Implications for practice and research

• Self-monitoring is a highly effective behaviour change technique, which should be more widely used in improving prescribing in hospitals and more generally in changing professional practice.

• Further research is required on how this intervention can be sustained and spread at scale.

Context

The aims of antimicrobial stewardship are to ensure effective, timely treatment of patients with infection and to minimise collateral damage from unnecessary use of antimicrobials (Clostridium difficile infection and spread of antimicrobial resistance). In hospitals junior doctors make complicated antimicrobial prescribing decisions. The context in which these decisions take place is also challenging, where workplace cultures often fail to promote learning and feedback and …