An evaluation of the impact of a national facilitated antimicrobial stewardship e-learning course on learners' practice in Egypt.

Background: In Egypt, the political commitment to addressing antimicrobial resistance (AMR) is increasing and there is an ambition to rapidly scale up antimicrobial stewardship (AMS) in hospitals. The British Society for Antimicrobial Chemotherapy (BSAC) partnered with World Health Organization (WHO) Egypt to support this goal through structured education and training. A country-specific, accredited, facilitated online AMS training course with an interactive live session was developed. Objectives: To evaluate participants' feedback regarding this course and identify translation of knowledge into AMS interventions and programmes. Methods: Formal evaluation of learning (all 15 cohorts) and translation into action (cohorts 1-3) was undertaken via a post-course survey using a head, heart and hands approach, then follow-up surveys at 3 and 6 months were used to identify application of knowledge in practice. Results: To date, 1776 learners from across Egypt have undertaken the training over 15 cohorts, of which 74.7% passed the post-course test. Overall, feedback was positive, and participants highlighted several immediate actions they had planned in their hospital. At the 3-month follow-up the most frequently reported AMS interventions were new guidelines and education, and changes to microbiology testing. At 6 months, guidelines remained the most frequent AMS intervention. Staff collaboration was a reported facilitator to establishing AMS, while resistance from physicians was a perceived barrier. Conclusions: This course presents an efficient way to roll out AMS education on a national scale with support from government authorities and healthcare organizations. This learning model could be replicated in other countries and contexts to support high-level commitment to AMS.