How do you get the public on board with the rising global plague of drug-resistant infections that kill 700,000 people a year and are estimated to eventually surpass deaths by cancer?
You go digital: The people at FutureLearn, a division of the Open University, are offering a free online 6 week course called “Antimicrobial Stewardship: Managing Antibiotic Resistance,” to a worldwide audience. And it’s an eye-opener.
Their teaching philosophy is that “learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.” So for example after each presentation there’s a (well-used) discussion forum where you address the issues presented and answer the questions posed.
But it was something else that really got my attention: The course confronts head-on the human realities — the human frailties — that are an inevitable part of healthcare delivery. For example, in the very first video (below) that sets the stage for the entire course, we’re presented with an infectious disease outbreak at a hospital where the following issues, among others, are presented:
1) An ill-informed CEO – a physician – who seems more concerned with the reputation of the hospital and reassuring the public that everything’s under control than with coming to grips with the outbreak itself.
2) The power differential between doctors and patients and how that undermines healthcare. The wife of a patient remarks, “I just thought he’d be okay and protected … I suppose I should have said something, really. But you don’t like to, do you? Consultants know best, and I don’t want to upset anyone, especially when Bill’s relying on them to perform his operation.”
3) Nurses and other staff who are too busy to do their job. And so, for example, they allow a patient recovering from a drug-resistant infection to “help” other patients by keeping them company and assisting with their feeding.
4) Conflicts that arise even about which antibiotic to use: The national guidelines say one thing, hospital guidelines might say another, and within the hospital itself the attending physician will often push a “blockbuster” drug instead of following the microbiologist’s recommendation.
5) And of course the ever-ubiquitous issue of hospital staff following their hygiene rules about as much as the rest of us follow speed limits.
Most courses in science and health shy away from looking at the mistakes practitioners themselves make. But not here; and note that the course is offered by hospital insiders. For instance, it’s run by Professor Dilip Nathawani, an infectious diseases physician who leads a national antibiotics stewardship program in the UK and is chair of the British Society for Antimicrobial Chemotherapy. With respect to the 5 issues presented above, he admits, “Sadly, what you have seen is not an unusual scenario in many hospitals and departments across the world.”
Putting the healthcare workers and the public in the same classroom at the same time is empowering. We learn their language, and we can understand healthcare delivery from their perspective. On the issue of drug-resistant infections, this is the next best thing to going to medical school or to nursing school yourself.
Here’s the video that introduces the fact pattern that the course is based on: