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Doucette EJ, Pateman M, Fullerton MM, Lip A, Houle SKD, Kellner JD, Leal J, MacDonald SE, McNeil D, Davidson S, Constantinescu C. "You can push these conversations, but don't push your patient away": healthcare learner perspectives on virtual simulation games as an educational approach to address vaccine hesitancy. Front Public Health 2024; 12:1408871. [PMID: 39022406 PMCID: PMC11252083 DOI: 10.3389/fpubh.2024.1408871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Background Vaccine hesitancy is a significant threat to public health. Healthcare providers (HCPs) can address hesitancy during routine patient conversations; however, few multidisciplinary education tools exist for HCPs to learn to engage in vaccine discussion especially considering new vaccine technologies such as mRNA vaccines. The objectives of this study were to explore HCP learners' experiences with COVID-19 vaccine communication, and qualitatively evaluate an online learning module composed of virtual simulation games (VSGs) which utilize the PrOTCT Framework for HCP vaccine communication. Methods Three virtual focus groups were conducted from December 2022 to January 2023 with Canadian healthcare learners in nursing (N = 6), pharmacy (N = 9), and medicine (N = 7) who participated in a larger study measuring the effectiveness of the VSGs. Using a pragmatic approach, a qualitative thematic analysis was conducted using NVivo to identify themes and subthemes. Results A total of 22 HCP learners participated in this study and three key themes were identified. Across all three disciplines, participants expressed that (1) their prior education lacked training on how to hold vaccine conversations, resulting in uncomfortable personal experiences with patients; (2) the VSGs increased their confidence in holding vaccine conversations by providing novel tools and skills; and (3) participants also provided feedback to improve the VSGs which was implemented and supported the dissemination to all HCP professions. Conclusion Although HCPs are a trusted source of vaccine information, participants in this study felt they received little training on how to engage in challenging conversations regarding COVID-19 vaccines. The introduction of the PrOTCT Framework and presumptive statements provided novel strategies for HCP to initiate vaccine conversations, especially considering new vaccine technologies and participants appreciated the emphasis on coping strategies and resilience. It is essential that HCP are provided both opportunities to practice managing these conversations, and tools and skills to succeed at an early point in their careers to prepare them for future roles in vaccine advocacy, delivery, and promotion.
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Affiliation(s)
- Emily J. Doucette
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Margaret Pateman
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc., Rocky Mountain House, AB, Canada
| | - Madison M. Fullerton
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc., Rocky Mountain House, AB, Canada
| | - Alyssa Lip
- Division of Respirology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - James D. Kellner
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jenine Leal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Antimicrobial Resistance - One Health Consortium, University of Calgary, Calgary, AB, Canada
- Real World Evidence Consortium, University of Calgary, Calgary, AB, Canada
| | - Shannon E. MacDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Deborah McNeil
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Langford BJ, Branch-Elliman W, Nori P, Marra AR, Bearman G. Confronting the Disruption of the Infectious Diseases Workforce by Artificial Intelligence: What This Means for Us and What We Can Do About It. Open Forum Infect Dis 2024; 11:ofae053. [PMID: 38434616 PMCID: PMC10906702 DOI: 10.1093/ofid/ofae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
With the rapid advancement of artificial intelligence (AI), the field of infectious diseases (ID) faces both innovation and disruption. AI and its subfields including machine learning, deep learning, and large language models can support ID clinicians' decision making and streamline their workflow. AI models may help ensure earlier detection of disease, more personalized empiric treatment recommendations, and allocation of human resources to support higher-yield antimicrobial stewardship and infection prevention strategies. AI is unlikely to replace the role of ID experts, but could instead augment it. However, its limitations will need to be carefully addressed and mitigated to ensure safe and effective implementation. ID experts can be engaged in AI implementation by participating in training and education, identifying use cases for AI to help improve patient care, designing, validating and evaluating algorithms, and continuing to advocate for their vital role in patient care.
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Affiliation(s)
- Bradley J Langford
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Hotel Dieu Shaver Health and Rehabilitation Centre, Department of Pharmacy, St Catharines, Ontario, Canada
| | - Westyn Branch-Elliman
- Department of Medicine, Section of Infectious Diseases, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
- National Artificial Intelligence Institute, Department of Veterans Affairs, Washington, District of Columbia, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Priya Nori
- Division of Infectious Diseases, Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Alexandre R Marra
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Gonzalo Bearman
- Division of Infectious Diseases, Virginia Commonwealth University Health, Virginia Commonwealth University, Richmond, Virginia, USA
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Habbous S, Saunders N, Chan KK, Hota S, Wang J, Messenger D, Hellsten E. SARS-CoV-2 infection among physicians over time in Ontario, Canada: a population-based retrospective cohort study. Croat Med J 2024; 65:30-42. [PMID: 38433510 PMCID: PMC10915769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
AIM To assess this risk of SARS-CoV-2 infection among Ontario physicians by specialty and in comparison with non-physician controls during the COVID-19 pandemic. METHODS In this retrospective cohort study, the primary outcome was incident SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR). Secondary outcomes were hospitalization, use of critical care, and mortality. RESULTS From March 1, 2020 to December 31, 2022, 6172/30 617 (20%) active Ontario physicians tested positive for SARS-CoV-2. Infection was less likely if physicians were older (OR 0.78 [0.76-0.81] per 10 years), rural residents (OR 0.70 [0.59-0.83]), and lived in more marginalized neighborhoods (OR 0.74 [0.62-0.89]), but more likely if they were female (OR 1.14 [1.07-1.22]), worked in long-term care settings (OR 1.16 [1.02-1.32]), had higher patient volumes (OR 2.05 [1.82-2.30] for highest vs lowest), and were pediatricians (OR 1.25 [1.09-1.44]). Compared with community-matched controls (n=29 763), physicians had a higher risk of infection during the first two waves of the pandemic (OR 1.38 [1.20-1.59]) but by wave 3 the risk was no longer significantly different (OR 0.93 [0.83-1.05]). Physicians were less likely to be hospitalized within 14 days of their first positive PCR test than non-physicians (P<0.0001), but there was no difference in the use of critical care (P=0.48) or mortality (P=0.15). CONCLUSION Physicians had higher rates of infection than community-matched controls during the first two waves of the pandemic in Ontario, but not from wave 3 onward. Physicians practicing in long-term care facilities and pediatricians were more likely to test positive for SARS-CoV-2 than other physicians.
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Affiliation(s)
- Steven Habbous
- Steven Habbous, 525 University Ave, Toronto, Ontario, Canada, M5G 2L3,
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Stewart S, Totka JP, Hanrahan K. Ted Lasso and Team Science for Evidence-Based Practice Teamwork. J Perianesth Nurs 2024; 39:155-159. [PMID: 38099886 DOI: 10.1016/j.jopan.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/24/2023] [Indexed: 02/04/2024]
Affiliation(s)
- Stephanie Stewart
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
| | - Joan P Totka
- College of Nursing, Marquette University, Milwaukee, WI; Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI
| | - Kirsten Hanrahan
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA.
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Bearman G, Nori P. Implementing behavior change in healthcare epidemiology and antimicrobial stewardship: The worst that can happen is you fail. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e129. [PMID: 37592962 PMCID: PMC10428149 DOI: 10.1017/ash.2023.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Gonzalo Bearman
- Division of Infectious Diseases, Virginia Commonwealth University Health, Richmond, VA
| | - Priya Nori
- Division of Infectious Diseases, Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY
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