Diagnostic Stewardship: A KAP Study on MBBS Students and Healthcare Professionals in Tertiary Care Hospital
DOI:
https://doi.org/10.64149/J.Carcinog.24.8s.1079-1097Keywords:
Diagnostic stewardship, antimicrobial resistance, CBME curriculum, antimicrobial stewardship, medical education, knowledge attitudes practices, continuing medical education, laboratory utilizationAbstract
Background: Diagnostic stewardship has emerged as a critical discipline for optimizing test utilization and combating antimicrobial resistance. Despite its importance, there is limited data on awareness and practices among medical students and healthcare professionals in India, particularly within the Competency-Based Medical Education (CBME) framework.
Objective: To assess knowledge, attitudes, and practices (KAP) regarding diagnostic stewardship among MBBS students and practicing physicians, and identify factors influencing implementation.
Methods: A cross-sectional survey was conducted at Datta Meghe Medical College, Nagpur, involving 220 participants including MBBS Phase 2 and Phase 3 students, resident doctors, and practicing physicians. A validated questionnaire assessed knowledge (8 questions), attitudes (10 questions), and practices (9 questions) using a five-point Likert scale. Data were analyzed using descriptive statistics, univariate analysis, and multivariate logistic regression.
Results: The overall mean KAP score was 66.2%, with 32.7% participants demonstrating good KAP levels. Significant knowledge gaps were identified, particularly regarding the "Four Rs" framework (45.5% correct) and pre-analytical factors (38.2% correct). While 88.6% held positive attitudes toward diagnostic stewardship, concerns about clinical autonomy (42.3%) and treatment delays (38.2%) persisted. Practice scores revealed knowledge-practice gaps, especially in managing asymptomatic bacteriuria (52.7% appropriate). Previous antimicrobial stewardship training (OR=2.86, p<0.001) and attendance at CME/workshops on stewardship (OR=1.75, p=0.032) independently predicted good KAP scores. Lack of adequate training was the most cited barrier (76.4%).
Conclusion: Significant knowledge and practice deficiencies exist regarding diagnostic stewardship. Integration of comprehensive diagnostic stewardship competencies into the CBME curriculum and implementation of structured CME/workshop programs are urgently needed.
