Elsevier

Academic Pediatrics

Volume 17, Issue 4, May–June 2017, Pages 431-435
Academic Pediatrics

Research in Pediatric Education
A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal

https://doi.org/10.1016/j.acap.2017.01.010Get rights and content

Abstract

Objective

Influenza vaccine hesitancy is common in the primary care setting. Though physicians can affect caregivers' attitudes toward vaccination, physicians report uneasiness discussing vaccine hesitancy. Few studies have targeted physician–patient communication training as a means to decrease vaccination refusal.

Methods

An immersive virtual reality (VR) curriculum was created to teach pediatric residents communication skills when discussing influenza vaccine hesitancy. This pilot curriculum consisted of 3 VR simulations during which residents counseled graphical character representatives (avatars) who expressed vaccine hesitancy. Participants were randomized to the intervention (n = 24) or control (n = 21) group. Only residents in the intervention group underwent the VR curriculum. Impact of the curriculum was assessed through difference in influenza vaccine refusal rates between the intervention and control groups in the 3 months after the VR curriculum.

Results

Participants included postgraduate level (PL) 2 and PL3 pediatric residents. All eligible residents (n = 45) participated; the survey response rate was 100%. In patients aged 6 to 59 months, residents in the intervention group had a decreased rate of influenza vaccination refusal in the postcurriculum period compared to the control group (27.8% vs 37.1%; P = .03).

Conclusions

Immersive VR may be an effective modality to teach communication skills to medical trainees. Next steps include evaluation of the curriculum in a larger, multisite trial.

Section snippets

Setting and Study Population

This educational study was conducted at the Cincinnati Children's Hospital Medical Center (CCHMC) pediatric primary care center (PPCC). The PPCC is a large academic clinic that serves as the continuity site for approximately 80 pediatric residents. Curriculum participants included postgraduate level (PL) 2 and PL3 categorical pediatric residents. Resident consent was obtained before enrollment. Residents were assigned to the intervention group (n = 24) or the control group (n = 21) on the basis

Demographics

The VR curriculum was implemented in November 2015. All eligible residents agreed to participate (n = 45). There were no differences in baseline demographic characteristics between the control and intervention groups (Table).

Influenza Vaccine Refusal Rates

During the postcurriculum period, there were 486 clinical encounters of patients aged 6 to 59 months who were eligible for influenza vaccination. Control group residents saw 235 of these patients, and intervention group residents saw 253 patients. The EMR alert identified

Discussion

In this pilot educational study, residents who underwent the VR curriculum to teach communication skills related to influenza vaccine hesitancy had decreased rates of vaccine refusal in the postcurriculum period compared to residents in the control group. These findings are important because influenza vaccination represents an important public health goal.

This is not the first curriculum to target vaccine hesitancy. A prior vaccine hesitancy curriculum demonstrated improved resident knowledge

Acknowledgments

Supported in part by the Health Resources and Services Administration (HRSA D55HP23195; PI: Klein). Funders played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the article.

References (26)

  • K.A. Poehling et al.

    The underrecognized burden of influenza in young children

    N Engl J Med

    (2006)
  • L.A. Grohskopf et al.

    Prevention and control of influenza with vaccines: recommendations of the advisory committee on immunization practices, United States, 2015–16 influenza season

    MMWR Morb Mortal Wkly Rep

    (2015)
  • A. Kennedy et al.

    Vaccine attitudes, concerns, and information sources reported by parents of young children: results from the 2009 HealthStyles survey

    Pediatrics

    (2011)
  • Cited by (0)

    Conflict of Interest: The authors declare that they have no conflict of interest.

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