Effectiveness of Online Vaccine Communication Training and Assessment Using Virtual Encounters With Standardized Vaccine-Hesitant Parents

BACKGROUND: There are no accepted best practices for counseling vaccine-hesitant parents, and targeted training in this area is not required during residency, despite widespread vaccine hesitancy among parents. To this end, much interest has focused on structured approaches to interacting with vaccine-hesitant parents. The Announce-Inquire-Mirror-Secure (AIMS) Method for Healthy Conversations is one such structured communication strategy that attempts to build trust between provider and parent, opening the door to receptivity to vaccination. OBJECTIVE: Determine if online training in a structured vaccine hesitancy communication strategy results in specific behaviors and increased confidence during telemedicine encounters with standardized patients (SPs). Methods: Pediatrics and medicine-pediatric residents were randomized to receive either AIMS or control training online. Residents underwent pre- and post-training telemedicine encounters with SPs simulating a well-child immunization visit. Encounters were video-recorded and assessed using the Vaccine Hesitancy Communication Assessment (VHCA). Resident confidence and SP evaluations of the encounter were assessed pre- and post-training. Investigators, residents, SPs, and video raters were blinded to treatment allocation. RESULTS: From December 2020 to June 2021, a total of 54 of 58 (93%) eligible residents were enrolled in the study; 51 (94%) completed the study per-protocol, and 47 (92%) of these had evaluable video files. Resident self-confidence improved in both groups. AIMS behaviors were more commonly detected in AIMS than in control-trained residents. SP assessment of resident communication skills did not differ between groups. CONCLUSIONS: Vaccine hesitancy communication training and assessment using SPs can be successful when implemented entirely in a virtual environment. Confidence gains were seen in both the AIMS and control arms, suggesting that this outcome resulted from the SP encounter itself. Similar online training and simulation programs could prove valuable as residents enter practice and the use of telemedicine expands.