Research

Based on our observational research with providers and patients at Penn State’s University Health Services, we identified five areas of communication skill relevant to antibiotic stewardship in student health. These skills (now addressed in the five videos) were: 1) explaining diagnosis and treatment, 2) conveying the risks of antibiotics, 3) advising on symptom management, 4) supporting patients, and 5) understanding emerging adulthood.

We then conducted a survey study with providers (N = 100) at student health centers nationally to determine the extent to which these communication skills were regarded as important for antibiotic stewardship. The providers in our study rated all five of these communication skills as important or highly important both for themselves and their colleagues (means of 4.00-4.85 on a 5-point scale). In qualitative feedback, providers also identified other skills of importance, including conflict management (especially, with “difficult patients”) and discussing antibiotics with international students. Training videos on the first five skills were developed (see II, below), and videos on the other two skills are under development.

Prior to final animation of the videos, we asked healthcare providers at student health centers nationally (N = 50) to evaluate the video scripts and storyboards (draft animations). Providers rated the extent to which the scripts and storyboards were appealing, understandable, credible, useful, persuasive, informative, and beneficial. Providers’ ratings on all dimensions were significantly higher than the scale mid-point, indicating a positive response to the materials. The vast majority of the providers also indicated that they would not hesitate to use the skills presented in the videos. Providers also gave detailed qualitative feedback on the content and visual elements of the videos, and this feedback informed revisions made prior to animation.

Third—and fourth-year medical students were recruited nationally from one or more major medical schools. In addition, healthcare providers (MD, DO, NP, or PA) were recruited from student health centers at colleges nationwide. 60 medical students and 75 healthcare providers completed all elements of the multi-part study.

Participants began with an online assessment of the communication skills targeted by five of the training videos (the “Difficult Patient” and “International Student” videos were not yet available). After a 1-week waiting period, participants were given online access to the five training videos. After viewing each video, they completed a brief online evaluation of the video as a training tool and then completed the same communication skill assessment. Three months later, participants again completed the same communication skill assessment. 

Results from both open- and close-ended skill assessments indicated strong educational efficacy for the program, especially in the short term. In addition, participants who originally perceived the skills as less important had lower self-efficacy, were less motivated to improve, and benefited more from the intervention than other participants. This can be understood in light of greater room for improvement whose skill, efficacy, and motivation were lower initially. These findings highlight the program’s potential for improving antibiotic stewardship and underscore the vital role of health communication in addressing this interdisciplinary challenge.

For this study, students will be recruited from medical (MD/DO), physician assistant (PA), and nurse practitioner (NP) programs to participate in a 2-hour online seminar utilizing 4-5 of the training videos along with role-play, discussion, and quiz activities to reinforce the material. Skill assessments will be conducted before and after the seminar to assess its educational impact on these future prescribers.