Non Technical Summary
Veterinarians face several challenges when communicating with their clients about the health and welfare of the animals they treat. One of those challenges is talking with clients about the proper use of antibiotics and other antimicrobial treatment options for animals. Antimicrobial resistance is a threat to animal, human, and environmental health around the world. Veterinarians are key information and treatment resources for clients across fields of study, from companion animals to animal agriculture. The goal of our grant project is to help veterinary medicine students be more comfortable communicating about proper use and disposal of antibiotics, adoption of vaccines and antibiotic alternatives, as well as improving their comfort in managing information and medication requests from clients. For this integrated USDA project, we will first identify the gaps in current veterinary medicine instruction about antimicrobial resistance and science communication. Next, we will work with experts in veterinary medical education and science communication to develop a series of modules to supplement current veterinary medicine education that focuses on improving knowledge about antimicrobial resistance and the ability to communicate about antibiotic use (i.e., antimicrobial stewardship) to various audiences (e.g., clients, the public, and other veterinarians). After testing and revising the modules to be sure they are effective at accomplishing these outcomes, we will make the modules available to students and practicing veterinarian to gain continuing education credits and help curb antimicrobial resistance in animal health. The project offers one of the first USDA-funded projects to emphasize science communication as a key element of contributing to antimicrobial stewardship and the prevention of antimicrobial resistance in veterinary medicine.

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
311	3899	1100	25%
903	3899	1100	75%

Knowledge Area
311 - Animal Diseases; 903 - Communication, Education, and Information Delivery;

Subject Of Investigation
3899 - Other animals, general;

Field Of Science
1100 - Bacteriology;

Goals / Objectives
This project has three objectives in service of its overall goal of improving the training of veterinary medicine students regarding AMR and science communication.Objective 1 (Obj. 1): Identify gaps in knowledge about AMR/AMS and communication skills training among current veterinary medicine students (100% research).Objective 2 (Obj. 2): Develop modules that address knowledge gaps about AMS and students' ability to communicate about AMS to relevant stakeholders (25% research/75% education).Objective 3 (Obj. 3): Disseminate the modules to veterinary training (veterinary medical and veterinary technical) programs and professional associations (10% research/60% education/30% extension).

Project Methods
Obj. 1: Identify specific gaps in knowledge about AMR/AMS and communication skills training among current veterinary medicine students.To understand more about veterinary medicine students' and instructors' experiences in training about AMR, AMS, and communication skills, we will conduct a series of focus groups that serve multiple purposes.During Year 1, we will conduct nine focus groups (3 at each of the three primary veterinary school locations) of current veterinary students and of current veterinary school faculty involved with training on AMR and communication. For the purposes of our project, the focus groups will offer important insights into current veterinary medicine training about the three main topics of interest of the modules (AMR, AMS, and science communication). The focus group discussions allow for facilitated, targeted discussion about student and faculty experiences. Our focus group moderators will ask questions about what AMR topics have been covered in class previously, how comfortable participants are in communicating about AMR to clients and peers, as well as other questions focused on AMR and science communication training in their respective veterinary medicine programs. The focus groups will allow us to consider student experiences and current instructional and training practices to inform module development.The focus groups will provide the research team information about experiences with AMU/AMR/AMS information, as well as basic information on communication skills training. The focus groups need to be combined with other approaches at gathering data, however, to capture a baseline of knowledge about veterinary medical student experiences across the US. Using the connections and contacts of the main veterinary school personnel, we will recruit at least 30 students, in any year of veterinary school training, from each of the 33 accredited veterinary medicine programs in the United States. Our goal is to have a sample of at least 990 students across accredited programs. With a sample size of at least 990 students, we should have sufficient representation from various years of a program to determine AMR/AMS knowledge during a student's time in veterinary school. Our current plan means the likelihood of having a too small sample size of respondents to our survey is highly unlikely.The survey will build upon the focus groups by assessing students' knowledge, attitudes, and behaviors related to AMU/AMR/AMS and communication about these topics. Additional questions may be added to the survey to follow-up on participants' responses during the focus group sessions. The reason to conduct a wider survey, with a larger population of veterinary medical students, is to allow for gathering data that assesses the knowledge and experiences of students across the US to promote evidence-based decision-making when determining what specific AMR/AMS and science communication content to include in the modules. The survey will include items and questions used in past research to allow for comparisons between US veterinary medical students and those in other surveyed countries and ensure high quality measurement of the various concepts/variables discussed below.The research team, using insights from the focus groups about what topics are and are not covered in AMR instruction across veterinary medicine programs, will select knowledge assessment items taken from past surveys of veterinary medical students from countries outside the US. We will supplement items from those past knowledge assessments of student AMR knowledge with additional questions derived from focus group insights to ensure we gather all information needed to gauge current student knowledge of the science of AMR and AMS behaviors. Additionally, like these other large surveys of veterinary medical students, we will collect demographic and background information including but not limited to sex, age, race/ethnicity, location, and year of planned graduation.Important to communicating information about AMR and AMS behaviors to clients requires the consideration of values, attitudes, and beliefs of both the communicator (e.g., a veterinarian) and their audiences (e.g., clients and other stakeholders). We will examine the beliefs, attitudes, and values about AMU/AMR/AMS held by veterinary medical students, as well as perceptions of students' abilities to communicate with stakeholders and their current communication training. We will include survey items evaluating attitudes and values toward (and about) AMU/AMR/AMS, beliefs about previous science communication training, communication apprehension, veterinary communication skills, and science communication self-efficacy. The final set of questions on the survey will assess current communication behaviors, as well as expectations to perform AMS behaviors in the future.Obj. 2: Develop modules that address knowledge/attitude gaps about AMS and students' ability to communicate about AMS to relevant stakeholders.This second objective focuses primarily on the development of the modules that are the key deliverable of the grant. We will implement user testing methods to pilot test the user experience of working through the online modules. This process is standard in technology innovation contexts, particularly for interface design, where end users engage in a "think aloud" session to talk through what they are thinking and feeling while working through a new interface. For our modules, we will test all four modules with six different people (each) working through the user experience protocol. While this number may seem small, this is a common number of participants for user testing as previous research has shown that 5 participants can identify around 80% of critical issues in an interface. We will recruit veterinary students and/or recent veterinary medicine graduates to complete the think aloud protocol. This allows us to collect qualitative data about user experience and quality of the interaction patterns. The user feedback will allow us to revise module content and design prior to sharing the modules with the advisory board. After receiving feedback on the modules from the advisory board, we will make final changes on the modules prior to engaging in the large-scale implementation and evaluation of the modules across the three study sites.The four modules will be included in multiple courses across the three participating institutions during either the end of Year 2 or the start of Year 3 of the grant, pending the team's finalizing of the modules. We will evaluate the modules on three dimensions: (1) improvements in AMR and science communication knowledge, (2) changes in attitudes about the importance and immediacy of practicing responsible AMU and AMS, and (3) student satisfaction with the modules.Each module will be set up to include a pre-module questionnaire that assesses module-specific knowledge questions (similar, when possible, to the items used in the Obj. 1 survey), attitudes toward AMU/AMR/AMS, and require students to respond to one scenario-based question (again like the Obj. 1 survey). The post-module questionnaire will include the knowledge and attitude questions from the pre-module questionnaire, as well as items related to satisfaction with the modules.Obj. 3: Disseminate the modules to veterinary training (veterinary medicine and veterinary technician) programs and professional associations after making any needed revisions after assessing module effectiveness.Once modules have been disseminated, we will continue to monitor the pre-/post-module questionnaires that will be built into the online course offering to determine if any content changes are needed and to continue monitoring changes in baseline knowledge related to AMR and science communication from the pre-module surveys. We will follow the same procedures as those outlined under Obj. 2.