Partnerships in the Development of a Vaccine Safety and Safety Communication Curriculum for Medical Residents
In the U.S., subpopulations of children and adults continue to be under immunized, putting themselves and others at risk of vaccine-preventable diseases. Multiple barriers to full and timely immunizations exist, including lack of physician training and implementation of evidence-based strategies for communicating vaccine benefits and risks. Furthermore, some vaccines, including MMR and varicella, still carry stigmas that, while lacking an evidence-base, mean that parents and individuals may reject a potentially life-saving vaccine based on erroneous popularized conceptions of unfounded risks. As such, under immunization and missed opportunities for patients and among providers continue to present both a personal and public health risk that must be addressed.
We brought together a group of project participants from professional medical societies, academia, public health, and a collaborative of community immunization coalitions to address the enhancement of resident education on immunization safety and safety communication. These include the American Academy of Pediatrics, California, the California Academy of Family Physicians, the California Immunization Coalition, California Department of Public Health, Immunization Branch, Children's Hospital, University of California San Diego, University of California Davis, and Stanford University School of Medicine.
Goals (all achieved as of 10/2011)
Goal 1: Identify major, common vaccine safety concerns
By December 15, 2009, complete a literature search to identify published common vaccine safety concerns, conduct at least 4 focus groups each of community members and physicians in order to further refine understanding of current major vaccine safety concerns, and design a survey for residents.
Goal 2: Develop an Immunization Safety Communication Curriculum for Medical Residents
Develop an Immunization Safety Communication Curriculum for Medical Residents: By June 15, 2010, prepare a variety of effective methods to teach vaccine safety communication to Medical Residents such that they can be delivered in different settings and with different levels of direct trainer involvement, including an online curriculum and training-of-trainers materials. We are planning two major methods for delivering the vaccine curriculum, an on-line interactive module and an in-person training using written materials.
Goal 3: Pilot Immunization Safety Communication Curriculum
Pilot Immunization Safety Communication Curriculum: By July 1, 2010 (the beginning of the year for residents), curriculum will be fully ready to use at 4 pilot sites (Stanford, UCSD, UCD, USC).
Goal 4: Disseminate an Immunization Safety Communication Curriculum to training programs in the United States
Disseminate an Immunization Safety Communication Curriculum to training programs in the United States: Contact 100% of residency training programs in the U.S. regarding their interest in supplementing their current primary care curriculum with the newly-developed curriculum. By January 1, 2011, identify at least 6 residency programs interested in using the on-line curriculum, and make this curriculum available to their residents. By January 1, 2011, identify at least 2 residency programs interested in train-the-trainer sessions, and complete these sessions in order to facilitate the incorporation of curricular materials into existing residency training programs. By March 1, 2011 re-contact 100% of residency training program that did not participate in the initial phases of the project regarding their interest in participating (should have data showing program effectiveness to share). By July 1, 2011 make this curriculum available to at least 10 additional residency programs.
Goal 5: Evaluate the effectiveness of the curriculum
Evaluate the effectiveness of the curriculum: Assess pediatric and family practice resident's acquisition and utilization of key elements of vaccine safety and vaccine risk communication and resulting increase in vaccination of children and adolescents.
Needs Assessment Survey
The sample included residents in pediatrics (239, 80.2%), internal or family medicine (30, 10.1%), and dual medicine-pediatrics (29, 9.7%). 20.6% of the residents reported "not learning" about vaccine safety communication in their residency programs. Preferred learning methods, which were also the most commonly-utilized methods, included didactic lectures and role-modeling/cases. Electronic teaching method were less desired, but also very rarely utilized. Over 95% of residents reported thinking that vaccine safety communication would be very or somewhat important in their careers.
- See also: Sarnquist, C et al. "Communicating about vaccines and vaccine safety: What are medical residents learning and what do they want to learn?" Journal of Public Health Management and Practice. 2013.Jan-Feb;19(1):40-6. doi: 10.1097
Online cases and small group materials pilot
Responses to the online (87 participants) and small-group (64 participants) cases in the pilot phase of the project have been overwhelmingly positive. Over 97% of the residents participating in the pilot reported both that reviewing the cases was a good use of their time and that they anticipated utilizing the information they learned with their patients. Furthermore, over 90% reported both improved ability to communicate about vaccination as well as improved comfort level discussing vaccination with patients.