Are the final-year medical students competent enough to tackle the immunization challenges in their practice?
Abstract
Background/Aim. The competence of healthcare workers (HCWs) to advocate the importance of immunization to per-sons who are hesitant about vaccines is extremely important. The aim of this study was to evaluate the final-year medical stu-dents’ competencies related to immunization challenges in their practice using their knowledge, attitudes, and study practices. Methods. The cross-sectional study was conducted among 442 final-year students of the Faculty of Medicine, University of Belgrade, Serbia. The instrument used for data collection was an anonymous questionnaire consisting of 38 questions. Hierar-chical multiple regression analysis was conducted to identify the predictive value of different factors in immunization knowledge among medical students. Results. The median total knowledge score with the interquartile range was 7 ± 3.00 out of 13. There was a statistically significant positive correlation between the knowledge score and the grade point average (GPA) (r = 0.207, p < 0.001). Thirty-five percent of students felt moderately capa-ble of conducting work regarding vaccination without supervi-sion. Furthermore, 92.1% of students considered that additional training and information channels about immunization needed to be implemented in curricula for HCWs. The results of the hi-erarchical regression analysis showed that gender, age, GPA, study duration, self-confidence regarding immunization knowledge, the flu, and hepatitis B vaccination status explained a total of 36% of the variance in the immunization knowledge score. Less than two-thirds of students believed they had enough knowledge to reassure a person hesitant about immun-ization. Conclusion. The results of our study showed an average level of knowledge about immunization among final-year medi-cal students. As less than two-thirds of students believe that they have enough knowledge to reassure a hesitant person, there is a need for a better understanding and improving the parts of the curricula of medical faculties regarding immunization.
References
1. Eguia H, Vinciarelli F, Bosque-Prous M, Kristensen T, Saigí-Rubió F. Spain's Hesitation at the Gates of a COVID-19 Vaccine. Vac-cines (Basel) 2021; 9(2): 170.
2. World Health Organization. Immunization coverage. Available from: https://www.who.int/news-room/fact-sheets/detail/im munization-coverage [published 2020 July 15].
3. Angelo KM, Gastañaduy PA, Walker AT, Patel M, Reef S, Lee CV, et al. Spread of Measles in Europe and Implications for US Travelers. Pediatrics 2019; 144(1): e20190414.
4. Medic S, Petrovic V, Loncarevic G, Kanazir M, Begovic Lazarevic B, Rakic Adrovic S, et al. Epidemiological, clinical and la-boratory characteristics of the measles resurgence in the Republic of Serbia in 2014-2015. PLoS One 2019; 14(10): e0224009.
5. Ristic M, Milosevic V, Medic S, Djekic Malbasa J, Rajcevic S, Boban J, et al. Sero-epidemiological study in prediction of the risk groups for measles outbreaks in Vojvodina, Serbia. PLOS One 2019; 14(5): e0216219.
6. Getman R, Helmi M, Roberts H, Yansane A, Cutler D, Seymour B. Vaccine Hesitancy and Online Information: The Influence of Digital Networks. Health Educ Behav 2018; 45(4): 599–606.
7. McClure CC, Cataldi JR, O’Leary ST. Vaccine Hesitancy: Where We Are and Where We Are Going. Clin Ther 2017; 39(8): 1550–62.
8. Omer SB, Amin AB, Limaye RJ. Communicating About Vaccines in a Fact-Resistant World. JAMA Pediatr 2017; 171(10): 929–30.
9. Melovic B, Jaksic Stojanovic A, Vulic TB, Dudic B, Benova E. The Impact of Online Media on Parents' Attitudes toward Vaccina-tion of Children-Social Marketing and Public Health. Int J En-viron Res Public Health 2020; 17(16): 5816.
10. World Health Organization. Tailoring Immunization Programmes (TIP). Copenhagen: WHO Regional Office for Europe; 2019. Licence: CC BY-NC-SA 3.0 IGO.
11. Vogel B, Reuter S, Taverna M, Fischer MR, Schelling J. Vaccination: Developing and implementing a competency-based-curriculum at the Medical Faculty of LMU Munich. GMS J Med Educ 2016; 33(1): Doc5.
12. Picchio CA, Carrasco MG, Sagué-Vilavella M, Rius C. Knowledge, attitudes and beliefs about vaccination in primary healthcare workers involved in the administration of systematic child-hood vaccines, Barcelona, 2016/17. Euro Surveill 2019; 24(6): 1800117.
13. Karlsson LC, Lewandowsky S, Antfolk J, Salo P, Lindfelt M, Oksanen T, et al. The association between vaccination confi-dence, vaccination behavior, and willingness to recommend vaccines among Finnish healthcare workers. PLoS One 2019; 14(10): e0224330.
14. Filia A, Bella A, D’Ancona F, Fabiani M, Giambi C, Rizzo C, et al. Childhood vaccinations: Knowledge, attitudes and practices of pediatricians and factors associated with their confidence in addressing parental concerns, Italy, 2016. Euro Surveill 2019; 24(6): 1800275.
15. Paterson P, Meurice F, Stanberry LR, Glismann S, Rosenthal SL, Larson HJ. Vaccine hesitancy and healthcare providers. Vac-cine 2016; 34(52): 6700–6.
16. Karafillakis E, Dinca I, Apfel F, Cecconi S, Wűrz A, Takacs J, et al. Vaccine hesitancy among healthcare workers in Europe: A qualitative study. Vaccine 2016; 34(41): 5013–20.
17. Smith PJ, Kennedy AM, Wooten K, Gust DA, Pickering LK. Asso-ciation between health care providers’ influence on parents who have concerns about vaccine safety and vaccination cov-erage. Pediatrics 2006; 118(5): e1287–92.
18. Brown KF, Kroll JS, Hudson MJ, Ramsay M, Green J, Long SJ, et al. Factors underlying parental decisions about combination childhood vaccinations including MMR: A systematic review. Vaccine 2010; 28(26): 4235–48.
19. Smith LE, Amlot R, Weinman J, Yiend J, Rubin GJ. A systematic review of factors affecting vaccine uptake in young children. Vaccine 2017; 35(45): 6059–69.
20. Dybsand LL, Hall KJ, Carson PJ. Immunization attitudes, opin-ions, and knowledge of healthcare professional students at two Midwestern universities in the United States. BMC Med Educ 2019; 19(1): 242.
21. Zarobkiewicz MK, Zimecka A, Zuzak T, Cieślak D, Roliński J, Grywalska E. Vaccination among Polish university students. Knowledge, beliefs and anti-vaccination attitudes. Hum Vaccin Immunother 2017; 13(11): 2654–8.
22. Pelly L, Pierrynowski MacDougalL D, Halperin B, Strang RA, Bow-els SK, Baxendale DM, et al. The VAXED project: An Assess-ment of Immunization Education in Canadian Health Profes-sional Programs. BMC Med Educ 2010; 10: 86.
23. Tuohetamu S, Pang M, Nuer X, Mahemuti, Mohemaiti P, Qin Y, et al. The knowledge, attitudes and practices on influenza among medical college students in Northwest China. Hum Vaccin Immunother 2017; 13(7): 1688–92.
24. Tafuri S, Gallone MS, Cappelli MG, Martinelli D, Prato R, Germi-nario C. Addressing the anti-vaccination movement and the role of HCWs. Vaccine 2014; 32(38): 4860–5.
25. Dubé E, Gagnon D, Nickels E, Jeram S, Schuster M. Mapping vac-cine hesitancy- country-specific characteristics of a global phe-nomenon. Vaccine 2014; 32(49): 6649–54.
26. Navarro Alonso JA, Bernal González PJ, Niguez Carbonell JC. Analysis of factors influencing vaccine uptake: perspective from Spain. Vaccine 2001; 20 Suppl 1: S13–5; discussion S1.
27. European Joint Action on Vaccination (2018); Available from: https://eu-jav.com/. (cited 2021 Feb 12).
28. Whitaker JA, Poland CM, Beckman TJ, Bundrick JB, Chaudhry R, Grill DE, et al. Immunization education for internal medicine residents: A cluster-randomized controlled trial. Vaccine 2018; 36(14): 1823–9.