Development of a competency-based medical education curriculum for antimicrobial stewardship

Antimicrobial stewardship (AS) programs are becoming a critical part of infectious diseases (ID) and medical microbiology training programs. As post-graduate medical education shifts toward competency-based medical education (CBME), the curriculum for AS training requires a similar transition. Our objective was to develop an educational curriculum combining principles of AS and CBME and apply a prospective audit and feedback (PAF) as an educational strategy.

A new competency-based educational curriculum (CBEC) was created which addressed multiple stages along the competence continuum. The Centers for Disease Control and Prevention (CDC) core elements for AS were used to generate Entrustable Professional Activities (EPAs) and milestones for this CBEC.

Trainees completed a PAF as an AS educational strategy on all antimicrobial starts in a pediatric hospital (141 beds) over a 1-month rotation. The PAF created 26 audits and addressed all (100%) of the CDC's core elements for inpatient AS programs through seven EPAs and 20 milestones.

The PAF allowed for 26 interventions to improve effective antimicrobial use and mapped to multiple EPAs and milestones. Additionally, the PAF utilized all of the CDC's core elements for inpatient AS programs. It is imperative to ensure that educational strategies expose residents to AS interventions that have been shown to decrease antimicrobial usage in various settings. The current manuscript may serve as a model for how a CBEC can be developed, and how AS interventions can be integrated into a CBME program.