Effect of E-Learning on Appropriate Antibiotic Prescribing by Medical Students A Quasi-Experimental Study during COVID-19 Pandemic

Document Type : Original Article

Authors

1 Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran

2 Research Center, Kashan University of Medical Sciences, Kashan, Iran

10.4103/iahs.iahs_69_22

Abstract

Aims: 
This study aimed to determine the effect of E-learning on the understanding of appropriate antibiotic prescribing (AAP) by medical students and to assess their satisfaction with this method.
Materials and Methods: 
This quasi-experimental study was conducted among the physiopathology students of Kashan University of Medical Sciences in the first and second semesters of 2020–2021. Students were divided into E-learning education as an intervention group (IG) and face-to-face education as a control group (CG). After the final examination, the mean scores of students in both groups were compared. In addition, the level of students' satisfaction in the IG with E-learning method was assessed using a standard questionnaire. Data were analyzed using SPSS 22.
Results: 
We included 85 and 47 students in the CG and IG. The mean and standard deviation (SD) of the understanding score about antibiotics in the E-learning group and the face-to-face education group were 18.8 ± 1.26 and 17.16 ± 1.93 out of 19, respectively, which were statistically significantly different (P = 0.004). The mean and SD of the overall score of satisfaction of the students in the IG was 85.48 ± 23.08 out of 130 points (medium level). Furthermore, the level of satisfaction of male students was significantly higher than female students (P = 0.009).
Conclusion: 
E-learning was effective in improving the process of educating students to the AAP. This education method can be used as an alternative or complementary of face-to-face education, especially in critical conditions such as the pandemic of diseases including COVID-19.

Highlights

Ehsan Nabovati [Pubmed] [Google Scholar]

Keywords


1. Andrajati R, Tilaqza A, Supardi S. Factors related to rational antibiotic prescriptions in community health centers in Depok City, Indonesia. J Infect Public Health 2017;10:41‑8.
2. Ganguly NK, Arora NK, Chandy SJ, Fairoze MN, Gill JP, Gupta U, et al. Rationalizing antibiotic use to limit antibiotic resistance in India. Indian J Med Res 2011;134:281‑94.
3. Hecker MT, Aron DC, Patel NP, Lehmann MK, Donskey CJ. Unnecessary use of antimicrobials in hospitalized patients: Current patterns of misuse with an emphasis on the antianaerobic spectrum of activity. Arch Intern Med 2003;163:972‑8.
4. Yadegarinia D, Zamiri S. Pattern of empiric antibiotic prescription in patients referred to an emergency department of a Medical University affiliated hospital in Tehran. Pajoohandeh J 2009;14:31‑6.
5. Gebeyehu E, Bantie L, Azage M. Inappropriate use of antibiotics and its associated factors among Urban and rural communities of Bahir Dar City administration, Northwest Ethiopia. PLoS One 2015;10:e0138179.
6. Dache A, Dona A, Ejeso A. Inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia: A cross‑sectional study. SAGE Open Med 2021;9:1-9. [doi: 10.1177/20503121211042461].
7. Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2017;2:CD003543.
8. Baktygul K, Marat B, Ashirali Z, Harun‑Or‑rashid M, Sakamoto J. An assessment of antibiotics prescribed at the secondary health‑care level in the Kyrgyz Republic. Nagoya J Med Sci 2011;73:157‑68.
9. Ayuthya SK, Matangkasombut OP, Sirinavin S, Malathum K, Sathapatayavongs B. Utilization of restricted antibiotics in a university hospital in Thailand. Southeast Asian J Trop Med Public Health 2003;34:179‑86.
10. Lee CR, Lee JH, Kang LW, Jeong BC, Lee SH. Educational effectiveness, target, and content for prudent antibiotic use. Biomed ResInt 2015;2015:214021.
11. Pulcini C, Gyssens IC. How to educate prescribers in antimicrobial stewardship practices. Virulence 2013;4:192‑202.
12. Organization WH. The Evolving Threat of Antimicrobial Resistance: Options for Action. Geneva: World Health Organization; 2012.
13. Rocha‑Pereira N, Lafferty N, Nathwani D. Educating healthcare professionals in antimicrobial stewardship: Can online‑learning solutions help? J Antimicrob Chemother 2015;70:3175‑7.
14. Nabovati E, TaherZadeh Z, Eslami S, Abu‑Hanna A, Abbasi R. Antibiotic prescribing in inpatient and outpatient settings in Iran: A systematic review and meta‑analysis study. Antimicrob Resist Infect Control 2021;10:15.
15. Mian A, Khan S. Medical education during pandemics: A UK perspective. BMC Med 2020;18:100.
16. Sajed AN, Amgain K. Corona virus disease (COVID‑19) outbreak and the strategy for prevention. Europasian J Med Sci 2020;2:1‑3.
17. Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID‑19: A rapid systematic review. Lancet Child Adolesc Health 2020;4:397‑404.
18. Almaiah MA, Al‑Khasawneh A, Althunibat A. Exploring the critical challenges and factors influencing the E‑learning system usage during COVID‑19 pandemic. Educ Inf Technol (Dordr) 2020;25:5261‑80.
19. Cook DA. Web‑based learning: Pros, cons and controversies. Clin Med (Lond) 2007;7:37‑42.
20. Mukhtar K, Javed K, Arooj M, Sethi A. Advantages, limitations and recommendations for online learning during COVID‑19 pandemic era. Pak J Med Sci 2020;36:S27‑31.
21. Jayara S. The advantages and disadvantages of online teaching in medical education. J Med Evid 2020;1:144.
22. Sikkens JJ, Caris MG, Schutte T, Kramer MH, Tichelaar J, van Agtmael MA. Improving antibiotic prescribing skills in medical students: The effect of e‑learning after 6 months. J Antimicrob Chemother 2018;73:2243‑6.
23. EllawayR, Masters K. AMEE guide 32: E‑Learning in medical education Part 1: Learning, teaching and assessment. Med Teach 2008;30:455‑73.
24. Little P, Stuart B, Francis N, Douglas E, Tonkin‑Crine S, Anthierens S, et al. Effects of internet‑based training on antibiotic prescribing rates for acute respiratory‑tract infections: A multinational, cluster, randomised, factorial, controlled trial. Lancet 2013;382:1175‑82.
25. Yimenu DK, Emam A, Elemineh E, Atalay W. Assessment of antibiotic prescribing patterns at outpatient pharmacy using world health organization prescribing indicators. J Prim Care Community Health 2019;10:1-14.
26. Available from: http://medicine.kaums.ac.ir//UploadedFiles/400/Group/ pharma/tarh%20dars% 20pharma2%201400‑2.pdf. [Last accessed on 2020 Sep 22].
27. Katzung BG. Basic and Clinical Pharmacology. 14th ed. University of California, San Francisco: McGraw Hill Professional; 2017.
28. Wang YS. Assessment of learner satisfaction with asynchronous electronic learning systems. Inf Manage 2003;41:75‑86.
29. Nourian A, Nourian A, Ebnahmadi A, Akbarzadeh Baghban A, Khoshnevisan MH. Comparison of e‑learning and traditional classroom instruction of dental public health for dental students of Shahid Beheshti Dental School during 2010‑2011. J Dent Sch 2012;30:174‑83.
30. Kayzouri A, Sadeghpour M. A comparison on the effects of traditional, e‑learning and traditional‑e learning on the pharmacology course of nursing students. Journal of Sabzevar University of Medical Sciences 2017;24:123-7.
31. Moreira IC, Ventura SR, Ramos I, Rodrigues PP, editors. Learner’s Satisfaction Within a Breast Imaging eLearning Course for Radiographers. Proceedings of the 26th IEEE International Symposium on Computer‑Based Medical Systems; IEEE; 2013.
32. Tayem YI, Almarabheh AJ, Abo Hamza E, Deifalla A. Perceptions of medical students on distance learning during the COVID‑19 pandemic: A cross‑sectional study from Bahrain. Adv Med Educ Pract 2022;13:345‑54.
33. Elzainy A, El Sadik A, Al Abdulmonem W. Experience of e‑learning and online assessment during the COVID‑19 pandemic at the college of medicine, Qassim University. J Taibah Univ Med Sci 2020;15:456‑62.