Doctors don’t always get enough vaccinology and immunology training in medical school. Gaps in knowledge among frontline health professionals affect their confidence when faced with questions from parents and patients.
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Dr Barbara Pahud, UMKC School of Medicine and Children’s Mercy Hospital, Kansas City, wanted to change this. She decided to develop a curriculum for doctors to expand their knowledge and expertise.
To ensure the curriculum was as user-friendly and convenient as possible, Dr Pahud used ‘flip classroom’ technology – online modules accessible via smartphone, tablet and laptop. Did it work?
To find out, Dr Pahud’s team ran a randomized trial – testing knowledge and attitudes before and after doctors had taken the course – to see whether it would have a real-world impact on how they engage with parents about vaccine-related questions.
‘The curriculum helped them feel more comfortable,’ she said. ‘They were able to immunise families they would not have immunised before. After taking the curriculum they had the self-confidence and knowledge to adequately address parental concerns.’
The education tool began with a pilot module for first-year hospital doctors. The plan now is to expand to other hospital-based physicians and then move to nurses and other health professionals who need training in vaccinology.
Solving a global problem
Dr Pahud’s course was first introduced in the US but may be needed elsewhere. In France, for example, GP attitudes to, and knowledge of, immunisation is mixed.
Dr Pierre Verger, Observatoire Regionale de la Santé, says medical training in vaccinology should be expanded. This must include continuing medical education and the development of communication tools to support GPs engaging with parents/patients on vaccination.
Health professionals need an accepting attitude
Training for health professionals shows that, in addition to knowledge, communication skills can be a vital asset to engaging with hesitant parents. In Australia, for example, the SKAI project has been looking at how doctors can respond to questions from parents. At the heart of this is an open mind and a respectful attitude.
Research shows doctors also want written resources and content that they can provide to parents. Dr Nina Berry, University of Sydney, explains how her research group has developed fact sheets and other resources that answer questions and guide discussions on vaccinations.
Other communication skills can also improve the quality of doctor-patient interaction. One prominent technique is motivation interviewing, which helps guide parents to solve their own problem or question about immunisation.
It is, say experts, a more respectful approach than the sometimes combative attitude that can develop in conversations between vaccine-hesitant parents and their healthcare professionals.
These techniques can be learned, like any skill, and deployed in clinics around the world. By learning what someone already knows or believes about vaccination, health professionals can tailor the conversation to offer useful additional information on which to base their decision.