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. 2025 Feb 20;25(1):283.
doi: 10.1186/s12909-025-06856-x.

Impact of educational intervention on knowledge of antimicrobial resistance and antibiotic use patterns among healthcare students: a pre- and post-intervention study

Edidiong Orok  1 , Favour Ikpe  2 , Tonfamoworio Williams  2 , Inimuvie Ekada  3
Affiliations

Impact of educational intervention on knowledge of antimicrobial resistance and antibiotic use patterns among healthcare students: a pre- and post-intervention study

Edidiong Orok et al. BMC Med Educ. .

Abstract

Background: Antimicrobial resistance (AMR) is a growing global health threat, partly driven by inappropriate antibiotic use. Healthcare students, as future practitioners, must have a good understanding of AMR to contribute to antimicrobial stewardship. This study aimed to evaluate the impact of an educational intervention on healthcare students' knowledge of AMR and to assess patterns of antibiotic use prior to the intervention.

Methods: A quasi-experimental pre-and-post study design was conducted with unpaired groups of healthcare students. An educational intervention was carried out comprising of two 20-minute PowerPoint lectures, as well as question and answer sessions focused on understanding the spread, impact, and prevention of AMR. A self-administered questionnaire was given as a pre-test and repeated as a post-test immediately after the training. Students' knowledge of AMR and patterns of antibiotic use was assessed pre-intervention while knowledge of AMR was assessed post-intervention. The knowledge was categorised into domains (Understanding Antibiotic and Antimicrobial Resistance; Spread and Impact of Antibiotic/Antimicrobial Resistance; Prevention of Antibiotic/Antimicrobial Resistance). The total score for each domain of knowledge tested was categorized into good knowledge (≥ 80%) and poor knowledge (< 50%).

Results: The number of participants in the pre- and post-intervention were 185 and 157 students with average age of 17.7 years and 17.8 years respectively. Post-intervention, there was a significant increase in students' AMR knowledge, with correct responses regarding spread and impact of AMR increasing from 40.5% pre-intervention to 62.4% post-intervention (p < 0.001; φ (effect size = 0.218). The proportion of students demonstrating good overall knowledge increased from 28.1 to 44.6% (p = 0.001; φ (effect size = 0.171). Misconceptions, such as misunderstanding that antibiotic resistance does not result from the body becoming resistant to antibiotics, persisted but not statistically significant (24.9-17.2%, p = 0.055). Pre-intervention also revealed varied antibiotic use patterns, including the inappropriate use of antibiotics for malaria (51.7%, (n = 76)), and common cold (25.2% (n = 37)).

Conclusions: The study findings indicate that educational interventions can effectively improve healthcare students' knowledge of AMR, though persistent misconceptions underscore the need for more targeted educational efforts. Incorporating structured AMR content into healthcare curricula could help the students contribute to antimicrobial stewardship. Future research should evaluate knowledge retention and behaviour changes to optimize the long-term impact of AMR education.

Keywords: Antibiotic stewardship; Antibiotic use patterns; Antimicrobial resistance; Educational intervention; Healthcare students; Nigeria.

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Conflict of interest statement

Declarations. Compliance with ethical standards: This study obtained ethical approval from the Afe Babalola University Health Research and Ethics Committee (ABUADHREC) on 2/10/2023 before commencement, and the approval number was ABUADHREC/19/05/2023/28. Informed consent was obtained from all subjects and/or their legal guardian(s). This study was conducted while assuring the participants about the confidentiality of every piece of information provided to the participants. All methods were carried out in accordance with relevant guidelines and regulations. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not Applicable.

Figures

Fig. 1
Fig. 1
Self-reported conditions for antibiotic use among students in the past 12 months prior to intervention (n = 147)
Fig. 2
Fig. 2
Self-reported antibiotics used by students in the past 12 months prior to intervention (n = 147)
Fig. 3
Fig. 3
Pretest awareness of antimicrobial resistance among students by college (n = 185)
Fig. 4
Fig. 4
Sources of information on antimicrobial resistance reported by students prior to intervention (n = 105)
See this image and copyright information in PMC

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