3. DEVELOPMENT AND EVALUATION OF A COMPREHENSIVE VACCINE HESITANCY CURRICULUM

Abstract

Background Vaccine hesitancy may lead to delayed or incomplete vaccination, increased risk of vaccine-preventable disease and distrust between pediatricians and families. Studies have shown many pediatric providers are uncomfortable addressing parental concerns and educating hesitant parents on vaccine safety, necessity and misconceptions, yet few curricula to fill this need have been published. We developed and implemented a comprehensive longitudinal curriculum for pediatric residents on vaccine hesitancy and evaluated its efficacy via randomized controlled trial, hypothesizing that residents undergoing the curriculum would demonstrate improved knowledge, comfort and communication skills with vaccine hesitant families compared to a control group. Methods Using Kern's curriculum design framework, we designed and implemented didactic sessions for each pediatric vaccine and interactive role-playing sessions on communication skills. Half the pediatric residents were randomized to the intervention group (IG) and received the curriculum over 1 year; the control group (CG) received standard education only. Residents completed written pre and posttests and a standardized patient (SP) assessment at the end of the study period; group differences were evaluated using independent t-tests. Results 35 residents were randomized to IG and 35 to CG. Pre-test scores did not differ significantly between the 2 groups.The CG did not show a significant difference between pre and posttest scores for didactic knowledge or reported comfort level. The IG showed a significant increase in both knowledge and comfort level post curriculum. IG pretest knowledge score increased from 47% to 66%,p=0.00. IG pretest comfort level increased from 2.9/5 to 3.76/5,p=0.00. IG group SP score was significantly higher than the CG: 78% vs. 52%,p=0.00. Conclusion Implementation of a comprehensive curriculum on vaccine hesitancy resulted in improvements in vaccine knowledge base, communication skills and comfort level with vaccine hesitancy discussions in pediatric residents. Studies should be done to assess the impact of such a curriculum on patients and vaccination rates.