases; Urinary tract infections; Urogenital system
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11121829

Background: Antimicrobial resistance is a growing health problem worldwide. One strategy to face this problem in a reasonable way is training health personnel for the rational use of antimicrobials. There are some difficulties associated with medical staff to receiving training with E-learning education, but there is a lack of studies and insufficient evidence of the effectiveness of this method compared to face-to-face learning. Methods: An educational intervention on antimicrobial resistance (AMR) and antimicrobial prescription practice (APP) was designed and implemented using two approaches: face-to-face and E-learning among physicians of the intensive care unit (ICU) and internal medicine ward (IMW) at Eugenio Espejo Hospital in Quito. Modalities of interventions were compared to propose a strategy of continuous professional development (CPD) for all hospital staff. An interventional study was proposed using a quasi-experimental approach that included 91 physicians, of which 49 belong to the IMW and 42 to the ICU. All of them received training on AMR—half in a face-to-face mode and the other half in an asynchronous E-learning mode. They then all participated on APP training but with switched groups; those who previously participated in the face-to-face experience participated in an E-learning module and vice-versa. We evaluated self-perception about basic knowledge, attitudes and referred practices towards AMR and APP before and after the intervention. A review of medical records was conducted before and after training by checking antimicrobial prescriptions for all patients in the ICU and IMW with bacteremia, urinary tract infection (UTI), pneumonia, and skin and soft tissue infection. The study received IRB clearance, and we used SPSS for statistical analysis. Results: No statistically significant difference was observed between the E-learning and the face-to-face methodology for AMR and APP. Both methodologies improved knowledge, attitudes and referred practices. In the case of E-learning, there was a self-perception of improved attitudes (p < 0.05) and practices (p < 0.001) for both AMR and APP. In face-to-face, there was a perception of improvement only in attitudes (p < 0.001) for APP. In clinical practice, the use of antimicrobials significantly improved in all domains after training, including empirical and targeted treatment of bacteremia and pneumonia (p < 0.001) and targeted treatment of UTI (p < 0.05). For the empirical treatment of pneumon