Identified needs in antimicrobial stewardship education for pediatric advanced practice providers: a qualitative analysis.

Introduction: There is limited research investigating advanced practice provider (APP) knowledge and perspectives on education in antimicrobial stewardship (AS). Setting: Large academic children's hospital. Participants: APPs in Division of Pediatrics, Antimicrobial Stewardship Program (ASP) stakeholders. Objective design: We conducted four focus groups with APPs and one focus group with ASP stakeholders. APPs were asked eleven open questions about training, influences on prescribing practices, knowledge gaps and desired topics for education in AS as well as general barriers to learning. ASP stakeholders were asked five open-ended questions about teaching initiatives, knowledge gaps and high yield teaching topics for APPs. Results: 20 APPs and 6 ASP stakeholders (1 medical director, 3 pharmacists and 2 pediatric infectious diseases fellows) participated in focus groups. Four domains and eight themes were generated. (1) Barriers to AS in Practice: lack of critical thinking and conflict between the ASP and APPs within the cultural context of the institution. (2) Approach to Education: logistical challenges to curriculum development and adopting APP centered approaches to teaching. (3) Education for New to Practice APPs: learning basics of microbiology, infectious diseases and utilizing resources to encourage AS in practice. (4) Education for Experienced APPs: learning approaches to common clinical scenarios and updates to improve AS in practice. Conclusions: Curricular content should acknowledge the cultural influences of the institution, target knowledge gaps and areas of interest of learners, and be delivered via flexible and engaging learning modalities that encourage maximal participation.