Ethical approval was obtained from the IRC of the medical college with a reference number 2075/76/76.
Study design and study area
This was a pre post interventional study conducted among the workshop participants. There were 33 participants. All participants agreed to be administered the pretest questionnaire at the time of registration on day one. After completion of each session, a feedback questionnaire was provided to obtain the participant’s opinion about the session. KAP scores were again measured at the conclusion of the workshop.
Selection of participants
The participants were selected on first come first served basis. A letter for call for participants was sent to various medical and paramedical colleges for nominating and sending participants for this workshop. The participants were divided in three groups based on their academic backgrounds. The groups included healthcare professionals like medical professionals including doctors, nurses and interns, dental doctors, pharmacy professionals and academicians.
Resource Persons of the workshop
The resource persons (facilitators) from various institutes were selected on the basis of their expertise. One resource person was Professor and Head, Department of Pediatrics and Chair, Medical Education Department, from a Medical College who facilitated a session on Medical ethics. Another resource person was an Intensivist from Intensive Care Unit (ICU) of Tribhuwan University Teaching Hospital who presented on antimicrobial stewardship. Professor and Head, Department of Microbiology, Nepal Medical College facilitated a session on infection control and tackling AMR and another session on ‘To know thy enemy’. Program Director, Global Antimicrobials Resistance Partnerships (GARP) Nepal talked about the effectiveness of ongoing antimicrobial resistance (AMR) activities in Nepal. A senior drug administrator from Department of Drug Administration (DDA) discussed monitoring the use of antimicrobials and also on the role of media, government and NGOs to combat AMR.
An associate professor from Department of Clinical Pharmacology and Therapeutics from Nepal Army Institute of Health Sciences facilitated a session on the rational use of antimicrobial agents and also on the role of microbiology laboratory to contain AMR. An associate professor, Department of Clinical Pharmacology and Therapeutics, of a Medical College facilitated the session on various strategies to reduce AMR and the roles of healthcare professionals (HCPs) to combat AMR. The details for the sessions has been added as “Additional file 2”.
Data collection tool
A structured questionnaire to measure knowledge, attitude and practice (KAP) was developed by consulting relevant literature. It was validated after iterative discussion with the content experts.
The KAP questionnaire was divided into thirteen sections. The first section contained the demographic information of the participants followed by the 12 sections which contained a set of three statements related to each session of the workshop.
The questions related to the demographic section were the participant’s age, gender, ethnic group, place of residence, work experience and area of work. A 5-point Likert scale was used to obtain the degree of agreement with the 36 statements.
The feedback questionnaire contained information about the name of session followed by the respondent’s degree of agreement using a 5-point Likert scale for seven questions related to the particular session. The statements were about the clarity of the objectives, relevance of the examples used in the sessions, relevance of the case scenarios used in the sessions, satisfactory roles of the facilitators, importance of the sessions for the future practice of the participants, friendly atmosphere and also about the satisfaction with group dynamics during the group work. There was an overall grading for the individual session rated out of 10 by the participants in addition to the responses made using the 5-point Likert scale. The response from the participants were categorized as, 1 = Strongly disagree with the statement, 2= Disagree with the statement, 3= Neutral, 4= Agree with the statement, 5= Strongly agree with the statement. There was also space provided for free-text comments by the participants. The questionnaire used for data collection has been added as “Additional file 1”.
Statistical analysis
The responses obtained from the pretest as well as posttest were coded and entered in SPSS Version 21 software. Similarly, the data from feedback were also coded, entered and analyzed using SPSS Version 21 (SPSS Inc., Chicago, IL, USA). Difference in the mean scores towards various questions before and after the workshop were analyzed using appropriate statistical tests. A p-value of <0.05 was considered statistically significant.