Incorporation of human patient simulation into an antimicrobial stewardship based infectious diseases elective

Purpose: Human patient simulation (HPS) immerses students in interactive learning while avoiding patient safety risks; however the utility of teaching antimicrobial stewardship (AS) principles hasn’t been demonstrated for HPS. Our goal was to incorporate HPS into an infectious diseases elective, originally developed to teach knowledge and application of AS with complex cases, without compromising student learning satisfaction. We aimed to conduct HPS cases for the learning objectives recognition and management of antimicrobial-induced adverse effects, including selection of alternative regimens.

Methods: Two longitudinal HPS cases, bacterial endocarditis (BE) and cryptococcal meningitis (CM), were conducted over week-3 and 4 of a 5-week 1-credit elective with two high-fidelity mannequins during two 1-hour group sessions for 11 third (of fourth) professional year pharmacy students. Four pharmacy residents trained in conducting scripted high-fidelity HPS-sessions role-played and synchronized manifestations of antimicrobial adverse effects in response to student-groups’ assessment and recommendation appropriateness, including alternative antimicrobials. Students completed individual pre- and post-HPS graded assignments, and anonymous pre- and post-course assessments (baseline AS knowledge and perceived learning satisfaction, respectively, with 5-point Likert or open-ended questions).  

Results: All 11 students completed HPS-sessions, assignments and assessments. Two (18%) had baseline AS knowledge. Nine (82%) indicated course improved application of science/practice knowledge for complex patients in AS context to very-high/high degree. Eighty-two and 73 percent indicated course improved BE and CM management knowledge to very high/high degree, respectively, while 82 and 91 percent indicated HPS added to BE and CM management knowledge to very high/high degree, respectively. Eighty-two percent of students’ open-ended responses indicated HPS was the course “best part”.

Conclusion: HPS was used for critical thinking and problem solving in teaching AS principles without compromising student learning satisfaction. HPS can be readily incorporated into case-based AS scenarios for learning objectives involving recognition, management and alternative agent selection for antimicrobial-induced adverse effects.