1 Start 2 Complete

Please complete each of the following questions

What type of program are you currently in? *

SelectAn Adult ID Fellowship ProgramA Pediatric ID Fellowship ProgramA combined Adult/Pediatric ID Fellowship ProgramA Pharmacy Residency ProgramAn Internal Medicine Residency ProgramA Pediatric Residency ProgramAn Internal Medicine/Pediatric Residency ProgramA Family Medicine Residency ProgramOther

What type of program are you currently in? Other

Approximately how many trainees in your program are completing this curriculum this year? *

Does your training program have any formal antimicrobial stewardship curriculum other than this curriculum?

No

Yes

Does your program formally assess your trainees’ competence in antibiotic stewardship activities?

No, we do not currently have any educational activities related to antimicrobial stewardship in our program

No, we currently have educational activities related to antimicrobial stewardship but do not formally assess our trainees’ competence in it

Yes (please describe)

Does your program formally assess your trainees’ competence in antibiotic stewardship activities? Yes (please describe)

For the following statements, indicate how confident you are in your ability to: *

	Not at all	Somewhat	Moderately	Very	Extremely
Explain the importance of antimicrobial stewardship	Explain the importance of antimicrobial stewardship - Not at all	Explain the importance of antimicrobial stewardship - Somewhat	Explain the importance of antimicrobial stewardship - Moderately	Explain the importance of antimicrobial stewardship - Very	Explain the importance of antimicrobial stewardship - Extremely
Model antimicrobial stewardship best practices	Model antimicrobial stewardship best practices - Not at all	Model antimicrobial stewardship best practices - Somewhat	Model antimicrobial stewardship best practices - Moderately	Model antimicrobial stewardship best practices - Very	Model antimicrobial stewardship best practices - Extremely
Structure a conversation to effect change in the antibiotic prescribing patterns of other healthcare professionals	Structure a conversation to effect change in the antibiotic prescribing patterns of other healthcare professionals - Not at all	Structure a conversation to effect change in the antibiotic prescribing patterns of other healthcare professionals - Somewhat	Structure a conversation to effect change in the antibiotic prescribing patterns of other healthcare professionals - Moderately	Structure a conversation to effect change in the antibiotic prescribing patterns of other healthcare professionals - Very	Structure a conversation to effect change in the antibiotic prescribing patterns of other healthcare professionals - Extremely
Describe elements of an effective antimicrobial stewardship program	Describe elements of an effective antimicrobial stewardship program - Not at all	Describe elements of an effective antimicrobial stewardship program - Somewhat	Describe elements of an effective antimicrobial stewardship program - Moderately	Describe elements of an effective antimicrobial stewardship program - Very	Describe elements of an effective antimicrobial stewardship program - Extremely
Discuss antimicrobial stewardship as a potential career pathway	Discuss antimicrobial stewardship as a potential career pathway - Not at all	Discuss antimicrobial stewardship as a potential career pathway - Somewhat	Discuss antimicrobial stewardship as a potential career pathway - Moderately	Discuss antimicrobial stewardship as a potential career pathway - Very	Discuss antimicrobial stewardship as a potential career pathway - Extremely

How satisfied are you with the overall quality of the IDSA Core Antimicrobial Stewardship Curriculum? *

Not at all

Somewhat

Moderately

Very

Extremely

Would you recommend this curriculum to others? *

No

Yes

What were your favorite aspects of the curriculum?

Were there any barriers that made it difficult for you to use the IDSA Core Antimicrobial Stewardship curriculum?

If so, please describe them

Are there topics that you wish had been covered in this curriculum?

Do you have any other suggestions for improving this curriculum?

Additional Comments:

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