Engaging Empathically: Effects of a Motivational Interviewing Learning Session and Standardized Patient Encounter on Medical Student Confidence in Counseling COVID-19 Vaccine-Hesitant Patients.

Abstract

Purpose: Though vaccines against COVID-19 are now widely available, a significant portion of the U.S. population remains unvaccinated. 1 Motivational interviewing (MI) has been shown to be effective in mitigating vaccine hesitancy. 2 We aimed to develop a training module for medical students to learn and practice MI techniques for use in counseling COVID-19 vaccine-hesitant patients. Approach: We developed an integrated learning module consisting of a 20-minute prerecorded didactic session covering the basics of vaccine hesitancy, MI techniques, Sharing Information, and SMART Goal Setting followed by a 15-minute telehealth standardized patient (SP) encounter with a vaccine-hesitant individual. During AY 2020–2021, all third-year (CO 2022, n = 124) and fourth-year (CO 2021, n = 88) students at the Florida International University Herbert Wertheim College of Medicine completed the module. Before viewing the prerecorded sessions, students completed a 4-question presession confidence survey (5-point Likert, Strongly Disagree–Strongly Agree). After completing the SP encounter, students completed a 5-question postsession confidence and satisfaction survey. Pre- and postsession survey results were compared by unpaired t test. Outcomes: Mean presession agreement with the statement “I feel comfortable counseling patients who demonstrate vaccine hesitancy” was found to be 2.98 (SD 0.90) and 3.67 (SD 0.70) for third- and fourth-year students, respectively. Postsession agreement increased to 4.08 (SD 0.55, P < .05) and 4.35 (SD 0.62, P < .05), respectively. Mean presession agreement with the statement “I am comfortable using MI techniques to encourage patients to become vaccinated” was found to be 3.3 (SD 0.83) and 3.65 (SD 0.69) for third- and fourth-year students, respectively. Postsession agreement increased to 4.00 (SD 0.63, P < .05) and 4.28 (SD 0.69, P < .05), respectively. Mean presession agreement with the statement “I can identify patient populations who are most at risk for vaccine hesitancy” was found to be 3.17 (SD 0.84) and 4.01 (SD 0.6) for third- and fourth-year students, respectively. Postsession agreement increased to 4.08 (SD 0.59, P < .05) and 4.50 (SD 0.54, P < .05), respectively. Mean presession agreement with the statement “I am familiar with common vaccine myths” was found to be 3.52 (SD 0.83) and 3.9 (SD 0.49) third- and fourth-year students, respectively. Postsession agreement increased to 4.20 (SD 0.48, P < .05) and 4.52 (SD 0.52, P < .05), respectively. Postsession satisfaction was high at 3.83 (SD 0.73) and 4.35 (SD 0.64) third- and fourth-year students, respectively. Significance: COVID-19 vaccine hesitancy remains a significant public and individual health threat and discussions about vaccine acceptance are difficult and sometimes divisive. To affect change, health care professionals must learn to engage empathically with vaccine-hesitant individuals. Implementation of our COVID-19 vaccine hesitancy learning module resulted in significant improvements in student confidence and high levels of learner satisfaction across both medical student cohorts. We developed a vaccine-hesitancy learning module that provides medical students with basic skills for engaging with vaccine-hesitant patients (“knows”) and provides an opportunity for early learners to practice those skills (“shows”). We have since developed an interactive online learning platform to replace the prerecorded didactic session, incorporated additional knowledge assessments, and introduced a post-SP encounter video reflection exercise. Data from this new version is forthcoming.