1860. Mind the Gap: Knowledge, Attitudes, and Practices of Internal Medicine Residents Toward Adult Immunizations
Session: Poster Abstract Session: Vaccines: Improving Immunization Uptake
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • 1860.pdf (551.8 kB)
  • Background: Immunization education for internal medicine (IM) residents is lacking. Most efforts have used a unimodal fact-based approach and have not prepared trainees to address patients’ immunization questions, concerns, and perspectives in medical decision making.

    Methods: An anonymous 35-item electronic questionnaire of immunization knowledge, attitudes, and practices was conducted among IM residents at Mayo Clinic. Residents’ immunization knowledge was assessed by a 10-item IM board style multiple choice evaluation of CDC Advisory Committee on Immunization Practices (ACIP) recommendations. Five point Likert scales were used to assess attitude (1=Strongly disagree; 3=No opinion; 5=Strongly agree) and practice (1=Never; 3=Sometimes; 5=Always) items.

    Results: Of 143 residents, 99 (69%) completed the survey. Mean knowledge score (% correct on ACIP recommendation assessment) was 43.5% (median=40%; STD=17.9%). 96% of residents agreed it is important to address patients’ reasons for vaccine refusal. However, only 52% were (2% strongly and 50% somewhat) confident in addressing patients’ concerns about vaccine side effects; 56% were (4% strongly and 52% somewhat) confident in addressing questions about vaccine efficacy; 66% were (6% strongly and 60% somewhat) confident in addressing patients’ fears of vaccines. The most cited reasons for not addressing vaccine refusal were lack of time (65%) and resident discomfort discussing vaccine refusal (17%). Only 22% of residents indicated they always try to understand the patient’s perspective on vaccines and tailor their discussion of vaccines to the patient’s viewpoint and decision making style

    Conclusion: Residents have knowledge deficits of ACIP adult immunization recommendations and gaps in confidence in discussing immunization efficacy, side effects, and their patients’ fears of vaccines in our study population. Further immunization educational efforts that disseminate fact-based knowledge, in addition to teaching residents how to understand and address their patients’ questions and fears are needed. A cluster-randomized controlled trial using a preferred cognitive styles and decision making model for immunization education is underway in this study population.

    Jennifer Whitaker, MD, MS1, Caroline Poland, MA, LCAC, NCC2, Kris Thomas, MD1, Rajeev Chaudhry, MBBS, MPH1, Andrew Halvorsen, MS1, Majken Wingo, MD1, Jill Huber, MD1, Timothy Olson, MD1, Matthew Thomas, MD1, Karen Mauck, MD, MS1, John Bundrick, MD1, Mary Jo Kasten, MD1, Abinash Virk, MD1, Diane Grill, MS1, Ramila Mehta, MS1 and Gregory Poland, MD, FIDSA1, (1)Mayo Clinic, Rochester, MN, (2)Taylor University, Upland, IN

    Disclosures:

    J. Whitaker, Pfizer Independent Grants for Learning and Change: Grant Investigator , Grant recipient , Research grant and Research support

    C. Poland, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research support

    K. Thomas, None

    R. Chaudhry, Pfizer Independent Grants for Learning and Change: Investigator , Research grant and Research support

    A. Halvorsen, None

    M. Wingo, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research grant and Research support

    J. Huber, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research grant and Research support

    T. Olson, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research grant and Research support

    M. Thomas, Matthew Thomas: Grant Investigator , Research grant and Research support

    K. Mauck, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research grant and Research support

    J. Bundrick, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research grant and Research support

    M. J. Kasten, None

    A. Virk, Pfizer Independent Grants for Learning and Change: Grant Investigator , Research grant and Research support

    D. Grill, None

    R. Mehta, None

    G. Poland, Merck: Scientific Advisor , Consulting fee
    CSL Biotherapies: Scientific Advisor , Consulting fee
    Avianax: Scientific Advisor , Consulting fee
    Sanofi Pasteur: Scientific Advisor , Consulting fee
    Dynavax: Scientific Advisor , Consulting fee
    Novartis Vaccines: Scientific Advisor , Consulting fee
    PAXVAX Inc.: Scientific Advisor , Consulting fee
    Emergent Biosolutions: Scientific Advisor , Consulting fee
    Adjuvance: Scientific Advisor , Consulting fee
    Vaxess: Scientific Advisor , Consulting fee

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.