Impact of interprofessional service-learning on the effectiveness of knowledge transfer of antimicrobial resistance to Hong Kong elders: a quasi-experiment

Describing the evidence linking interprofessional education interventions to improving the delivery of safe and effective patient care: a scoping review

Empirical evidence indicates that collaborative interprofessional practice leads to positive health outcomes. Further, there is an abundance of evidence examining student and/or faculty perceptions of learning or satisfaction about the interprofessional education (IPE) learning experience. However, there is a dearth of research linking IPE interventions to patient outcomes. The objective of this scoping review was to describe and summarize the evidence linking IPE interventions to the delivery of effective patient care. A three-step search strategy was utilized for this review with articles that met the following criteria: publications dated 2015-2020 using qualitative, quantitative or mixed methods; the inclusion of healthcare professionals, students, or practitioners who had experienced IPE or training that included at least two collaborators within coursework or other professional education; and at least one of ten Centers for Medicare & Medicaid Services quality measures (length of stay, medication errors, medical errors, patient satisfaction scores, medication adherence, patient and caregiver education, hospice usage, mortality, infection rates, and readmission rates). Overall, n=94 articles were identified, providing overwhelming evidence supporting a positive relationship between IPE interventions and several key quality health measures including length of stay, medical errors, patient satisfaction, patient or caregiver education, and mortality. Findings from this scoping review suggest a critical need for the development, implementation, and evaluation of IPE interventions to improve patient outcomes.

Knowledge, attitudes, and practices regarding antibiotic use among the population of the Republic of Serbia - A cross-sectional study

BACKGROUND

Antimicrobial resistance presents one of the most significant threats to public health. This study aimed to examine antibiotic usage within the general population in the Republic of Serbia and their knowledge, attitudes, and behavior concerning this topic.

METHODS

We conducted an online cross-sectional study over two weeks in December 2022, on a sample of 1014 respondents, representative of the Republic of Serbia's population. Predictors of the Antibiotic Knowledge Score (composed of four questions) were analyzed by multivariate ordinal logistic regression.

RESULTS

In 2022, 76.8% of the participants from the Serbian population had taken antibiotics, mostly upon a medical prescription, with the most common reasons being upper respiratory tract infections. Only 31.3% of all respondents received any kind of advice about the rational use of antibiotics and half of them changed their opinions on using antibiotics after receiving this information. The average Antibiotic Knowledge Score was 2.6 out of 4, with 32.5% of respondents answering all knowledge questions correctly. The multivariate ordinal logistic regression analysis showed that female gender, higher education level, and the willingness to change opinions regarding the usage of antibiotics after receiving information about the rational use of antibiotics from any available source were significant predictors of better knowledge about antibiotics use. Respondents who were open to changing their opinion after receiving information about the rational use of antibiotics had 28% higher odds of higher antibiotic knowledge scores.

CONCLUSION

This is the first population-level study on public knowledge, attitudes, and practices about antibiotic use in Serbia and therefore the baseline for future research and measuring the impact of potential interventions. Our findings underline the importance of taking into account specific population characteristics, knowledge levels, and attitudes when designing educational and intervention strategies for antibiotic use. Policymakers can leverage these findings to target specific groups and enhance the population's knowledge and practices regarding rational antibiotic usage.

The priorities, challenges, and scope of clinical communication teaching perceived by clinicians from different disciplines: a Hong Kong case study

Background

In the absence of a well-rounded syllabus that emphasises both interpersonal and medical dimensions in clinical communication, medical students in the early stages of their career may find it challenging to effectively communicate with patients, especially when dealing with perceived priorities and challenges across different disciplines.

Methods

To explore the priorities, challenges, and scope of clinical communication teaching as perceived by clinicians from different clinical disciplines, we recruited nine medical educators, all experienced frontline clinicians, from eight disciplines across seven hospitals and two medical schools in Hong Kong. They were interviewed on their clinical communication teaching in the Hong Kong context, specifically its priorities, challenges, and scope. We then performed interpretative phenomenological analysis of the interview data.

Results

The interview data revealed five themes related to the priorities, challenges, and scope of clinical communication teaching across a wide range of disciplines in the Hong Kong context, namely (1) empathising with patients; (2) using technology to teach both the medical and interpersonal dimensions of clinical communication; (3) shared decision-making with patients and their families: the influence of Chinese collectivism and cultural attitudes towards death; (4) interdisciplinary communication between medical departments; and (5) the role of language in clinician–patient communication.

Conclusions

Coming from different clinical disciplines, the clinicians in this study approached the complex nature of clinical communication teaching in the Hong Kong context differently. The findings illustrate the need to teach clinical communication both specifically for a discipline as well as generically. This is particularly important in the intensive care unit, where clinicians from different departments frequently cooperate. This study also highlights how communication strategies, non-verbal social cues, and the understanding of clinical communication in the Hong Kong Chinese context operate differently from those in the West, because of differences in sociocultural factors such as family dynamics and hierarchical social structures. We recommend a dynamic teaching approach that uses role-playing tasks, scenario-based exercises, and similar activities to help medical students establish well-rounded clinical communication skills in preparation for their future clinical practice.

Understanding the Implementation of Antimicrobial Policies: Lessons from the Hong Kong Strategy and Action Plan

In 2017, the Hong Kong Strategy and Action Plan on Antimicrobial Resistance 2017–2022 (HKSAP) was announced with the aim of tackling the growing threat of antimicrobial resistance (AMR) in Hong Kong. However, little is known about how the planned activities have been implemented. In this study, we examine the status of implementation of the HKSAP using the Smith Policy Implementation Process Model. Semi-structured interviews with 17 informants found that important achievements have been made, including launching educational and training activities targeting the public, farmers, and healthcare professionals; upgrading the AMR surveillance system; and strengthening AMR stewardship and infection control. Nevertheless, participants also identified barriers to greater implementation, such as tensions across sectors, ongoing inappropriate drug use and prescription habits, insufficient human and technical resources, as well as a weak accountability framework. Environmental factors such as the COVID-19 pandemic also affected the implementation of HKSAP. Our study indicated that expanding engagement with the public and professionals, creating a collaborative environment for policy implementation, and building a well-functioning monitoring and evaluation system should be areas to focus on in future AMR policies.