Table 4 Personal paradigm problems related to learning objectives and abilities, based on the MARE design framework [19]
Personal paradigm category | Respondents | Personal paradigm problem (PPP) | Learning objective (LO) | Type of expected ability |
|---|---|---|---|---|
P-diagnosis | P 1,3-5,7-9,10–11 | 1. Neglected to conduct the necessary laboratory tests | 1. Implementing microbiological and other investigations to diagnose | Knowledge: Skill |
P1–2,4-5,9 | 2. paid no attention to the importance of diagnosis | 2. Maintaining patient respect in line with best practice, regulatory standards, and contractual requirements | Action: Attitude | |
P1–11 | 3. Unversed in the official antibiotics guideline document | 3. Stating national public health antibiotics guidelines | Knowledge: Cognition | |
4. Selecting and prescribing antibiotic therapy according to national/local practice guidelines | Competence: Cognition | |||
P-treatment | P1–2,4-6,8–10 | 4. Prescribed antibiotics for no obvious evidence of bacterial infection | 5. Not initiating antibiotic treatment in the absence of bacterial infection | Competence: Attitude |
P1,4–5,7,11 | 5. Failed to communicate with patients about no antibiotic treatments | 6. Mastering delayed antibiotic therapy and negotiation with the patient | Performance: Skill | |
7. Educating patients and their caregivers, nurses and other support clinical staff | Action: Cognition | |||
P-prescription and P-drug | P4–6,8–11 | 6. Did not know local AMR patterns | 8. Using local microbial−/antimicrobial-susceptibility patterns when conducting empirical treatments | Competence: Cognition |
P2,4–5,9,11 | 7. Prescribed antibiotics without waiting for laboratory test results | 9. Understanding the importance of taking microbiological samples for culture before starting antibiotic therapy | Knowledge: Attitude | |
P3–4,10 | 8. Preferred to prescribe broad-spectrum antibiotics | 10. Avoiding the unnecessary use of broad-spectrum antibiotics | Competence: Attitude | |
P2,4–5,9 | 9. Preferred to prescribe expensive antibiotics | 11. Working within the ethical code of conduct | Performance: Attitude | |
12. Applying legal and ethical frameworks affecting prescribing practice | Performance: Attitude | |||
P11 | 10. Stopped antibiotic treatment when the symptoms disappeared | 13. Constructing the prescription for an antimicrobial with its pharmacokinetics and knowing how this affects the choice of dosage regimen | Competence: Cognition |