THE VAXED PROJECT: an assessment of immunization education in Canadian health professional programs

Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion

BACKGROUND

Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs' effectiveness using a pre-post self-assessment pilot study.

METHODS

A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy.

RESULTS

There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4-5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education.

CONCLUSIONS

Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.

Knowledge, attitudes and perceptions of nursing students regarding vaccines

BACKGROUND

 Final-year nursing students are actively involved in the delivery of public immunisation programmes as part of workplace-based learning, and require adequate knowledge, clinical skills, and attitudes regarding vaccines. This study investigated the knowledge, attitudes and perceptions regarding vaccines of final year nursing students at a South African University.

METHODS

 This cross-sectional study, through the use of an online survey questionnaire, assessed the knowledge, attitudes and perceptions regarding vaccines and the Expanded Programme of Immunization of final-year nursing students registered at a South African University during the 2021-2022 academic year.

RESULTS

 There were 68 participants enrolled in the study (85% response rate). Participants displayed good knowledge regarding vaccines (average score of 52.54/70 ± 5.01 standard deviation [s.d.]), and overall positive perceptions of their training on vaccines and its safety. Knowledge gaps were identified in the mechanisms through which vaccines confer immunity in the human body and the cold chain requirements for the storage of vaccines. Of concern was the prevalent misconception among 78% of participants that vaccines are not effective.

CONCLUSION

 The findings of this study indicate that final year nursing students at the University of KwaZulu-Natal, South Africa have good knowledge regarding vaccines. However, an improved understanding of the mechanism of vaccines will aid nursing students to confront and address misperceptions by clients thereby reducing improving vaccine uptake. Curriculum planners should also consider the inclusion of communication strategies to address vaccine hesitancy.Contribution: The study contributes to data on nurse education regarding vaccines in the African context, and identifies areas to improve vaccine uptake.

A systematic review of pre-service training on vaccination and immunization

INTRODUCTION

The World Health Organization's Global Strategy on Human Resources for Health: Workforce 2030 sets policy recommendations and targets for in-service and pre-service training programs to improve workforce competency. To date, comprehensive reviews on immunization training have mainly focused on in-service trainings. This systematic review aimed to synthesize current literature on pre-service immunization training, including primary immunization competencies covered, methods used, outcomes on improving competencies and behavior change for immunization service delivery, and student readiness for immunization practice, in both low-resource and high-income settings.

METHODS

A systematic search of seven scholarly databases identified published literature on pre-service training on immunization published between January 2001 and November 2021. It included all geographic regions and languages, study designs, and individuals preparing to enter the immunization workforce. Additional search methods included reviewing references of retrieved articles, scanning journals, and engaging pre-service training experts for unpublished reports.

RESULTS

Search results yielded 5,611 articles; 39 articles met the inclusion criteria. Five articles were identified through other search methods. Studies took place mostly in high-income countries (35/44), targeted professional (medical, nursing, and pharmacy) students and tutors at health training institutions. Eight of the ten recommended immunization competencies were included in the curricula and methods used to deliver pre-service training varied. Teaching techniques and applied learning strategies using realistic situations increased students' knowledge, attitudes, and awareness of vaccine benefits; built confidence to administer vaccines and communicate with hesitant patients; and increased the likelihood of recommending vaccines.

CONCLUSION

This review was the first step to understanding pre-service training on immunization. Further research is needed to inform pre-service training programs in low- and middle-income countries, particularly for nurses, vaccinators with low-level educational backgrounds, and other healthcare professional students. Prioritizing essential audiences, designing and delivering practical training, and evaluating results will help prepare students for the immunization challenges of tomorrow.

Training Residents and Medical Students to Overcome Parents' Vaccine Hesitancy

Strong provider recommendations increase vaccine confidence. Medical students and pediatric residents, as future physicians, will play an important role in the messaging about vaccines to their parents and patients. The importance of inclusion of vaccine education and communication skills in the medical school curriculum and residency training programs must be recognized to ensure provider confidence in discussions with vaccine-hesitant parents and patients.

Empowering Health Workers to Build Public Trust in Vaccination: Experience from the International Pediatric Association's Online Vaccine Trust Course, 2020-2021

BACKGROUND

The quality of interactions between health workers (HWs) and caregivers is key in vaccine acceptance. To optimize this, HWs need knowledge about best vaccine communication practices in person and on social media. Most pre-service curricula do not include such approaches. COVID-19 necessitated the International Pediatric Association (IPA) to shift from in-person train the trainer workshops to developing an online Vaccine Trust Course to address these gaps.

METHOD

The seven-module, 8-hour Vaccine Trust Course was offered online in seven languages and promoted globally. Course outcomes for participants between September 1, 2020 and September 30, 2021 were assessed using enrollment, participation, and completion data; pre-and post-training surveys of attitudes, knowledge, and practice skills; and follow-up practice surveys 3 months post course completion.

RESULTS

Of the 4,926 participants across 137 countries who registered; 2,381 (48.3 %) started the course, with 1,217 (51.1 %) completing. The majority were 25 - 39 years (57 %), female (57 %), and in pediatrics (70 %); 31 % came from India. 62 % of completers rated course structure/design as excellent, 36 % as good. Over 80 % rated the content as the most valuable aspect. Three months post training, 61 % HWs reported increased empathy towards caregivers, confidence while counseling and increased vaccine acceptance amongst their patients. 21 % identified the course as the only factor in these positive changes.

CONCLUSION

Shifting from face-to-face to online training due to the COVID-19 pandemic helped increase the global reach of HWs course engagement and uptake. Trained HWs reported increased empathy towards caregivers and confidence while counseling and increased patient vaccine acceptance.

Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review

In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.

An Interactive COVID-19 Vaccine Hesitancy Workshop for Internal Medicine Residents and Medical Students

Introduction

Since being first identified in December 2019, SARS-CoV-2 has resulted in millions of illnesses and deaths worldwide. Despite the safety and availability of effective vaccines that offer protection from severe COVID-19 disease, a sizable minority of the United States population has reported COVID-19 vaccine hesitancy and remains unvaccinated.

Methods

We developed an interactive workshop for internal medicine residents and medical students in which a framework is utilized to aid the subtyping of COVID-19 vaccine hesitancy. Learners then interactively apply this framework through vaccine counseling in a role-playing exercise.

Results

The workshop increased confidence in the learner's ability to determine the COVID-19 vaccine hesitancy subtype after participation in the workshop (53% preworkshop, 81% postworkshop, p=0.01). The workshop also increased reported confidence in tailoring COVID-19 vaccine counseling after participation in the workshop (60% preworkshop, 90% postworkshop, p=0.005). These gains were also seen when participant learners were compared with nonparticipant learners for both subtyping confidence (81% postworkshop, 26% nonparticipant, p<0.0001) and confidence in providing tailored counseling (90% postworkshop, 60% nonparticipant, p=0.004).

Conclusion

The implementation of our workshop correlated with an increase in the reported trainee confidence related to COVID-19 vaccine counseling. This offers a promising early step in developing educational programs that build trainee skills in this domain. More work is needed to establish robust curricula to support learners in reaching patients who express COVID-19 vaccine hesitancy. 

A Needs-Based Analysis of Teaching on Vaccinations and COVID-19 in German Medical Schools

The COVID-19 pandemic highlights the need for improving public confidence in vaccines. Academic gaps and redundancies on vaccinations must be identified to revise the medical curriculum for up-to-date training of medical students. This cross-sectional survey assessed the status of vaccine-related teaching in general and specific to COVID-19 in medical schools across Germany. A total of 4313 medical students completed a questionnaire comprising items on national learning goals and perceived needs for teaching on vaccinations. Mixed methods were used to analyse data quantitatively for relative frequencies (%) and correlations between teaching items and semesters (Spearman’s rho), and qualitatively (content analysis). Our findings showed that 38.92% of the students were dissatisfied with teaching on vaccine-preventable diseases, but the perceived satisfaction increased in later semesters (r = 0.46, p < 0.001). Moreover, 75.84% and 68.15% of the students were dissatisfied with teaching related to vaccine scepticism and vaccine-related communication strategies, respectively. Furthermore, 63.79% reported dissatisfaction with teaching on COVID-19 disease and 72.93% with teaching on COVID-19 vaccines. A total of 79.12% stated they educated others on COVID-19 and its vaccines and 75.14% felt responsible to do so. A majority of the medical students were dissatisfied with teaching on dealing with vaccine scepticism, communication strategies and COVID-19 vaccines. We recommend practice-oriented vaccine education, especially for teaching communication skills to medical students.

Vaccine hesitancy in health-care providers in Western countries: a narrative review

INTRODUCTION

Vaccine hesitancy (VH) is a leading cause of suboptimal vaccine uptake rates worldwide. The interaction between patients and health-care providers (HCPs) is the keystone in addressing VH. However, significant proportions of HCPs, including those who administer vaccines, are personally and professionally vaccine-hesitant.

AREAS COVERED

This narrative review sought to characterize the nature, extent, correlates, and consequences of VH among HCPs. We included 39 quantitative and qualitative studies conducted in Western countries, published since 2015, that assessed VH among HCPs in general, for several vaccines. Studies were reviewed using the WHO 3Cs model - (lack of) confidence, complacency, and (lack of) convenience.

EXPERT OPINION

Despite the lack of validated tools and substantial heterogeneity in the methods used to measure VH among HCPs, this review confirms its presence in this population, at frequencies that vary by country, profession type, setting, and level of medical education. Lack of knowledge and mistrust in health authorities/pharmaceutical industry/experts were among its principal drivers. Improving the content about vaccination in HCPs' training programs, facilitating access to reliable information for use during consultations, and developing and validating instruments to measure HCPs' VH and its determinants are key to addressing VH among HCPs.

The Attitude towards Vaccination of Health Sciences Students at a Spanish University Improved over the First 18 Months of the COVID-19 Pandemic

It is important to know the attitudes of students of health sciences (SHSs) towards vaccination since they will be tomorrow's health professionals. Vaccination is a powerful tool in the fight against COVID-19. The aim of the present, cross-sectional study was to examine how the COVID-19 pandemic has influenced the attitude of SHSs towards vaccination. Data were collected in the form of a questionnaire from all students of nursing, physiotherapy and chiropody matriculated at a Madrid University for the academic year 2019/2020 (i.e., before the start of the pandemic [Q1]), and from all those matriculated for the year 2021/22 (i.e., c18 months after the pandemic was declared [Q2]). A multivariate analysis was performed to identify the influence of sex, degree being studied, course year and the time of answering (Q1 or Q2), on the dimensions Beliefs, Behaviours and General Attitude. Overall, 1894 questionnaires were returned (934 [49.3%] for Q1, and 960 [50.7%] for Q2), of which 70.5% were completed by students of nursing, 14% by students of physiotherapy and 15.4% by those studying chiropody. In Q2, the results for all three dimensions were significantly better (p < 0.05). The most important influencing factors were being a student of nursing, being in the final years of training (years 3 or 4), female gender and answering at the time of Q2. The results obtained are encouraging since student nurses (who showed Q1 and Q2 General Attitude scores of 3.34 and 3.47 (maximum possible 4), respectively [p < 0.05]) are the health professionals of tomorrow most likely to be involved in vaccination programmes.

Vaccine Coverage against Influenza and SARS-CoV-2 in Health Sciences Students during COVID-19 Pandemic in Spain

Vaccination against influenza and SARS-CoV-2 is recommended in health sciences students to reduce the risk of acquiring these diseases and transmitting them to patients. The aim of the study was to evaluate how the pandemic influenced the modification of influenza vaccination coverage during the 2019/2020 and 2021/2022 campaigns and to analyze the vaccination coverage against SARS-CoV-2 in health sciences students. A cross-sectional study was conducted among students of the Faculty of Nursing, Physiotherapy and Podiatry of the Complutense University of Madrid. A questionnaire was administered in two stages, the first, Q1, before the start of the pandemic, where we analyzed influenza coverage during the 2019/2020 campaign and a second, Q2, 18 months after the start of the pandemic where we analyzed influenza coverage during the 2021/2022 campaign and coverage against SARS-CoV-2. A total of 1894 students (58.78% of the total of those enrolled) participated. Flu vaccination coverage increased from 26.7% in Q1 to 35.0% in Q2 (p < 0.05), being higher in the age group older than 21 years, who studied nursing, were in their fourth year and lived with people at risk. Vaccination coverage against SARS-CoV-2 was very high (97.8%), especially in students vaccinated against influenza. Coverage of the influenza vaccine in health sciences students increased from 2019–2020 to 2021–2022, being higher in the age group older than 21 years, who studied nursing, were in their first and fourth year and lived with people at risk. Coverage of the SARS-CoV-2 vaccine in health sciences students was very high, especially in those vaccinated against influenza.

Immunization training for pharmacy students: a student-centered evaluation

Background:

Persistent and emerging public health challenges mean Pharmacy students require training in immunization services. Curtin University, Australia, integrated blended-delivery immunization training into the final-year Bachelor of Pharmacy (Hons) and graduate-entry Master of Pharmacy curricula in 2019 and 2020, utilizing materials licenced from the Pharmaceutical Society of Australia.

Objective:

This study evaluated changes in students’ attitude, confidence, self-perceived knowledge and self-perceived skills pre- and post-training delivered in 2020.

Methods:

Pre- and post-training questionnaires featured 42 opinion statements grouped under headings ‘Attitudes’, ‘Confidence’, ‘Self-Perceived Knowledge’ and ‘Self-Perceived Skills’, and answered using five-point Likert scales (1 = strongly disagree to 5 = strongly agree). Completed pre- and post-training questionnaires were matched using respondent-generated codes. Data were subjected to descriptive and multivariate regression analysis to test pre-post changes and associations and changes in mean scores.

Results:

128 (95.5%) and 132 (98.5%) students completed the pre- and post-training questionnaires, respectively. Immunization training resulted in significant (p<0.05) improvement in students’ mean Confidence score (3.33 vs 3.96), Self-Perceived Knowledge score (3.08 vs 4.47) and Self-Perceived Skills score (2.81 vs 4.55). Improvement in students’ mean Attitude score was also statistically significant (4.45 vs 4.61), yet more positively skewed pre-training. No significant pre-post differences were found between the Bachelor and Master students. Post-training, all respondents agreed that the training program increased their attitude, confidence, perceived knowledge and perceived skills, rating the training experience as either Excellent (91.6%) or Good (8.4%).

Conclusions:

Immunization training integrated into final-year BPharm (Hons) and MPharm curricula improved Attitudes, Confidence, Self-Perceived Knowledge and Self-Perceived Skills, all key to further role development in public health. This method is recommended to other Pharmacy schools to determine the impact and acceptability of immunization training programs amongst students.

A brief educational intervention can improve nursing students' knowledge of the human papillomavirus vaccine and readiness to counsel

Provider recommendation is a primary reason for patient uptake of the human papillomavirus (HPV) vaccine. Most provider-focused educational interventions are focused on physicians, even though nurses are also important sources of vaccine-related information for their patients. This study examined whether a HPV educational intervention could improve nursing students' HPV knowledge, beliefs, and comfort with counseling. The same lecture on HPV and HPV vaccination was given to both medical and nursing students. To determine the effects of the lecture, students were asked to complete identical pre- and post-lecture tests with questions on demographics, knowledge, attitudes, and comfort with counseling on the HPV vaccine. Pre- and post-lecture test scores were compared between nursing and medical students to assess whether there were differences in pre-lecture test scores and/or changes in post-lecture test scores. On the pre-lecture tests, fewer nursing students responded correctly to knowledge questions, indicated positive attitudes or comfort with counseling about the HPV vaccine compared to medical students. However, similar frequencies of nursing and medical students responded correctly to knowledge questions and indicated a positive attitude, as well as a high comfort level with counseling on the post-lecture tests. Study results show that integrating lectures in a nursing program curriculum could be a feasible way to increase students' HPV knowledge. Having health-care providers with similar levels of knowledge, attitudes, and comfort with counseling on HPV vaccination is ideal, as all share the responsibility of recommending the vaccine to patients.

The intent of students to vaccinate is influenced by cultural factors, peer network, and knowledge about vaccines

Young adults are the future vaccine decision-makers as parents or health-care professionals. To understand their attitudes and behaviors toward vaccination, we conducted a cross-sectional survey of 2079 students attending the University of Antwerp, Belgium and the University of Pisa, Italy. Principal component analysis was used to investigate associations between survey responses and the intent to vaccinate. Vaccination knowledge, attitudes, and behaviors among university students in Italy and Belgium were high. However, only one-half of respondents displayed an intent to vaccinate. High levels of knowledge, positive attitudes, and confidence in vaccines were positively associated with age, higher level of study, being a medical student, a recent vaccination experience, and not knowing trusted persons who did not believe in vaccines. Country of origin was highly correlated with the survey responses and was clustered with lifestyle, family, and data source variables, suggesting a strong modifying effect of culture and family attitudes on how vaccines are perceived in this age-group. Recent meningococcal vaccination campaigns and public discussions around mandatory vaccination in Italy may have influenced these results. We show that the intent to vaccinate was correlated with two main clusters of variables linked to culture (country, family, lifestyle), and to scholarship (knowledge, attitudes, data source) that together influence the behavior of students with respect to vaccination. Our study reinforces previous findings that knowledge about vaccines is key to shaping attitudes and behaviors, but also shows that cultural and lifestyle factors are another platform that could be leveraged in promoting vaccination among young people.

Attitude towards Vaccination among Health Science Students before the COVID-19 Pandemic

Health science students are tomorrow's health professionals, the duties of whom could include vaccination. This work examines the general attitude towards vaccination in students attending the Faculty of Nursing, Physiotherapy and Chiropody at a university in Madrid, Spain, using the 'Attitudes and Behaviour With Regard To Vaccination Among Health Science Students Questionnaire'. The results were subjected to multivariate analysis to identify the influence of sex, the degree being pursued, and 'course year'. The number of students vaccinated against influenza in the campaign preceding the present study was also recorded, as were the factors that influenced decision-making in this regard. A total of 934 students completed the questionnaire. Their beliefs regarding vaccination were positive (mean score 3.23 points out of 4), as was their behaviour (3.35/4). Their general attitude (all variables taken together) was therefore also good (3.27/4). Only 26.8% of the students had been vaccinated against influenza. Beliefs scores among the students of nursing in their more senior course years were significantly better than those recorded for all other groups. These students also showed the best general attitude towards vaccination and formed the largest group vaccinated against influenza. The results obtained are encouraging since nursing students are the most likely of future healthcare professionals to be involved in vaccination programmes.

Vaccination perception and coverage among healthcare students in France in 2019

BACKGROUND

Vaccine hesitancy in healthcare workers has been increasing especially in France while they are the cornerstone of vaccination programs. Greater understanding of healthcare students (HCS) vaccine knowledge, attitudes and beliefs is necessary to provide an adequate vaccination education to better equip them to promote vaccination in their future careers. The aim of this study was to assess vaccination perception (VP) (perception of benefits and risks of vaccines) and its impact on vaccination coverage (VC) for mandatory and recommended vaccines among HCS.

METHODS

A standardized, anonymous self-reporting electronic questionnaire was prospectively sent to HCS (medicine, nursing, pharmacy, midwifery, physiotherapy students and 1st year of health sciences students) of Normandy University in France between 18/03/2019 and 8/04/2019. VP was evaluated with questions regarding vaccination hesitancy, safety of vaccine and the benefit/risk balance of vaccination. Global VC (GVC) was defined as being vaccinated according to the mandatory and/or recommended vaccination schedule by national French law in 2018.

RESULTS

542 HCS took part in this survey. VC was high for mandatory (diphtheriae, poliomyelitis, tetanus 93.5%, hepatitis B virus 88.6%) and even most of recommended vaccinations (measles 95%, pertussis 88.2%). Global VC (40.4%) was not statistically different between HCS except for 1st year health sciences students who were less vaccinated (25.6%). Regarding VP, 97.8% of HCS thought that vaccine are effective. When vaccine safety and level of vaccine hesitancy were assessed (on a 0-10 scale, 0: not safe or not hesitant and 10: completely safe and strongly hesitant for vaccine), 91% of respondents stated that vaccine safety is ≥7 and in 80% the vaccine hesitancy was < 3. There was no difference among student categories. 80.6% of HCS recommended all vaccines but only 52% agreed that flu vaccination should be mandatory for HCS. In the multivariate analysis, being a 1st year health care sciences student was associated with a lower GVC (OR 95% CI = 2 [1.2-3.3], p = 0.004) than being a medical student.

CONCLUSION

HCS perceived vaccine as effective and secure. Despite the good perception of vaccines, less than half HCS are well vaccinated.

Evaluation of a pilot immunization curriculum to meet competency training needs of medical residents

BACKGROUND

Vaccination is the most cost-effective medical intervention known to prevent morbidity and mortality. However, data are limited on the effectiveness of residency programs in delivering immunization knowledge and skills to trainees. The authors sought to describe the immunization competency needs of medical residents at the University of Toronto (UT), and to develop and evaluate a pilot immunization curriculum.

METHODS

Residents at the University of Toronto across nine specialties were recruited to attend a pilot immunization workshop in November 2018. Participants completed a questionnaire before and after the workshop to assess immunization knowledge and compare baseline change. Feedback was also surveyed on the workshop content and process. Descriptive statistics were performed on the knowledge questionnaire and feedback survey. A paired sample T-test compared questionnaire answers before and after the workshop. Descriptive coding was used to identify themes from the feedback survey.

RESULTS

Twenty residents from at least six residencies completed the pre-workshop knowledge questionnaire, seventeen attended the workshop, and thirteen completed the post-workshop questionnaire. Ninety-five percent (19/20) strongly agreed that vaccine knowledge was important to their career, and they preferred case-based teaching. The proportion of the thirty-four knowledge questions answered correctly increased from 49% before the workshop to 67% afterwards, with a mean of 2.24 (CI: 1.43, 3.04) more correct answers (P < 0.001). Sixteen residents completed the post-workshop feedback survey. Three themes emerged: first, they found the content specific and practical; second, they wanted more case-based learning and for the workshop to be longer; and third, they felt the content and presenters were of high quality.

CONCLUSIONS

Findings from this study suggest current immunization training of UT residents does not meet their training competency requirements. The study's workshop improved participants' immunization knowledge. The information from this study could be used to develop residency immunization curriculum at UT and beyond.

Not Throwing Away My Shot: Leveraging a Peer Vaccination Workshop to Increase Residents' Immunization Skills

OBJECTIVE

The Accreditation Council for Graduate Medical Education (ACGME) requires that pediatric residents demonstrate competence administering immunizations. Despite mandatory simulation training, less than half our residents reported immunization competence. All residents need to receive their influenza vaccination, but schedule restrictions present logistical challenges. We implemented a peer influenza immunization workshop and assessed the impact on resident immunization competence compared to simulation-only training.

METHODS

Prospective cohort study at a pediatric residency program in a tertiary academic center. We implemented an annual influenza immunization workshop including immunization education, simulated practice, and peer influenza immunization. We compared workshop participation to simulation-only training on resident confidence immunizing, number of immunizations logged, and ACGME survey results for immunization skills.

RESULTS

In 2019, 80% (N = 59) of residents participated in the workshop. Participants were more likely to report confidence in immunization skills than nonparticipants (P = .001). Resident-administered immunizations increased from 1 in the 3 years preceding workshop implementation to 74 during the 2019 to 2020 academic year. Significantly, more ACGME survey respondents reported preparedness to immunize after workshop implementation (P = .02).

CONCLUSIONS

Implementation of an influenza immunization workshop provides an innovative opportunity to increase resident preparedness performing an ACGME-required procedure while also helping ensure programs remain compliant with influenza requirements.

Assessing primary health care nurses' knowledge toward immunizations: A quantitative study

Background: The current nursing workforce needs to be skilled, confident, and competent to address the rapid change in Primary Health Care services, to align with the National Vision of Qatar. This is emphasized in the Primary Health Care Strategy 2018-2023. This strategy outlines the need of having a skilled nursing workforce to administer and educate the public about the importance of immunizations. Primary Health Care nurses emanate from several nationalities and hence possess various level of knowledge and background related to immunization administration.

Design and methods: To assess Primary Health Care nurses’ knowledge before and after the delivered immunization education program in Qatar. The study was part of a Sequential mixed method research study that aimed to assess the Primary Health Care nurses’ knowledge, attitude, and practice of nurses before and after the conducted training program. A self-administered survey, specifically developed for the research project was loaded in Qualtrics and sent to participants of the immunization education program before and after training. Participants were trained in two cohorts from October to December, 2018 in Qatar. For the purposes of this paper, data about the immunization knowledge was statistically analyzed using the SPSS Software version 25 and Microsoft Excel.

Results: Specific areas were identified as knowledge gaps among the participants of the two cohorts. Moreover, the developed education program showed overall improvement in the participants’ knowledge.

Conclusions: The study results have demonstrated that the delivered immunization education program significantly increases the participants’ knowledge about immunization in certain areas of the primary healthcare clinics they work, including vaccine safety, efficiency, and contraindications in the delivery of vaccines to the public.

Vaccine Hesitancy among Master's Degree Students in Nursing and Midwifery: Attitude and Knowledge about Influenza Vaccination

Influenza vaccination among healthcare workers may reduce morbidity and protect fragile patients. Most of the evidence concerning the vaccine hesitancy of healthcare workers reported lack of knowledge and wrong attitude. The aims of this study were to explore the knowledge and attitudes about influenza vaccination among master's degree students in Nursing and Midwifery, and to evaluate the effectiveness of their involvement in the hospital vaccination campaign in order to increase intention to receive immunization. The students of nurses and midwives were involved in the vaccination sessions of the 2018-19 hospital campaign. They were recruited to complete an online survey. Students of the 2nd year (involved in the vaccination campaign) and the 1st year (not involved) were compared. Descriptive and inferential statistics were performed for data analysis. Students who intend to receive influenza vaccination in the following year registered a percentage of 83.6% and showed an overall attitude of 66.8%. The involvement of the students in the vaccination campaign led to a significant increase in their positive vaccination attitude (80.9% vs. 87.0%) and in their intention to receive flu vaccination in the following year (67.7% vs. 100%). A positive attitude towards vaccinations was observed by nurses and midwives. Their involvement in the planning and activities during the vaccination campaign could positively influence their opinions and intention to receive vaccination.

A Comparison of the Attitudes to Influenza Vaccination Held by Nursing, Midwifery, Pharmacy, and Public Health Students and Their Knowledge of Viral Infections

Influenza is a viral vaccine-preventable disease. The present study aims to explore the attitude to influenza immunization and the knowledge of influenza among students in Poland. A cross-sectional survey was conducted at the end of 2019 and the beginning of 2020 among students of Nursing, Midwifery, Pharmacy, and Public health in all years of study. Data was obtained from 1137 students (90.7% female, 9.3% male), mean age 21.3 ± 1.62 years. The urban students were more likely to be vaccinated against seasonal influenza than rural students (OR: 1.52; 95% CI [1.10-2.10], p = 0.010362). The students of Public health were more likely to be vaccinated against influenza (48.9%, regularly annually 1.1%) than Pharmacy (31%, regularly annually 2.5%), Nursing (30.7%, regularly annually 1.3%) or Midwifery (25.1%, regularly annually 2.4%). First-year and second-year students were vaccinated more often (OR: 2.75; 95% CI [1.99-3.82], p = 0.00000; OR: 1.84; 95% CI [1.32-2.59], p = 0.0004, respectively) than later-year students. All students reported the main reasons for vaccination to be their own protection and parental decision. Concluded, present findings demonstrate a low prevalence of flu vaccination among medical students. Therefore, strategies are needed to increase the uptake of influenza vaccine in students, especially considering the future contact between this group of future health care workers and higher risk groups.

Healthcare Workers Training Courses on Vaccinations: A Flexible Format Easily Adaptable to Different Healthcare Settings

Since 2017, Italy has expanded the compulsory vaccination from 4 to 10 for those aged 0 to 16 years. Because of the great organizational effort required for the immunization services, minor attention was given to the vaccinations not included among the mandatory ones. This situation led to a real difficulty in harmonizing the vaccination procedures even inside a single region. In the Lazio region, the Laboratory of Vaccinology of the University of Rome Tor Vergata established a working group to create a new training model for healthcare professionals. The course program proposed an update of three vaccinations which are not mandatory but actively offered. It included the same part of scientific updating and a variable part based on local experiences. A specific anonymous questionnaire on knowledge and attitude was administered. The study aimed to propose a general format of training courses for vaccination centers adaptable to the individual local health units (ASLs) and to evaluate through questionnaires. The results show differences in knowledge and attitudes toward non-mandatory vaccinations among the ASLs of Lazio, confirming the usefulness of a support to make knowledge and procedures homogeneous. This model could be adapted to any healthcare setting and exported to other services.

Medical students' knowledge and attitudes regarding vaccination against measles, influenza and HPV. An international multicenter study

Introduction

Inaccurate information leads to increased scepticism concerning vaccinations among health care workers. Therefore, a proper education of medical students on vaccination is important.

Methods

During summer term 2015, we performed a paper-based survey to identify the knowledge and attitudes of medical students on vaccinations against measles, influenza and HPV in seven medical schools in Germany, Austria and Switzerland.

Results

Altogether, 3,652 questionnaires were analyzed. Knowledge of country-specific public recommendations increased significantly with the number of semesters of medical studies. Concerning the knowledge about vaccinations against measles, influenza and HPV, one third of the answers were given correctly. Again, a strong correlation between the knowledge and the semester of medical studies could be observed. The attitudes concerning vaccinations in general and especially for HCWs were highly positive.

Conclusions

This study provides some important arguments for the development of a comprehensive vaccination education for medical students.

Knowledge and attitudes toward vaccination among Saudi medical students

Background:

Studies have identified healthcare providers as an important determinant of vaccination acceptance. However, knowledge and attitudes toward vaccination have not been sufficiently studied in Saudi Arabia, especially among medical students. Therefore, we conducted this study to explore vaccination knowledge and attitudes among medical students at a large Saudi university.

Methods:

A cross-sectional survey was conducted on 182 Saudi medical students between February 2019 and May 2019. Participants were invited to fill out a self-administered questionnaire assessing knowledge and attitudes toward vaccination. The statistical analysis included descriptive analysis, Chi-square test, independent samples t-test, and analysis of variance (ANOVA). The relationship between knowledge and attitudes was assessed using Pearson's correlation test.

Results:

A total of 182 respondents completed the questionnaires, giving a response rate of 91%. The study included male (52.7%) and female (47.3%) students from study years 2, 3, 4, 5, and 6. The overall mean knowledge score was under average [3.05/9, standard deviation (SD) = 1.86] and the respondents showed generally moderate attitudes toward vaccination (mean = 30.60/45, SD = 6.07). While there was no sex difference in both the scores on knowledge and attitudes domains, the year of study was significantly associated with the mean knowledge score (F = 6.48, P < 0.01) and attitudes score (F = 7.12, P < 0.01). As predicted, there was a significant linear relationship between vaccination knowledge and attitudes (r = 0.71, P < 0.01).

Conclusion:

The study revealed generally moderate attitudes of Saudi medical students toward vaccination. However, several knowledge gaps were detected. The implications of the current findings are discussed.

Development of a Platform to Align Education and Practice: Bridging Academia and the Profession in Portugal

Limited fitness for practice may result from a mismatch between education and practice. Aiming to meet the common interests of academics and practitioners, the Portuguese Pharmaceutical Society (PPS) developed the Education and Practice Platform (EPP). The EPP includes one representative from each pharmacy faculty, and all Councils of Speciality Boards of Practice. Brainstorming with involved parties enabled sharing of interests, concerns and identifying a common path. Aims, mission, vision and values were set. The EPP’s mission is to: act as an enabler to foster the quality and adequacy of education through sharing best practices, ultimately leading to facilitate professional integration, and to foster quality development in teaching practices with recognition for autonomy in freedom to teach and to learn. Its vision is an alignment of education and practice with the PPS’ statutes to ensure validation of the competences defined for each practice area, and compliance with international guidance. Key performance indicators (KPIs) were set. Activities developed include the creation of a national forum to discuss education and practice, development of workshops on teaching methods and pharmacy internships, enhanced representation in international events and response to global and national requests. Ongoing work focuses on the creation of a common training framework in hospital and community pharmacy practice adapted to Portugal. The EPP is a worldwide case study, encouraging the development of discussion contributing to an open climate of sharing best practices, indirectly leading to foster a better alignment between education and practice. Many of these results are so far intangible in scientific terms but worth describing.

Knowledge and attitudes toward vaccination among Saudi medical students

Background:

Studies have identified health care providers as an important determinant of vaccination acceptance. However, knowledge and attitudes toward vaccination have not been sufficiently studied in Saudi Arabia, especially among medical students. Therefore, we conducted this study to explore vaccination knowledge and attitudes among medical students at a large Saudi university.

Methods:

A cross-sectional survey was conducted on 182 Saudi medical students between February 2019 and May 2019. Participants were invited to fill out a self-administered questionnaire assessing knowledge and attitudes toward vaccination. The statistical analysis included descriptive analysis, Chi-square test, independent samples t-test, and analysis of variance (ANOVA). The relationship between knowledge and attitudes was assessed using Pearson's correlation test.

Results:

A total of 182 respondents completed the questionnaires, giving a response rate of 91%. The study included male (52.7%) and female (47.3%) students from study years 2, 3, 4, 5, and 6. The overall mean knowledge score was under average (3.05/9, SD = 1.86) and the respondents showed generally moderate attitudes toward vaccination (Mean = 30.60/45, SD = 6.07). While, there was no sex difference in both the scores on knowledge and attitudes domains, the year of study was significantly associated with the mean knowledge score (F = 6.48, P < 0.01) and attitudes score (F = 7.12, P < 0.01). As predicted, there was a significant linear relationship between vaccination knowledge and attitudes (r = 0.71, P < 0.01).

Conclusion:

The study revealed generally moderate attitudes of Saudi medical students toward vaccination. However, several knowledge gaps were detected. The implications of the current findings are discussed.

First year allopathic medical student attitudes about vaccination and vaccine hesitancy

First year medical students at an allopathic medical school regional campus were asked to complete a 10-question survey at both the beginning and the conclusion of a required course on immunology, hematology and oncology. The survey was designed to solicit student attitudes about vaccination and the students' level of comfort with and exposure to vaccine hesitant patients. Surveys were administered to five consecutive classes from 2013 to 2017. Total response rate for completion of both surveys was 58.0% (178/307). Pre- and post-course surveys were administered to assess whether curricular experiences altered the students' perceptions about vaccinations and their ability to counsel vaccine hesitant patients. Curricular elements were presented in several different formats aimed at increasing student knowledge about vaccinations and student capacity to work with vaccine hesitant patients and families (problem-based learning, didactic lecture and interactive panel discussion). In the pre-survey, the majority of students reported having already encountered people who decline vaccinations (78.8%). Additionally, in the pre-survey the majority of medical students expressed strong support for vaccination (99.6% agreed with the statement that Vaccinations are a great public health accomplishment) and strong disagreement with both of the assertions that childhood vaccines cause autism and vaccine preservatives cause adverse health effects. In response to questions about comfort level while talking with patients about vaccine choices, baseline responses demonstrated a moderately high level of comfort. Post-course surveys revealed a statistically significant increase in student-rated comfort level in talking with patients about vaccine choices (pre-survey 79.2% report comfort versus post 97.8%; p < 0.001). Though this study is limited to student self-reporting, survey responses suggest that targeted curricular elements can improve medical student confidence in counseling patients about vaccinations. Future curricular elements designed to directly observe student performance could provide verification of counseling skill acquisition.

Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States

BACKGROUND

In addition to administering vaccinations, healthcare professionals (HCPs) also play a crucial role in providing education and advocacy to the public regarding immunizations. Yet, many current and future HCPs are unprepared or reluctant to address the vaccine conversation with hesitant patients. Doctors, pharmacists, and nurses are all recognized as the most trusted sources of vaccine information. By comparing future HCPs in these three distinct programs, we can better understand where potential gaps may lie in their training and education. With insight from students, potential changes to curriculum can improve future HCPs ability to address vaccine hesitancy in their respective careers. The objective of this study was to assess and compare the knowledge, attitudes, and opinions of HCP students on the topic of immunization.

METHODS

A cross-sectional survey was conducted in 2017 to assess students in nursing, medical, and pharmacy programs at two universities in the state of North Dakota in the United States. The survey assessed six key themes: 1) demographic information; 2) basic vaccine knowledge; 3) vaccine hesitancy; 4) likelihood to recommend vaccines; 5) confidence in addressing vaccine-related topics with patients; 6) an appraisal of the education they have received on vaccinations.

RESULTS

The survey was completed by 223 participants (overall response rate = 23.7%). Results indicated that vaccine-related knowledge varied greatly by program; high knowledge scores were achieved by 74.3% of medical students, 62.7% of pharmacy students, 57.1% of doctor of nursing practice (DNP) students, and 24.7% of bachelor of science in nursing (BSN) students. Over a third (34.2%) of BSN students believed that the current recommended immunization schedule places undue burden on a child's immune system, versus only 4.3% of medical students. Additionally, 54.2% of participants believed that spreading out recommended vaccines over several visits was an appropriate means of reducing parental stress about vaccinating.

CONCLUSIONS

Participant responses suggest that negative attitudes, lack of knowledge, and general discomfort exist across all programs, but especially among nursing students, regarding vaccination. Our findings indicate potential areas where targeted interventions could be implemented to better equip future HCPs in their ability to discuss and educate the public regarding vaccination.

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Awareness and Factors Associated with Health Care Worker's Knowledge on Rubella Infection: A Study after the Introduction of Rubella Vaccine in Tanzania

Background Congenital rubella syndrome is a global health problem. The incidence is much higher in Africa and Southeast Asia than the rest of the world, especially in countries where universal rubella vaccination has not been implemented. Healthcare worker's knowledge on rubella infection and the rubella vaccine is of utmost importance in achieving and maintaining vaccination coverage targets. This study aimed to assess health care workers knowledge on rubella infection in Kilimanjaro Tanzania, after the introduction of a rubella vaccination. Methods This was a health facility-based cross sectional study. It was conducted in three districts of the Kilimanjaro region between August and October 2016. The study involved eligible health care workers in selected health facilities. An interview guide was used for collecting information by face-to-face interviews. Multivariate analysis was used to assess factors associated with rubella knowledge among healthcare workers. Results A total of 126 health care workers were interviewed. An acceptable level of knowledge was considered if all five questions about rubella were correctly answered. Only 26.4% (n = 31) answered all questions correctly. In multivariate analysis education level and working department were predictors of rubella knowledge; health care workers with an advanced diploma had an adjusted odds ratio (AOR) of 7.7 (95% Confidence interval; CI: 1.4, 41.0), those with a university degree (AOR: 10; 95% CI: 2.4; 42.5) and health care workers in the outpatient department (AOR: 0.06; 95% CI: 0.04; 0.29). Conclusions Our study confirmed that health care worker's knowledge on rubella infection was low in the areas where rubella vaccination had been introduced. We recommend continuous education and supportive supervision post vaccine introduction in order to increase healthcare worker's knowledge on rubella infection, congenital rubella syndrome and prevention through sustained high vaccination coverage.

Knowledge, attitudes, behaviours, and beliefs of healthcare provider students regarding mandatory influenza vaccination

Influenza infection poses the same risk to healthcare students as to practising clinicians. While there is substantial dialog about the benefits, risks, and ethics of mandatory influenza immunization policies in Canada, there has been little engagement of healthcare students. To explore the knowledge, attitudes, beliefs, and behaviours of healthcare students, we administered a web-based survey to students at Dalhousie University. Influenza vaccination status varied by program type, with 86.3% of medical students (n = 124) and 52.4% of nursing students (n = 96) self-reporting receipt of the influenza vaccine both in the previous and current seasons; pharmacy students' coverage fell between the two. Pharmacy students had higher mean knowledge scores (10.0 out of 13 questions) than medical (9.26) and nursing (8.88) students. Between 56.1% and 64.5% of students across disciplines were in support of a mandatory masking or vaccination policy, and between 72.6% and 82.3% of students would comply if such a policy were in place. A sense of duty to be immunized, desire to be taught more about influenza and influenza vaccine, belief that the hospital has a right to know vaccination status, support for declination policy, and willingness to accept consequences of noncompliance were all predictors of student support of mandatory policies. Medical and pharmacy students tended to hold more pro-influenza vaccination attitudes, had higher knowledge scores, and better vaccine coverage than nursing students. Based on the overall vaccination behaviour, knowledge, beliefs, and attitudes of students surveyed, this study demonstrates that mandatory influenza immunization policies are generally supported by the next generation of practitioners.

Simulated Encounters With Vaccine-Hesitant Parents: Arts-Based Video Scenario and a Writing Exercise

Vaccine hesitancy is an increasing and urgent global public health challenge. Medical students' encounters with vaccine-hesitant parents, however, remain incidental and unexplored. During pre-clinical training, the vaccine-hesitant parents are typically represented through impersonal text-based cases, lists of their concerns, and sometimes a virtual patient. However, in reality, vaccine-hesitant parents have many health beliefs and arguments that are accompanied with intense emotions, and students remain unaware and unprepared for them. This study is an experimental pilot test in stimulating the medical students' understanding of, and ability to respond to, vaccine-hesitant parents' beliefs and questions. An arts-based video scenario and a writing exercise are used to demonstrate a rich case of vaccine hesitancy, including a simulated dialogue between a parent and a student. The study invites vaccine-hesitant parents to ask questions to medical students, then it incorporates these questions in a video scenario and subsequently invites the students to answer these questions as junior doctors. The study examines how the peer group discussion after the video viewing resembles a hospital breakroom conversation and how the written dialogue with a vaccine-hesitant parent simulates a consultation-room encounter.

Vaccine Education of Medical Students: A Nationwide Cross-sectional Survey

Physicians play a primary role in vaccination of the population. Strong initial training of medical students is therefore essential to enable them to fulfill this role. This cross-sectional nationwide online survey conducted between September 2015 and January 2016 obtained 2,118 completed surveys from 6,690 eligible respondents (response rate, 32%) at 27 of 32 medical schools in France regarding their education about vaccination. The data were analyzed in April-June 2016. The survey covered their knowledge, attitudes, practices, and perceptions, and assessed their level of perceived preparedness for their future practice as interns. Around a third of the students (n=708, 34%) felt insufficiently prepared for questions about vaccination, especially for communicating with patients on side effects (n=1,381, 66%) and strategies to respond to vaccine hesitancy (n=1,217, 58%). The mean knowledge score was 26/45 (SD=7.9). Lecture courses, which are the main education method used in French medical schools (1,891/5,660 responses, 33%), were considered effective by only 11% of students (693/6,155 responses), whereas practical training was significantly associated with better perceived preparedness (p<0.001). In conclusion, education about vaccination during medical school in France is not optimal. Methods based on practical learning methods (case-based learning, clinical placements, and other hands-on methods) appear to produce the best results and must be favored for improving students' preparedness.

Knowledge and attitudes toward vaccination: A survey of Serbian students

Since vaccination coverage in Serbia has been decreasing and health professionals have been identified as the most important factor in making decisions about immunization, vaccination knowledge and attitudes of students, especially medical students, are of particular interest. A cross-sectional survey was carried out on three groups of 509 Belgrade University students (medical, law and engineering students). The data were collected using an on-line questionnaire posted to student groups and included the Vaccine Knowledge Questionnaire and Attitudes Toward Vaccination Scale. This survey also included questions about demographic characteristics and perceived negative experiences. Multiple linear regression analysis was performed. There was a significant difference in the Vaccine Knowledge score (F=40.48, p<0.01) among the three groups of students. Medical students (N=251, Mean=4.47, SD=1.71) had significantly higher mean knowledge scores than did law (N=128, Mean=2.80, SD=1.56) or engineering students (N=130, Mean=3.98, SD=1.81). Compared with the law (Mean=49.77, SD=10.23) and engineering students (Mean=57.62, SD=12.21), medical students (Mean=59.52, SD=9.62) also had significantly higher attitude scores (F=37.56, p<0.01). These findings demonstrate general positive attitudes of Serbian students toward immunization. However, some knowledge gaps were identified. Multivariate analysis showed that those who had better vaccine knowledge, those who studies medicine, those who attended at university for more years, and those who do not know someone who had a negative experience with vaccines were more likely to have positive attitudes toward vaccination. Considering the growing vaccination hesitance in the general population, this is an important result that indicates that medical students are possible important participants in future public health campaigns. A strong association between vaccine knowledge and attitudes implies recommendations to introduce a specialized vaccination curriculum at both the undergraduate and graduate levels of medical study.

Immunizations challenge healthcare personnel and affects immunization rates

PURPOSE

This study measured 1. medical office immunization rates and 2. health care personnel competency in managing vaccine practices before and after evidence-based immunization education was provided.

METHOD

This descriptive study compared 32 family medicine and pediatric offices and 178 medical assistants, licensed practical nurses, registered nurses, nurse practitioners, and physicians in knowledge-based testing pre-education, post-education, and 12-months post-education. Immunization rates were assessed before and 18-months post-education.

RESULTS

Immunization rates increased 10.3% - 18months post-education; knowledge increased 7.8% - 12months post-education. Family medicine offices, licensed practical nurses, and medical assistants showed significant knowledge deficits before and 12-months post-education. All demographic groups scored less in storage/handling 12-months post-education.

CONCLUSION

This study is one of the first studies to identify competency challenges in effective immunization delivery among medical assistants, licensed practical nurses, and family medicine offices. Formal and continuous education in immunization administration and storage/handling is recommended among these select groups.

Vaccination learning experiences of nursing students: a grounded theory study

PURPOSE

This study aimed to explore the experiences of nursing students being trained to perform vaccinations.

METHODS

The grounded theory method was applied to gather information through semi-structured interviews. The participants included 14 undergraduate nursing students in their fifth and eighth semesters of study in a nursing school in Iran. The information was analyzed according to Strauss and Corbin's method of grounded theory.

RESULTS

A core category of experiential learning was identified, and the following eight subcategories were extracted: students' enthusiasm, vaccination sensitivity, stress, proper educational environment, absence of prerequisites, students' responsibility for learning, providing services, and learning outcomes.

CONCLUSION

The vaccination training of nursing students was found to be in an acceptable state. However, some barriers to effective learning were identified. As such, the results of this study may provide empirical support for attempts to reform vaccination education by removing these barriers.

Immunization knowledge and practice among Malaysian parents: a questionnaire development and pilot-testing

Background

Parents are the main decision makers for their children vaccinations. This fact makes parents’ immunization knowledge and practices as predictor factors for immunization uptake and timeliness. The aim of this pilot study was to develop a reliable and valid instrument in Malaysian language to measure immunization knowledge and practice (KP) of Malaysian parents.

Methods

A cross-sectional prospective pilot survey was conducted among 88 Malaysian parents who attended public health facilities that provide vaccinations. Translated immunization KP questionnaires (Bahasa Melayu version) were used. Descriptive statistics were applied, face and content validity were assessed, and internal consistency, test-retest reliability, and construct validity were determined.

Results

The mean ± standard deviation (SD) of the knowledge scores was 7.36 ± 2.29 and for practice scores was 7.13 ± 2.20. Good internal consistency was found for knowledge and practice items (Cronbach’s alpha = 0.757 and 0.743 respectively); the test-retest reliability value was 0.740 (p = 0.014). A panel of three specialist pharmacists who are experts in this field judged the face and content validity of the final questionnaire. Parents with up-to-date immunized children had significantly better knowledge and practice scores than parents who did not (p < 0.001 and p = 0.001 respectively), suggesting a good construct validity. A significant difference was found in knowledge and practice scores among parents’ age (p = 0.006 and p = 0.029 respectively) and place of living (p = 0.037 and p = 0.043). The parents’ knowledge level was positively associated with their practice toward immunization (Spearman’s rank correlation coefficient 0.310, p = 0.003).

Conclusions

The pilot study concluded that the Bahasa Melayu version of the immunization KP questionnaire has good reliability and validity for measuring the knowledge and practices of Malaysian parents and therefore this version can be used in future research.

Evaluation of an injection training and certification program for pharmacy students

OBJECTIVE

To evaluate an injection training and certification program for third-year (P3) pharmacy students, and to measure the impact of students' administration of immunizations at an influenza clinic on their knowledge, skills, and competence in immunization.

DESIGN

A repeated measures design was used to assess students' injection skills across the injection training and certification program and the influenza clinic. A repeated measures design was also used to evaluate students' self-reported knowledge, experience, and confidence.

ASSESSMENT

Postcertification and during influenza clinic comparisons showed significant improvement in students' knowledge, experience, and confidence after taking part in the influenza clinic. University staff members and students indicated in a survey that they were satisfied with the clinic services provided by pharmacy students.

CONCLUSION

The injection training and certification program and the university influenza clinic were effective in enhancing and fostering student skills development.

Immunization services offered in Québec (Canada) pharmacies

Canadian Pharmacists are easy to reach. Although Québec pharmacists are not allowed to administer vaccines, they can: (1) promote vaccination, (2) counsel patients on vaccination, (3) sell vaccines and (4) provide vaccine administration by a nurse. Our objectives were to describe immunization services given in Québec pharmacies and assess the potential relation between, on one hand, pharmacy characteristics and difficulties perceived by pharmacists and, on the other hand, vaccine administration. In 2008-09, an anonymous questionnaire was mailed to all Québec pharmacy owners (n = 1663). Among the 1102 (66%) respondents, 90% stated that vaccines were sold, 27% that a nurse administered vaccines in their pharmacy and 44% were planning to offer vaccine administration in the next five years. Three out of four stated they were doing vaccine promotion and 65%, vaccine counselling. Half of respondents said they would be willing to administer vaccines themselves if legislative modifications were made. Recommendations for cold chain maintenance were followed in 23% of pharmacies selling vaccines. Presence of another health professional in the pharmacy, higher number of opening hours, not being located in the same building than a medical clinic and having an agreement to collaborate with a public health unit or a medical clinic for immunization were positively associated with vaccine administration in multivariate analysis. Higher perceived difficulties with lack of demand from patients were negatively associated with vaccine administration. Most pharmacists are willing to increase their involvement in immunization. Collaboration between public health professionals and pharmacists should be reinforced.