Antimicrobial Resistance From a One-Health Perspective: A Multi-Disciplinary University Instruction from Extension Professionals

Purpose

Contemporary issues faced by Extension professionals are often technically and politically complex, crossing a range of subjects, academic disciplines, and value systems. Addressing complex social issues to achieve desired impacts across disparate audiences requires collaborative efforts that engage multiple disciplines, represent unique geographic regions and cultural settings, and implement varying outreach methods. For example, antimicrobial resistance (AMR) is truly a “wicked problem” as it is global, complex, and difficult to solve. It is a “big picture” issue that must be addressed at multiple smaller scales where values, beliefs, cultural norms, and habits collide with science, innovation, public policy, and behavioral science, all forming a complicated intersection of separate, yet linked, continuous feedback loops.

The iAMResponsibleTM Project, is a nationwide extension program working on outreach and education on AMR within agriculture, food production, and food safety systems. In 2019, the team prioritized two approaches to promote cross-disciplinary collaborations on AMR research and increase AMR-related outreach to disparate audiences: a) greater engagement of graduate students in understanding AMR and the value of their area of study to approaching this issue from a One Health perspective; and b) improved science communication skills among graduate students. To that end, we proposed the development of a web-based, graduate-level university course to expand the impact of iAMResponsibleTM programming by engaging students in learning about the scientific, cultural, and political aspects of AMR across relevant disciplines.

The primary objectives in offering this novel, web-based university course that integrates research-based learning with science communication were to:

    1. Facilitate optimal distribution and utilization of research-based, AMR-related food safety information and resources at the state, regional and national levels among future and current food producers and consumers; and
    2. Develop AMR/Food Safety content to fill existing gaps or emerging areas of significant needs that are not being addressed regionally, nationally, and globally.

What Did We Do

Multi-university instruction

Spring 2020

A one-credit, graduate-level seminar course exploring U.S. and global challenges related to AMR in food systems, research-based strategies to mitigate potential risks associated with AMR, and successful methods of communicating this complicated scientific topic to food producers and consumers was first taught simultaneously at the University of Nebraska–Lincoln and the University of Maryland. Instructors on site at each participating institution facilitated listing of the course in their course catalog to allow students to enroll for credit at the university where they are studying. Each meeting of the class featured invited presentations by experts from across the U.S. sharing research, policy, and communication perspectives on AMR.

Spring 2021

Following the same format as the initial offering, the course was taught simultaneously at the University of Nebraska-Lincoln, University of Maryland, North Carolina State University, University of Minnesota, and Washington State University.

Based on experiences and student feedback from the 2020 and 2021 offerings of the course, lecture topics for the 2022 offering include:

Topic Presenter
Introduction to antibiotic resistance one-health Dr. Amy Schmidt, University of Nebraska – Lincoln and Dr. Stephanie Lansing, University of Maryland
Principles of extension programming and outreach Dr. Joe Harrison, Washington State University
First fully live session: Introduction to the course and student expectations All Instructors
Impact of AMR on medical practice and human health Dr. Rosa Helena Bustos – head of clinical pharmacology at Universidad de la Sabana
Challenge of AMR for animal health care Dr. Paul Morley, Texas A&M University
The natural occurrence and current state of the AMR challenge for environmental pollution Dr. Thomas Ducey (USDA-ARS)
Guided panel: Environmental mitigations for AMR Panelists: Carlton Poindexter, University of Maryland; Dr. John Schmidt, USDA-ARS; Dr. Shannon Bartelt-Hunt, University of Nebraska;

Moderators: Dr. Stephanie Lansing and Dr. Mahmoud Sharara

Intervention and tracing of AMR in the food supply Aaron Asmus – Hormel Foods

Julie Haendiges, US-FDA

History of public attitudes towards microbiology and what it tells us about how to approach AMR Dr. Kari Nixon, Whitworth University
Alternating Spring Break Class activity on identifying and evaluating science communication
Alternating Spring Break Class activity on identifying and evaluating science communication
Worldwide Implications of AMR Student led examination of AMR as it is experienced around the world
Challenges in development of antibiotics and alternatives for antibiotics Dr. Glenn Zhang, Oklahoma State University
How to assign risk to AMR found in non-clinical settings Dr. Bing Wang, University of Nebraska
Dead week workday – students work time. Submit reports and recorded presentations by the end of the workday on Friday, April 22. Zoom rooms will be available as needed. Led by Dr. Noelle Noyes
Final project review Student project Q&A sessions

Science Communication

As a joint offering by several extension faculty, this course was designed not only to cover the fundamentals of AMR but also as an opportunity to introduce STEM students to important skills and concepts used by extension professionals. As a part of this multi-institution collaboration, students worked together with their peers across the country to review and develop research-based resources and methods for communicating scientific information about AMR to non-academic audiences. These efforts were facilitated by the inclusion of lectures on extension principles and science communication, and team-based outreach projects, to support development of outreach and educational thinking and skill development within students in STEM fields. Moreover, content created by students through team projects that produced well-designed outreach content were intended for dissemination by the iAMResponsibleTM Project. The result was the production of outreach materials that transcended expertise represented by project team members.

Evaluation methods

Methods for evaluating the content and delivery of this course have been adjusted with each subsequent offering. During the first year an informal focus group discussion was conducted with students at the end of the term to solicit feedback and suggestions for future iterations. Throughout the second session (2021) students filled out weekly surveys following each lecture, as well as a survey assessment of the course. Instructors were also asked to evaluate the course content and delivery following the 2021 offering.

Students are evaluated on a combination of participation in the course discussion (during the lecture period or online following the lecture) and on evaluation of student projects. The student projects include a large emphasis on teams cooperating to identify a target audience for their shared topic, establishing a shared goal for their audience, and creating impactful outreach products to achieve their intended outcomes. Moreover, as a part of their participation and evaluation for this course, students are asked to review the effectiveness of their peers’ outreach products and the peer critiques are incorporated into the final student evaluation for the course.

What Have We Learned

Feedback from the students

Results from the student focus group in 2020 were highly influential on the expanded instruction for science communication strategies and addition of international emphasis on AMR discussions in subsequent years. Survey results following the second session again highlighted the value the students placed in the instruction on science communication, audience identification, and navigating public attitudes toward AMR, science, and disease. Student participation in Spring 2020 (two institutions) and 2021 (five institutions) totaled 28 students. Evaluations by students revealed the following outcomes:

Student comments included:

Student surveys also indicated that the logistical issues surrounding the expectation for students to work with colleagues cross-institutionally on class assignments was the most significant challenge encountered. Accordingly, the syllabus for the current (Spring 2022) offering allocates more discussion time during lectures for students to grow more comfortable with one another and provides the students with a cross-institutional work environment on Slack to facilitate discussion outside of class time. We await the student evaluations from 2022 to provide a more detailed understanding of how these changes will affect student experience but, after 4 weeks of the course, the average weekly participation on Slack is holding at about 70% of participants who regularly check-in, read, or respond to discussion on the platform.

Feedback from the instructors

The development and delivery of this course has had the unintended consequence of providing an opportunity for the instructors of the course to also continue to learn and engage on this dynamic topic. Following delivery of the course in 2021, instructors were asked to evaluate the course content and delivery method, revealing the following data:

Future Plans

Utilization of course materials outside of the course

Lectures, and student projects developed during the first two offerings of the course have been repurposed and made available for a wider audience through the LPELC platform, further linking extension and classroom educational goals and providing the students in the course the opportunity to develop materials for immediate practical application within the national extension community.

How to apply the lessons learned for other extension issues areas

We believe that the results of the students’ evaluations indicate that the next generation of STEM professionals not only values expertise in extension skills but will actively seek to develop those skills for themselves if given the opportunity. Accordingly, we see a value in pursuing similar courses as part of an extension portfolio.

How to assess the long-term impacts

We will also seek to engage former participants in this course in an assessment of how the training received, in systems thinking, multidisciplinary collaboration, and science communication have been effective in their professional work in subsequent years.

Authors

Amy Schmidt, Associate Professor, University of Nebraska – Lincoln
aschmidt@unl.edu

Mara Zelt, Research Technologist, University of Nebraska
Stephanie Lansing, Professor, University of Maryland
Rohan Tikekar, Associate Professor, University of Maryland
Mahmoud Sharara, Assistant Professor, North Carolina State University
Joe Harrison, Professor Emeritus, Washington State University
Noelle Noyes, Assistant Professor, University of Minnesota

Additional Information

Selected course materials are available through the LPELC website

Acknowledgements

Funding for the iAMR Project was provided by USDA-NIFA Award Nos. 2017-68003-26497, 2018-68003-27467 and 2018-68003-27545. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture.

 

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