Peer Instruction as an Alternative Active Learning Pedagogy Across the Pharmacy Curriculum.

OBJECTIVE: The objective of this study was to determine if peer instruction (PI) is a useful active learning pedagogy to increase correct responses to pharmacotherapy concepts throughout didactic education in a Doctor of Pharmacy curriculum. METHODS: Peer instruction was implemented into 3 pharmacy practice courses spanning 3 years of didactic pharmacy education at Cedarville University: Introduction to Self-Care (PHAR 6112) in the first professional year, Respiratory Module (PHAR 6261) in the second professional year, and Special Populations Module (PHAR 7343) in the third professional year. ConcepTests, which are multiple-choice questions written to help students apply previous knowledge to new scenarios, were re-polled based on a PI algorithm after peer discussion. Changes in students paired before and after peer discussion ConcepTest responses were analyzed using a McNemar test and descriptive statistics. RESULTS: A total of 52 first-year students, 43 second-year students, and 49 third-year students participated in each respective course. Across all courses, an increase in the percentage of correct responses to ConceptTests after peer discussion was observed from the first polling (51.2%) to the second polling (90.4%). This increase in the percentage of correct responses was observed across all years of the curriculum, with greater increases in cohorts with previous participation in PI-based sessions. CONCLUSION: The use of PI fostered improvement in the percentage of correct responses to ConcepTests focused on pharmacotherapy concepts throughout the first 3 years of didactic education. This pedagogy may be an effective and useful active learning strategy in pharmacy education that does not require significant classroom infrastructure changes.

Motivational interviewing and vaccine acceptance in children: The MOTIVE study.

BACKGROUND AND OBJECTIVE: Vaccine coverage have been less than desired in young children in part due to parental vaccine hesitancy. Addressing health beliefs through patient-centered communication approaches such as motivational interviewing (MI) may improve vaccine confidence. Thus, the objective of this study was to determine the difference in paediatric vaccination coverage rates based on the Advisory Committee on Immunization Practices (ACIP) and Centers for Disease Control and Prevention (CDC) recommended schedule in children 0-6 years of age after an educational intervention for providers and integration of an MI-based communication tool, MOTIVE (MOtivational Interviewing Tool to Improve Vaccine AcceptancE). METHODS: Paediatric and family practice providers in a federally qualified health center in the United States completed an educational intervention regarding vaccine hesitancy and use of the MOTIVE tool. Providers then implemented the MOTIVE tool to address common health beliefs using strong, presumptive vaccine recommendations and an MI framework during encounters with patients 0-6 years of age. Data were collected from 1-year pre-educational intervention (July 2018-June 2019, N = 2504) and post-intervention (July 2019-March 2020, N = 1954) to examine differences in vaccination coverage rates and documented vaccine refusals. RESULTS: Use of the MOTIVE tool was associated with a statistically significant increase in IIV vaccination coverage rate in children 6 months to 6 years of age (32.4% versus 43.9%, p < 0.01). A significantly increased Hib vaccination coverage rate was observed in children 0-18 months of age. Patients with commercial insurance also had significantly higher vaccination coverage rates for the DTaP, IPV, and VAR vaccines during the intervention period. Use of the MOTIVE tool was associated with a decrease in documented vaccine refusals per 100 patients in children 0-6 years of age (31.5 versus 17.6, p < 0.01). CONCLUSION: Use of an MI-based communication tool may decrease vaccine refusals and improve childhood vaccination coverage rates, particularly for IIV. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT03934008, https://clinicaltrials.gov/ct2/show/NCT03934008, deidentified individual participant data will not be made available.

Implementation of a motivational interviewing-based decision tool to improve childhood vaccination rates: Pilot study protocol.

BACKGROUND: Parental concerns regarding the safety and efficacy of vaccines have been on the rise over the past decade, resulting in a decline in comprehensive vaccine coverage in children. Healthcare practitioners face many challenges when recommending childhood vaccinations, with many parents refusing vaccination due to these and other concerns. Effective communication strategies and tools can equip providers to communicate with vaccine hesitant parents, but validated tools are currently lacking. OBJECTIVES: This study aims to develop a validated parental communication tool utilizing motivational interviewing to increase vaccination adherence in children ages 6 years and younger. METHODS: The MOTIVE (Motivational Interviewing Tool to Improve Vaccination Adherence) tool will first be developed based on the most recent literature regarding vaccine hesitancy and related health beliefs. Following tool development, the tool will be reviewed via an external review process to ensure practicality of the tool for use in clinical practice. In implementing the MOTIVE tool, providers and clinic staff will be trained regarding vaccine hesitancy and motivational interviewing. The tool will then be implemented in routine well-child appointments. The primary outcome of this study is the percentage of children 0-6 years of age completing all recommended doses of the core vaccine series after implementation of the MOTIVE tool as compared to prior vaccination years. Secondary outcomes will also include parental attitudes towards vaccines and provider knowledge regarding motivational interviewing components and vaccine hesitancy. PROJECT IMPACT: Following completion of this study, the MOTIVE tool will be made available for other providers for use in their own clinical practice. The availability of effective communication tools will allow healthcare providers to engage in productive conversations regarding vaccination, aiming to increase vaccine uptake.