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Jensen RAA, Musaeus P, Pedersen K. Virtual patients in undergraduate psychiatry education: a systematic review and synthesis. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:329-347. [PMID: 37294380 DOI: 10.1007/s10459-023-10247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/28/2023] [Indexed: 06/10/2023]
Abstract
Virtual patients are increasingly used in undergraduate psychiatry education. This article reports on a systematic review aimed at providing an overview of different approaches in this context, describing their effectiveness, and thematically comparing learning outcomes across different undergraduate programs. The authors searched PubMed, PsycInfo, CINAHL, and Scopus databases for articles published between 2000 and January 2021. Quantitative and qualitative studies that reported on outcomes related to learners' knowledge, skills, and attitudes following an intervention with virtual patients in undergraduate psychiatry education were reviewed. Outcomes were thematically compared, and a narrative synthesis of the different outcomes and effectiveness was provided. Of 7856 records identified, 240 articles were retrieved for full-text review and 46 articles met all inclusion criteria. There were four broad types of virtual patient interventions: case-based presentation (n = 17), interactive virtual patient scenarios (n = 14), standardized virtual patients (n = 10), and virtual patient videogames (n = 5). The thematic analysis revealed that virtual patients in psychiatry education have been used for learners to construe knowledge about symptomatology and psychopathology, develop interpersonal and clinical communicative skills, and to increase self-efficacy and decrease stigmatizing attitudes towards psychiatric patients. In comparison with no intervention, traditional teaching, and text-based interventions, virtual patients were associated with higher learning outcomes. However, the results did not indicate any superiority of virtual patients over non-technological simulation. Virtual patients in psychiatry education offer opportunities for students from different health disciplines to build knowledge, practice skills, and improve their attitudes towards individuals with mental illness. The article discusses methodological shortcomings in the reviewed literature. Future interventions should consider the mediating effects of the quality of the learning environment, psychological safety, and level of authenticity of the simulation.
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Affiliation(s)
- Rikke Amalie Agergaard Jensen
- Research Unit of Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Centre for Involvement of Relatives, Mental Health Services Region of Southern Denmark, Vejle, Denmark.
| | - Peter Musaeus
- Centre for Educational Development (CED), Aarhus University, Aarhus, Denmark
| | - Kamilla Pedersen
- Centre for Educational Development (CED), Aarhus University, Aarhus, Denmark
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Woon LSC, Mohd Daud TI, Tong SF. "It kinda helped us to be there": students' perspectives on the use of virtual patient software in psychiatry posting. BMC MEDICAL EDUCATION 2023; 23:851. [PMID: 37946151 PMCID: PMC10636819 DOI: 10.1186/s12909-023-04834-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND At the Faculty of Medicine of the National University of Malaysia, a virtual patient software program, DxR Clinician, was utilised for the teaching of neurocognitive disorder topics during the psychiatry posting of undergraduate medical students in a modified team-based learning (TBL) module. This study aimed to explore medical students' learning experiences with virtual patient. METHODS Ten students who previously underwent the learning module were recruited through purposive sampling. The inclusion criteria were: (a) Fourth-year medical students; and (b) Completed psychiatry posting with the new module. Students who dropped out or were unable to participate in data collection were excluded. Two online focus group discussions (FGDs) with five participants each were conducted by an independent facilitator, guided by a questioning route. The data were transcribed verbatim and coded using the thematic analysis approach to identify themes. RESULTS Three main themes of their learning experience were identified: (1) fulfilment of the desired pedagogy (2), realism of the clinical case, and (3) ease of use related to technical settings. The pedagogy theme was further divided into the following subthemes: level of entry for students, flexibility of presentation of content, provision of learning guidance, collaboration with peers, provision of feedback, and assessment of performance. The realism theme had two subthemes: how much the virtual patient experience mimicked an actual patient and how much the case scenario reflected real conditions in the Malaysian context. The technical setting theme entailed two subthemes: access to the software and appearance of the user interface. The study findings are considered in the light of learning formats, pedagogical and learning theories, and technological frameworks. CONCLUSIONS The findings shed light on both positive and negative aspects of using virtual patients for medical students' psychiatry posting, which opens room for further improvement of their usage in undergraduate psychiatry education.
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Affiliation(s)
- Luke Sy-Cherng Woon
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Seng Fah Tong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Parkinson’s from inside out: emerging and unexpected benefits of a long-term partnership. RESEARCH FOR ALL 2023. [DOI: 10.14324/rfa.07.1.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This article is a personal reflection on a long-standing patient and public involvement (PPI) partnership between a person with Parkinson’s and a cognitive neuroscience researcher. They describe how the partnership arose, was established and evolved to produce unexpected benefits to the research and more broadly. Initially, working together helped to communicate the purpose of the research to a lay audience and to make lab-based testing sessions for people with Parkinson’s as comfortable as possible. They then worked together on the steering group for a research project about Parkinson’s and imitation, which led to co-designing interventions using imitation and imagination of movements to improve movements, including a dance class. Further benefits were realised through co-teaching undergraduate students about Parkinson’s, establishing a broader culture of PPI within the research lab and sharing their expertise of PPI more broadly. They consider key ingredients for successful collaboration, including shared curiosity, open-mindedness and trust, as well as the importance of informal discussion and space. Challenges are also considered, including authorship of research articles and anonymity. Their account demonstrates the value of the collaboration to research itself, but also the broader (often unexpected) benefits that can emerge when a collaboration has space and time to flourish.
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Plch L. Perception of Technology-Enhanced Learning by Medical Students: an Integrative Review. MEDICAL SCIENCE EDUCATOR 2020; 30:1707-1720. [PMID: 34457833 PMCID: PMC8368782 DOI: 10.1007/s40670-020-01040-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This review aims to explore the perception of technology-enhanced learning by medical students. From the initial 2947 records found, 38 studies from journals indexed in the Web of Science database were included after screening. Several main topics were isolated, based on a thematic analysis: student's attitude towards e-learning and modern technologies in medical education; social networks, video, and mobile devices as information source and communication tool; and barriers to the use of technologies in medical education. The results have shown that a positive attitude towards technologies in medical education and learning is prevalent among students. The popularity of blended learning was confirmed.
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Affiliation(s)
- Lukáš Plch
- Department of Educational Sciences, Faculty of Arts, Masaryk University, Arna Novaka 1, 602 00 Brno, Czech Republic
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Fog-Petersen C, Borgnakke K, Hemmingsen R, Gefke M, Arnfred S. Clerkship students' use of a video library for training the mental status examination. Nord J Psychiatry 2020; 74:332-339. [PMID: 31906771 DOI: 10.1080/08039488.2019.1709892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: Fewer patient encounters and diminished bedside teaching pose a challenge to medical students' opportunity to learn during clinical clerkships in psychiatry. Videos can be used for close examination of signs and symptoms and to increase engagement and recall. A video library holding recordings of psychiatric patients with mental status examinations were prepared. We explored the students' use of this library during their clerkships.Methods and materials: The video library was introduced to three rotations of medical students and made accessible on hospital computers. Four students volunteered as key informants and were followed daily throughout the clerkship by the first author, using the ethnographic method of participant observation. At the end of the clerkship, group interviews were conducted with each rotation of students, including the key informants. Twelve students participated in the study. Field notes taken during participant observation and the transcribed interviews were merged in a thematic analysis.Results: The analysis reveals the students' autonomous and arbitrary use of the video library. Creatively extending the use of the videos, they scheduled their video sessions according to their individual needs. The students furthermore blended experiences gained from the library and in the ward, thus coping in various ways with the shortcomings of the video library.Conclusions: The medical students felt they benefited from the simplified learning situation offered by the video library. Their frequent shortcuts through the videos during sessions highlighted weaknesses in the feedback and reflection processes occasioned by the library.
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Affiliation(s)
- Cecilie Fog-Petersen
- Department of Clinical Medicine, University of Copenhagen and Psychiatry est, Slagelse, Denmark
| | - Karen Borgnakke
- Department of Media, Cognition and Communication, University of Copenhagen, Copenhagen, Denmark
| | - Ralf Hemmingsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maria Gefke
- Psychiatric Centre Glostrup, Glostrup, Denmark
| | - Sidse Arnfred
- Department of Clinical Medicine, University of Copenhagen and Psychiatry est, Slagelse, Denmark
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Nunohara K, Imafuku R, Saiki T, Bridges SM, Kawakami C, Tsunekawa K, Niwa M, Fujisaki K, Suzuki Y. How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study. BMC MEDICAL EDUCATION 2020; 20:67. [PMID: 32143611 PMCID: PMC7059388 DOI: 10.1186/s12909-020-1969-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 02/17/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Clinical decision-making skills are essential for providing high-quality patient care. To enhance these skills, many institutions worldwide use case-based learning (CBL) as an educational strategy of pre-clinical training. However, to date, the influence of different learning modalities on students' clinical decision-making processes has not been fully explored. This study aims to explore the influence of video and paper case modalities on the clinical decision-making process of midwifery students during CBL. METHODS CBL involving a normal pregnant woman was provided for 45 midwifery students. They were divided into 12 groups; six groups received the video modality, and six groups received the paper modality. Group discussions were video-recorded, and focus groups were conducted after the CBL. Transcripts of the group discussions were analysed in terms of their interaction patterns, and focus groups were thematically analysed based on the three-stage model of clinical decision-making, which includes cue acquisition, interpretation, and evaluation/decision-making. RESULTS The students in the video groups paid more attention to psychosocial than biomedical aspects and discussed tailored care for the woman and her family members. They refrained from vaginal examinations and electric fetal heart monitoring. Conversely, the students in the paper groups paid more attention to biomedical than psychosocial aspects and discussed when to perform vaginal examinations and electric fetal heart monitoring. CONCLUSION This study clarified that video and paper case modalities have different influences on learners' clinical decision-making processes. Video case learning encourages midwifery students to have a woman- and family-centred holistic perspective of labour and birth care, which leads to careful consideration of the psychosocial aspects. Paper case learning encourages midwifery students to have a healthcare provider-centred biomedical perspective of labour and childbirth care, which leads to thorough biomedical assessment.
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Affiliation(s)
- Kana Nunohara
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
- Nursing Department, Gifu College of Nursing, Egira-cho 3047-1, Hashima, Gifu, 501-6295 Japan
| | - Rintaro Imafuku
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
| | - Takuya Saiki
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
| | - Susan M. Bridges
- Faculty of Education, The University of Hong Kong, Pokfulam Road, Pok Fu Lam, Hong Kong
| | - Chihiro Kawakami
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
| | - Koji Tsunekawa
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
| | - Masayuki Niwa
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
| | - Kazuhiko Fujisaki
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
| | - Yasuyuki Suzuki
- Medical Education Development Center, Gifu University, Yanagido 1-1, Gifu, 501-1194 Japan
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Pedersen K, Bennedsen A, Rungø B, Paltved C, Morcke AM, Ringsted C, Mors O. Evaluating the effectiveness of video cases to improve patient-centeredness in psychiatry: a quasi-experimental study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2019; 10:195-202. [PMID: 31658442 PMCID: PMC7246115 DOI: 10.5116/ijme.5d9b.1e88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 10/07/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of including interactive video-based patient cases in preparatory lectures on medical students' patient-centredness and attitudes towards psychiatry. METHODS This study was designed as a quasi-experimental intervention study. A preparatory lecture on diagnostic interviewing was given to 204 fourth-year medical students before a 4-week psychiatry clerkship. The students were divided into two groups. One group (n=102) received a preparatory lecture including an interactive video case portraying a doctor performing a diagnostic interview with a simulated patient (intervention group). The other group (n=102) received a conventional preparatory lecture using text-based instructional material (control group). We conducted a paired sample t-test to compare the students' confidence in exhibiting patient-centred communication and their attitudes towards psychiatry before receiving the preparatory lecture and after having completed a minimum of three weeks of clerkship training. RESULTS A total of 102 students, 51 in each group, completed a questionnaire at both measurement points. In the intervention group, we found a statistically significantly difference for the students' patient-centredness before (M=69.4, SD=10.0) and after (M=73.8, SD=8.6) the intervention t(97)=2.38, p= 0.02, but no changes in attitudes t(98) =1.07, p=0.28. In the control group, we found no changes in patient-centredness or attitudes. CONCLUSIONS Video cases in preparatory lectures appear to be better than text-based material at improving students' patient-centredness in psychiatry. However, neither video cases nor text-based material seem to influence the students' attitudes.
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Affiliation(s)
- Kamilla Pedersen
- Centre for Health Sciences Education, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Andreas Bennedsen
- Centre for Health Sciences Education, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Berit Rungø
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark
| | | | - Anne Mette Morcke
- Copenhagen Academy for Medical Education and Simulation at Rigshospitalet, Capital Region of Denmark, Copenhagen, Denmark
| | - Charlotte Ringsted
- Centre for Health Sciences Education, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark
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Gavzy SJ, Berenson MG, Decker J, Domogauer J, Alexander A, Pulaski M, Soto-Greene M, Sánchez N, Sánchez JP. The Case of Ty Jackson: An Interactive Module on LGBT Health Employing Introspective Techniques and Video-Based Case Discussion. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10828. [PMID: 31259237 PMCID: PMC6571794 DOI: 10.15766/mep_2374-8265.10828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/29/2019] [Indexed: 05/13/2023]
Abstract
Introduction The Institute of Medicine's 2011 report on lesbian, gay, bisexual, and transgender (LGBT) health and the legalization of same-sex marriage are just two of the numerous milestones that have hastened medical schools' efforts to prepare trainees to address the needs of LGBT community members. Early awareness of sexual diversity through self- and peer introspection and video-based education can help trainees build a foundation towards providing affirming care to LGBT patients. Methods The Kern model was used to develop, implement, and evaluate an interactive multimodal workshop to provide first-year medical students with a formative introduction to LGBT health. Learning objectives focused on comprehending the spectrum of human sexuality, health issues for LGBT patients, and better practices for promoting affirming care. The module consisted of a PowerPoint presentation, sexuality survey, videos of provider-patient encounters, and community-based resources. Results The workshop was implemented among 178 first-year medical students in September 2018, with 93% completing the pre-/postworkshop evaluations. Comparison of evaluations showed an increase in confidence in addressing each of the three learning objectives. Over 85% rated the PowerPoint and videos as very good or excellent. Discussion This workshop was effective in helping first-year medical students appreciate the spectrum of sexual diversity, health issues facing LGBT individuals, and better practices to promote affirming care. The real-time sexuality survey helped trainees appreciate sexual diversity through self-reflection and near-peer sharing. The videos and accompanying discussion provided real-life encounters, along with common pitfalls in and pearls for communicating with LGBT patients.
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Affiliation(s)
- Samuel J. Gavzy
- Fourth-Year Medical Student, Rutgers New Jersey Medical School
| | | | - Jilyan Decker
- Resident, Obstetrics and Gynecology Department, Rutgers New Jersey Medical School
| | - Jason Domogauer
- Resident, Medicine Department, Rutgers New Jersey Medical School
| | - Andreia Alexander
- Assistant Professor of Emergency Medicine, Indiana University School of Medicine
| | - Matthew Pulaski
- Fourth-Year Medical Student, Rutgers New Jersey Medical School
| | | | - Nelson Sánchez
- Associate Professor of Medicine, Weill-Cornell Medical College
| | - John Paul Sánchez
- Associate Dean, Diversity and Inclusion, Rutgers New Jersey Medical School
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Selvi O, Tulgar S, Senturk O, Topcu DI, Ozer Z. YouTube as an informational source for brachial plexus blocks: evaluation of content and educational value. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2019. [PMID: 30635118 PMCID: PMC9391886 DOI: 10.1016/j.bjane.2018.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Selvi O, Tulgar S, Senturk O, Topcu DI, Ozer Z. [YouTube as an informational source for brachial plexus blocks: evaluation of content and educational value]. Braz J Anesthesiol 2019; 69:168-176. [PMID: 30635118 DOI: 10.1016/j.bjan.2018.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/08/2018] [Accepted: 11/05/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES YouTube, the most popular video-sharing website, contains a significant number of medical videos including brachial plexus nerve blocks. Despite the widespread use of this platform as a medical information source, there is no regulation for the quality or content of the videos. The goals of this study are to evaluate the content of material on YouTube relevant to performance of brachial plexus nerve blocks and its quality as a visual digital information source. METHODS The YouTube search was performed using keywords associated with brachial plexus nerve blocks and the final 86 videos out of 374 were included in the watch list. The assessors scored the videos separately according to the Questionnaires. Questionnaire-1 (Q1) was prepared according to the ASRA guidelines/Miller's Anesthesia as a reference text book, and Questionnaire-2 (Q2) was formulated using a modification of the criteria in Evaluation of Video Media Guidelines. RESULTS 72 ultrasound-guided and 14 nerve-stimulator guided block videos were evaluated. In Q1, for ultrasound-guided videos, the least scores were for Q1-5 (1.38) regarding the complications, and the greatest scores were for Q1-13 (3.30) regarding the sono-anatomic image. In videos with nerve stimulator, the lowest and the highest scores were given for Q1-7 (1.64) regarding the equipment and Q1-12 (3.60) regarding the explanation of muscle twitches respectively. In Q2, 65.3% of ultrasound-guided and 42.8% of blocks with nerve-stimulator had worse than satisfactory scores. CONCLUSIONS The majority of the videos examined for this study lack the comprehensive approach necessary to safely guide someone seeking information about brachial plexus nerve blocks.
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Affiliation(s)
- Onur Selvi
- Maltepe University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Istambul, Turquia.
| | - Serkan Tulgar
- Maltepe University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Istambul, Turquia
| | - Ozgur Senturk
- Maltepe University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Istambul, Turquia
| | - Deniz I Topcu
- Gazi University, Institute of Health Sciences, Department of Medical Biochemistry, Ankara, Turquia
| | - Zeliha Ozer
- Maltepe University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Istambul, Turquia
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Kumar MM, Boies EG, Sawyer MH, Kennedy M, Williams C, Rhee KE. A Brief Provider Training Video Improves Comfort With Recommending the Human Papillomavirus Vaccine. Clin Pediatr (Phila) 2019; 58:17-23. [PMID: 30280580 DOI: 10.1177/0009922818805217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The American Academy of Pediatrics California Chapter 3 created a 20-minute training video targeting barriers to strong provider recommendation of the human papillomavirus (HPV) vaccine. The video included clinical vignettes featuring pediatricians modeling counseling techniques with vaccine-hesitant families. Ninety-six multidisciplinary providers (including pediatric residents) at 6 sites viewed the video and completed baseline and posttest questionnaires assessing their vaccine knowledge, attitudes toward vaccination, and comfort with skills needed to facilitate vaccination. Following the intervention, providers had substantial and statistically significant ( P < .05) improvements in multiple areas assessed, particularly knowledge of the burden of HPV-related disease in males and changes in vaccine response with age; likelihood of "strongly agreeing" that vaccination should not be delayed beyond preadolescence and that HPV vaccine is safe; and feeling "very comfortable" counseling vaccine-hesitant parents and facilitating vaccine completion. This cost-effective and easily disseminated training modality shows promise in increasing provider comfort with HPV vaccine counseling.
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Affiliation(s)
| | | | | | - Meredith Kennedy
- 2 American Academy of Pediatrics, California Chapter 3, San Diego, CA, USA
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