Evaluation of Online Gaming for Learning European Antibiotic Prescribing Practices

Methods: An exploration of current antibiotic prescribing practices revealed differences across Europe. An online course to learn about good practice in antibiotic prescribing was authored in English with the Moodle virtual learning environment using the UDENTE (Universal Dental e-Learning) platform. The design included online materials on current antibiotic prescribing recommendations and an antibiotics webcast. The main learning activity was a flash-based prescribing game. 10 Austrian, 20 UK and 6 Italian final year students completed the flexible course over two months. The evaluation included pre-and-post course tests to measure gain in knowledge from the game, a questionnaire and focus groups on learner attitudes.

Results: There were clear differences in prescribing patterns of antibiotics in each of the three countries for prophylaxis of infective endocarditis (IE) and treatment of dry socket. Antibiotic prophylaxis for IE reflected national guidelines eg American Heart Association (AHA) and National Institute of Clinical Excellence (NICE). 30% of Austrian, 50% Italian and 0% UK students would prescribe Amoxycillin with a beta-lactamase inhibitor. If prophylaxis was indicated, 20% Austrian, 25% Italian and 50% UK students would use 3g Amoxycillin instead of 2g.

Interaction with the prescribing game did improve the users' knowledge (e.g. 50% of Italian participant showed an increase in knowledge from the post questionnaire, the Italian cohort being small, but representing 30% of the year). Questionnaires and focus groups revealed much appreciation for the prescription game by all cohorts.

Conclusions: Our results indicate that there are still conflicting recommendations for antibiotic prescribing across Europe. Students must be alerted to this because they can practice across borders as EU dentists. The prescribing game was a helpful and effective learning tool, that supported learning of antibiotic prescribing practice in three European countries.