Introduction

Immunization education for physicians-in-training is crucial to address vaccine concerns in clinical practice. Vaccine education is not standardized across residency programs. The Collaboration for Vaccination Education and Research (CoVER) team developed an online curriculum for pediatric (Peds) and family medicine (FM) residents.

Methods

A cluster randomized controlled trial (RCT) was performed during the 2017–2018 academic year to evaluate the CoVER curriculum. A convenience sample of residency institutions were randomly allocated to the intervention or control group, with stratification by residency type. The intervention, the CoVER curriculum, consisted of four online modules and an in-person training guide. Control sites continued with their standard vaccine education. Pre-intervention and post-intervention surveys were emailed to residents in both groups. The primary outcomes compared between groups were changes in “vaccine knowledge,” “vaccine attitudes/hesitancy,” and “self-confidence” in immunization communication. The team assessing outcomes was unblinded to assignments. Hierarchical general linear model was used to adjust for residency type and residency year; residency site was modeled as a random effect.

Results

Overall, 1444 residents from 31 residency programs were eligible to participate (734 intervention, 710 control). The pre-intervention response rate was 730 (51%) and post-intervention was 526 (36%). Average knowledge scores increased from pre-intervention (control 53%; CoVER 53%) to post-intervention (control 58%; CoVER 60%). Increases in vaccine knowledge among FM residents were greater for CoVER compared to controls (p = 0.041). Vaccine hesitancy was more common among FM (23%) than Peds (10%) residents. In all three residency years, residents in the CoVER group showed greater increases in self-confidence in ability to discuss vaccines with parents/patients (p < 0.03) compared to control group.

Conclusion

The CoVER curriculum is an effective model to standardize immunization education of physicians-in-training. This RCT demonstrated the effectiveness of the CoVER curriculum to improve resident confidence in their ability to discuss vaccines with parents and patients.

中文翻译：

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在线免疫课程的随机对照试验

介绍

培训医师的免疫教育对于解决临床实践中的疫苗问题至关重要。住院医师培训并未对疫苗教育进行标准化。疫苗接种教育和研究协作（CoVER）团队开发了面向儿科（Peds）和家庭医学（FM）居民的在线课程。

方法

在2017-2018学年进行了一项集群随机对照试验（RCT），以评估CoVER课程。将居住机构的便利性样本随机分配到干预组或对照组，并按居住类型进行分层。干预措施是CoVER课程，由四个在线模块和一个现场培训指南组成。对照地点继续进行标准疫苗教育。干预前和干预后调查均通过电子邮件发送给两组居民。两组之间比较的主要结果是免疫沟通中“疫苗知识”，“疫苗态度/犹豫性”和“自信心”的变化。评估结果的团队对任务不知情。分层通用线性模型用于调整居住类型和居住年限。

结果

总体而言，来自31个居住项目的1444名居民有资格参加（734项干预，710个控制）。干预前的响应率为730（51％），干预后为526（36％）。平均知识得分从干预前（对照53％； CoVER 53％）增加到干预后（对照58％； CoVER 60％）。与对照组相比，CoVER FM居民中疫苗知识的增加更大（p = 0.041）。FM犹豫（23％）比Peds（10％）居民更为普遍。在所有三个居住年中，与对照组相比，CoVER组的居民与父母/患者讨论疫苗的能力显示出更大的自信心（p <0.03）。

结论

CoVER课程是规范培训医师免疫教育的有效模型。这项RCT证明了CoVER课程的有效性，可提高居民对他们与父母和患者讨论疫苗能力的信心。