title: A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal.
abstract: Influenza vaccine hesitancy is common in the primary care setting. Though physicians can affect caregivers' attitudes toward vaccination, physicians report uneasiness discussing vaccine hesitancy. Few studies have targeted physician-patient communication training as a means to decrease vaccination refusal.
  
  
  
  An immersive virtual reality (VR) curriculum was created to teach pediatric residents communication skills when discussing influenza vaccine hesitancy. This pilot curriculum consisted of 3 VR simulations during which residents counseled graphical character representatives (avatars) who expressed vaccine hesitancy. Participants were randomized to the intervention (n = 24) or control (n = 21) group. Only residents in the intervention group underwent the VR curriculum. Impact of the curriculum was assessed through difference in influenza vaccine refusal rates between the intervention and control groups in the 3 months after the VR curriculum.
  
  
  
  Participants included postgraduate level (PL) 2 and PL3 pediatric residents. All eligible residents (n = 45) participated; the survey response rate was 100%. In patients aged 6 to 59 months, residents in the intervention group had a decreased rate of influenza vaccination refusal in the postcurriculum period compared to the control group (27.8% vs 37.1%; P = .03).
  
  
  
  Immersive VR may be an effective modality to teach communication skills to medical trainees. Next steps include evaluation of the curriculum in a larger, multisite trial.
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: francis.real@cchmc.org.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Real
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Dominick
authors.initials: D
authors.lastname: DeBlasio
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Beck
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Ollberding
authors.affiliation: Division of Learning and Development, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: David
authors.initials: D
authors.lastname: Davis
authors.affiliation: Division of Learning and Development, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Bradley
authors.initials: B
authors.lastname: Cruse
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Zeina
authors.initials: Z
authors.lastname: Samaan
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Learning and Development, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Daniel
authors.initials: D
authors.lastname: McLinden
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Klein
mesh_terms: D000328:Adult; D003142:Communication; D003479:Curriculum; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D010372:Pediatrics / Q000193:education*; D000072758:Vaccination Refusal; D000076142:Virtual Reality
chemical_list: D007252:Influenza Vaccines
keywords: influenza; medical education; simulation; vaccine hesitancy; virtual reality