Although the global COVID-19 pandemic has shaken confidence in science and medicine among some, it has also provided an opportunity for health care professionals to work with patients and the general public to address health misinformation.
Via a unique Centers for Disease Control and Prevention–funded initiative, the Association of American Medical Colleges has awarded five grants to academic medical centers to develop competency based, interprofessional strategies to mitigate health misinformation, and to integrate these approaches into the curricula for health professions students. These Health Professions Education Curricular Innovations grantees, announced on July 21, 2022, offer innovative strategies to help diverse learners improve the way they communicate health information.
— Lisa Howley, PhD
Association of American Medical Colleges
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Patients Vulnerable to Misinformation: An Evidence-Based Approach to Address Root Causes Through Medical, Nursing, and Pharmacy Student Training
Successfully countering misinformation, particularly in the context of COVID-19, is a critical aspect of improving public health in the midst of this global pandemic. While doing so has been a challenge for many health care workers since the virus first appeared in 2020, over the past two-plus years, numerous effective strategies and approaches have been developed.
Using that body of knowledge as its base, the aim of this project, led by Samara Ginzburg, MD, senior associate dean for education and associate professor of medicine and science education at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York, is to create a new model for addressing health misinformation with evidence-based, myth- and misconception-debunking strategies.
The team will achieve this by curating best practices developed during the pandemic to address misinformation and encourage shared decision-making and patient-centered communication. Using the “Ask-Respond-Tell” framework and teach-back strategies for motivational interviewing, health professions learners will build competencies via small-group role-play sessions, simulations, and objective structured clinical examinations (a multipurpose testing tool designed for clinical settings) to address COVID-19 misinformation and help move individuals toward vaccine acceptance.
This approach has applications for medical, nursing, and pharmacy student education and will involve clinical training experiences for students in an interdisciplinary setting via a partnership with St. John’s College of Pharmacy and community-based organizations. Ultimately, these efforts will lead to the development of new interactive resources, including a real-time app to be used at the point of care with patients. Health professions learners will have the opportunity to practice what they’ve learned at a student-run health fair at the end of the project.
Florida International University Herbert Wertheim College of Medicine
Addressing Vaccine Misinformation: An Online Motivational Interviewing Module and Telehealth Standardized Patient Exercise to Address Misinformation With COVID-19 Vaccine-Hesitant Individuals
Despite the availability of safe and effective vaccines to reduce the severity of a COVID-19 infection, some people remain unvaccinated. These individuals currently constitute the vast majority of those hospitalized with severe COVID-19 infections and life-threatening complications. Unfortunately, many health care providers are not confident in their ability to effectively counsel individuals who are hesitant about the COVID-19 vaccines.
Led by Rebecca Toonkel, MD, assistant dean for curriculum, clinical education, and advising, and medical director, Albert and Debbie Tano Medical Simulation Center at Florida International University Herbert Wertheim College of Medicine, this project features a newly developed and highly interactive online module that addresses health misinformation by teaching students how to identify vaccine-hesitant individuals and how to share information using motivational interviewing techniques that may help such individuals move toward vaccine acceptance.
The curriculum also provides learners the opportunity to practice these skills through a telehealth-style standardized patient encounter. During this interaction, learners employ the communications skills they’ve built via the online module. After the encounter, students reinforce what they’ve learned via a self-reflection activity.
These skills-building sessions should increase student confidence in broaching other challenging topics and facilitate collaborative conversations. In turn, trained learners will be invited to use their skills at community-based events where they may interact with vaccine-hesitant individuals.
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Mitigating Medical Misinformation and Mistrust Through Effective Team Communication Using Innovative Competency-Based Interprofessional Instructional Design Strategies
In 2019, vaccine hesitancy was identified by the World Health Organization as one of the top 10 threats to public health. The ensuing COVID-19 pandemic and the politicization of vaccines that protect against the disease have only heightened the danger that vaccine hesitancy poses.
In an effort to offset this risk, this project, led by Alison Vargovich, PhD, assistant professor and licensed psychologist in the Department of Medicine, Division of Behavioral Medicine, at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, aims to help health professions students learn how to take an active role in dispelling the popular myths and misconceptions that drive vaccine hesitancy.
Through this curricular innovation, health professions students will gain valuable hands-on experience in how best to work with vaccine-hesitant individuals and influence change. Using a hybrid instructional design strategy to create an interprofessional educational experience, the program leverages online learning, virtual simulation, and in-person role playing to help learners build the knowledge and practice the skills they need to confront misinformation confidently and compassionately when it surfaces. Students will learn evidence-based communication practices to provide them with effective tools and strategies for conversations related to misinformation and vaccine hesitancy. A goal is to teach students how to have productive and respectful conversations, but also to recognize and address the drivers of the misbeliefs typically related to cognitive, social, and affective factors.
The instructional materials of this curricular innovation will be shared widely using the Creative Commons license and may serve as a resource for health professions students in medicine, nursing, pharmacy, and public health programs. The researchers have also designed a rigorous programmatic assessment plan, which includes collecting and analyzing both facilitator and student assessment data, to determine the impact that the hybrid instructional design strategy had on student knowledge and skill acquisition, along with students’ overall satisfaction with the program.
Maine Medical Center/Tufts University School of Medicine – MaineTrack
Interprofessional Education and Collaborative Learning: A Novel Training Tool for Addressing COVID-19 Health Misinformation
The misinformation that has powered hesitancy about the COVID-19 vaccines is widely varied, with different populations finding some aspects more compelling than others. Quite simply, there is no one-size-fits-all solution when it comes to dispelling misinformation. Getting to the core of those beliefs and understanding better the fears that drive them is the primary aim of this project, led by Jennifer Hayman, MD, pediatric hospitalist at Maine Medical Center and director of curriculum for MaineTrack at Tufts University School of Medicine.
This work is especially important in underrepresented populations, and the project aims to include members of these populations to better understand all aspects of vaccine hesitancy. Such inclusion will be accomplished via focus groups, which will bring together students of pharmacy, medicine, nursing, and social work in order to get the perspective of learners on the front lines of encouraging vaccination in the target communities.
Leveraging the expertise of two local preventive medicine physicians who specialize in COVID-19 misinformation, and including ongoing perspectives of community health outreach workers assisting with COVID-19 education in underrepresented populations in Maine, the team will create an educational toolkit containing best practices on responding to COVID-19 misinformation and vaccine hesitancy. This toolkit will include online teaching materials and two videos that explain the concept of misinformation and offer tools to manage conversations while demonstrating effective strategies to help health professions students learn how to navigate these challenging interactions.
The aim of these materials will be to create standardized patient scenarios, one demonstrating an interaction with a patient and the other an interaction with another health care colleague, so that health professions learners can see how best to interact with vaccine-hesitant and/or misinformed patients and colleagues. At the conclusion of the project, the team will convene a symposium of experts on COVID-19, public health, and medical mis- and disinformation to explore the impact of misinformation on COVID-19 outcomes as they relate to specific populations in Maine.
The University of Chicago Pritzker School of Medicine
Training Interprofessional Teams to Improve Scientific Communication and Address Health Misinformation in Diverse Communities
Humans love to tell stories, and this is how culture and knowledge have been disseminated since ancient times. But as the COVID-19 pandemic has shown, not all stories are made the same, and those that are filled with misinformation can do more harm than good. Combating medical mistrust and disseminating evidence-based information in ways that vaccine-hesitant people can understand is a critical element to increasing uptake of the COVID-19 vaccines.
Improving health professions students’ ability to share accurate, understandable narratives and information surrounding COVID-19 is at the core of this project. Led by Vineet Arora, MD, dean of medical education at the University of Chicago Pritzker School of Medicine, it establishes an interdisciplinary curriculum with leaders from medicine, nursing, and pharmacy to amplify health professions students’ voices and offer strategies to identify misinformation and its sources, to better deploy evidence-based information to combat that misinformation.
The group will run a series of interactive workshops on topics ranging from the importance of addressing misinformation in the clinician-patient relationship to the science of storytelling techniques and strategic communications. Improving how students communicate scientific information to a diverse lay population will be a key aspect of this project, and under the guidance of a team with expertise in scientific communications, students will create infographics and other materials. They will draw from skills developed by the climate science movement to help make the communication of a complex scientific topic more readily understandable to people who have had limited exposure to it. Students will be asked to share their work with their peers and on social media.
Preparing the Next Generation of Providers for the Next Pandemic
Across all these projects, an overarching theme has emerged: teaching the next generation of health professions students to address health misinformation, not just about the COVID-19 pandemic, but about vaccines and other misinformation that can harm patients’ health. “We hope this kick-starter grant and these projects are just the beginning of the conversation on this crucial topic in medical education and, ultimately, in improving health outcomes,“ says Andrea Anderson, MD, senior medical education consultant for the project.
Each project creates its own solution for integrating the lessons learned in devising new resources to reach reluctant populations, but all of them are looking to the hard-earned skills and knowledge that many health care providers have developed during the pandemic to move forward productively. By curating and leveraging this knowledge, these projects will help health professions learners and health care professionals at all levels address the myths and misinformation that too often harm patients’ health.