Not a Benign (Mis)Label: Penicillin Allergy Education for the Nonallergist

TL;DR

Many people are incorrectly labeled as penicillin-allergic, and a new educational workshop helps medical students better handle these cases.

Contribution

A novel 60-minute interactive curriculum for medical students to improve their understanding and management of penicillin allergy labels.

Findings

Medical students showed significant improvement in self-efficacy and knowledge after the workshop.

Students became more prepared to prescribe antibiotics and assess severity of allergic reactions.

The curriculum increased students' awareness of the health consequences of penicillin allergy labels.

Abstract

Up to 20% of the US population carries a penicillin allergy label; however, over 95% of those patients can safely tolerate penicillin. This discrepancy has important personal and public health consequences. There is no published curriculum for medical trainees that covers penicillin allergy history taking, risk assessment, and antibiotic prescribing.

We created a 60-minute, interactive curriculum that targeted medical students during their internal medicine rotation. We employed learning strategies including didactics, case-based learning, and role-playing. We compared self-efficacy and knowledge before and after the intervention using paired t tests.

A total of 28 medical students participated, with 25 completing both the pre- and postworkshop surveys. There was a statistically significant improvement in student-rated preparedness to prescribe antibiotics to patients with a penicillin allergy label (p < .001) and determine whether a patient has a history of an allergic reaction that was severe or life-threatening (p < .001). There was additionally a statistically significant increase in students’ perception that penicillin allergy labels carry important health consequences (p = .005), as well as increase in their total knowledge scores (p = .006).

The workshop employs adult learning techniques to improve self-efficacy and knowledge regarding penicillin allergy in medical students. Further work is needed to refine the curriculum, seek external validity, and determine the impact of this workshop on clinical outcomes.

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