Dynamic CBME in action: rule-based digital case-based learning to evaluate antibiotic-stewardship reasoning in MBBS...

Area of Science:

• Medical Education
• Infectious Diseases
• Public Health

Background:

• Antimicrobial resistance poses a significant global health threat.
• Effective antibiotic stewardship is crucial for combating resistance.
• India's Competency-Based Medical Education (CBME) framework necessitates improved clinical reasoning assessment.

Purpose of the Study:

• To evaluate a digital case-based learning (DCBL) module for antibiotic stewardship training.
• To assess the impact of algorithm-triggered formative feedback on medical learners' decision-making.
• To determine the feasibility and acceptability of DCBL in routine medical education.

Main Methods:

• A quasi-experimental, pre-post study involving 271 medical learners.
• Utilized three DCBL micro-cases: URTI, UTI, and acute watery diarrhoea.
• Assessed Script Concordance Test (SCT) performance, usability (SUS), and workload (NASA-TLX).

Main Results:

• Overall SCT scores showed no statistically significant improvement (p=0.33).
• A statistically significant improvement was observed in the UTI case (p=0.003), though below the small-effect threshold.
• The DCBL module was feasible and acceptable, with 76% rating usability as average or good.

Conclusions:

• A single-session DCBL intervention is feasible and acceptable within CBME.
• A domain-specific SCT improvement was noted for UTI cases.
• Further controlled, multisite, longitudinal studies are required to validate effectiveness.