Immunization education for internal medicine residents: A cluster-randomized controlled trial |
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| Affiliation: | 1. Mayo Clinic, 200 First St SW Rochester, MN 55905, USA;2. Taylor University, 236 W Reade Ave Upland, IN 46989, USA;3. University of Wisconsin, 600 Highland Ave Madison, WI 52792, USA;1. Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado;2. Division of General Internal Medicine, Denver Health, Denver, Colorado;3. Department of Biostatistics, Colorado School of Public Health, University of Colorado, Aurora, Colorado;4. Ambulatory Care Services Data and Analytics, Denver Health, Denver, Colorado;5. Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado;6. Department of Clinical Pharmacy, University of Colorado, Anschutz Medical Campus, Aurora, Colorado;7. Colorado Department of Public Health and Environment, Denver, Colorado;8. Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado;1. School of Nursing, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong;2. Dept. of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong;3. Dept. of Obstetrics and Gynaecology, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong;4. School of Nursing, University of British Columbia, 3333 University Way, Kelowna, British Columbia, Canada;1. Laboratoire de Virologie, CHU Besançon, France;2. UFR Santé, Université Bourgogne France-Comté, France;3. EA3181, Université Bourgogne France-Comté, France;4. Service de Maladies Infectieuses, CHU Besançon, France;5. CPIAS, CHU Besançon, France;6. Institut Régional de Formation Sanitaire et Sociale Bourgogne Franche-Comté, France;7. Institut de Formation en Soins Infirmiers, Besançon, France;8. Institut de Formation en Soins Infirmiers, Pontarlier, France;9. Institut de Formation en Soins Infirmiers, Dole, France;10. Institut de Formation aux Métiers de la Santé, Hôpital Nord Franche-Comté, Montbéliard, France;11. Unité de formation en Masso-kinésithérapie, CHU Besançon, France;12. Ecole de Sage-femmes, CHU Besançon, France;13. Service d’hygiène hospitalière, CHU Besançon, France;14. Service de Psychiatrie de l’adulte, CHU Besançon, France;15. Service de Neurologie, CHU Besançon, France;p. Service de Pédiatrie, CHU Besançon, France;q. Department of Pharmacy, CHU Besançon, France;r. INSERM, EFS BFC, UMR1098, University of Bourgogne Franche-Comté, Besançon, France;1. Department of Pediatrics-Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Ind;2. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Ind;3. Department of Pediatrics-Children''s Health Services Research, Indiana University School of Medicine, Indianapolis, Ind;4. Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis, Ind;5. The Regenstrief Institute, Indianapolis, Ind;6. Merck and Co, Kenilworth, NJ |
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| Abstract: | PurposeThe aims of this study are to evaluate the impact of a novel immunization curriculum based on the Preferred Cognitive Styles and Decision Making Model (PCSDM) on internal medicine (IM) resident continuity clinic patient panel immunization rates, as well as resident immunization knowledge, attitudes, and practices (KAP).MethodsA cluster-randomized controlled trial was performed among 143 IM residents at Mayo Clinic to evaluate the PCSDM curriculum plus fact-based immunization curriculum (intervention) compared to fact-based immunization curriculum alone (control) on the outcomes of resident continuity clinic patient panel immunization rates for influenza, pneumococcal, tetanus, pertussis, and zoster vaccines. Pre-study and post-study immunization KAP surveys were administered to IM residents.ResultsNinety-nine residents participated in the study. Eighty-two residents completed pre-study and post-study surveys. Influenza and pertussis immunization rates improved for both intervention and control groups. There was no significant difference in immunization rate improvement between the groups. Influenza immunization rates improved significantly by 33.4% and 32.3% in the intervention and control groups, respectively. The odds of receiving influenza immunization at the end of the study relative to pre-study for the entire study cohort was 4.6 (p < 0.0001). The odds of having received pertussis immunization at the end of the study relative to pre-study for the entire study cohort was 1.2 (p = 0.0002). Both groups had significant improvements in immunization knowledge. The intervention group had significant improvements in multiple domains that assessed confidence in counseling patients on immunizations.ConclusionsFact-based immunization education was useful in improving IM resident immunization rates for influenza and pertussis. The PCSDM immunization curriculum did not lead to increases in immunization rates compared with the fact-based curriculum, but it did significantly increase resident confidence in communicating with patients about vaccines. |
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| Keywords: | Immunization Internal medicine Resident Medical education Cognitive style Attitudes |
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