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J Educ Eval Health Prof. 2017 Jun 7. doi: 10.3352/jeehp.2017.14.13. [Epub ahead of print]

Junior doctors' preparedness to prescribe, monitor and treat patients with the antibiotic vancomycin in an Australian teaching hospital.

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Department of Pharmacy, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
School of Medicine, Flinders University, Adelaide, SA, 5000, Australia.
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, 5000, Australia.
Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Adelaide, Australia.
SA Pathology, Microbiology and Infectious Diseases, Flinders Medical Centre, Bedford Park, SA 5042, Australia.
Division of Medicine, Flinders Medical Centre, Bedford Park, SA 5042, Australia.



We aimed to assess preparedness of junior doctors to use vancomycin, and determined association between education and provision of a pocket guideline on self-reported confidence and objective knowledge.


This was a two component cross-sectional study. A sixty-minute educational session and provision of a pocket guideline were implemented. Preparedness was evaluated by self-reported confidence survey in early and late stages of each training year, and by continuing medical education (CME) knowledge scores.


Self-confidence was higher for those later in the training year (n=75) compared to those earlier (n=120) in the year for all questions. In the late group, vancomycin education was associated with higher self-confidence regarding frequency of therapeutic drug monitoring (p=0.02) and dose amendment (p=0.05), however confidence for initial monitoring was lower (p=< 0.005). Those with a pocket guideline were more confident treating patients with vancomycin (p=<0.001), choosing initial (p=0.01) and maintenance doses (p=<0.001), and knowing monitoring frequency (p=0.03). Eighty-five respondents completing the knowledge assessment scored a mean (SD) of 8.55 (1.55) from 10 questions with the interventions having no significant effect.


Attending an educational session and possessing a pocket guideline were associated with preparedness measured by higher self-reported confidence using vancomycin. High knowledge scores were attained following CME, however attending education or possessing a pocket guideline did not significantly increase knowledge scores. Our findings support education and provision of pocket guideline to increase self-confidence to prescribe vancomycin, yet highlight importance of evaluating content, format and delivery when seeking to improve preparedness to use vancomycin through education.


Drug Monitoring; Drug Prescriptions; Medical Staff, Hospital; Vancomycin

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