Development and evaluation of a massive open online course (MOOC) to teach medical students the prudent use of antibiotics.

Background: If antibiotics are used appropriately, the development of antimicrobial resistance (AMR) can be curbed. Many medical students feel that they do not receive sufficient training in this respect during their undergraduate medical education. In recent years, digital learning formats are being successfully employed in student teaching. Our aim was to develop and evaluate a massive open online course (MOOC) on appropriate antibiotic therapy and the development of AMR. The intention was to provide the MOOC as an effective learning format in medical schools and to encourage others to develop their own MOOCs on other topics.

Methods: We developed a MOOC for medical students that consisted of four modules (M1-4) on bacteriology, microbiology diagnostics, pharmacology, antibiotics, AMR, the One Health approach, principles of appropriate antibiotic therapy, and transfer of knowledge to clinical practice. MOOC learners were asked to answer the same 16 knowledge and five self-assessment questions at the beginning and end of the MOOC and to give course feedback in an anonymous online questionnaire.

Results: From July 1, 2021 until June 30, 2022 the MOOC was actively attended by 2061 learners. Of them, 473 (23%) completed the final exam and 389 (19%) answered the knowledge and self-assessment questions at the beginning and end of the MOOC. A significant increase in knowledge and a strengthening of competence and self-confidence was observed in these 389 learners. The median knowledge score increased significantly from 10/16 (IQR 8; 12) points before the MOOC to 16/16 (15; 16) afterwards (p < 0.001). Overall, course activity decreased from M1 (100% attendance) to M4 (38%). At the end of the MOOC, the online feedback questionnaire was completed by 304 (15%) learners, most of whom rated the MOOC positively. For example, 97% of them stated that they had increased their knowledge in relevant areas.

Conclusions: A high dropout rate for voluntary MOOCs is generally reported. Therefore, a course completion rate of 23% is acceptable. The learners who completed the MOOC showed a significant increase in knowledge and self-confidence. The use of the MOOC, or parts of it, as digital learning format for undergraduate medical education appears promising.