UB medical and health students pilot new training to counter medical misinformation


In an exam room at the University of Buffalo’s Jacobs School of Medicine and Biomedical Sciences, Hannah Bucholz angrily lectured two students in lab coats about the safety of the Covid-19 vaccine.

“These vaccines contain a lot of toxins, and before you push them on an unsuspecting public, you need to know what’s going on!” Bucholz growled. “Big Pharma is pushing this because they make tons of money on it, and the government is behind it all!”

The students tried to explain how the vaccine works, but Bucholz continued to argue. Finally, they thanked her for her time and ended the “consultation”.

But Bucholz was not a real patient. She was describing one in a simulation as part of a pilot program at UB aimed at training medical and health students to deal with the rise of medical misinformation about vaccinations and other treatments that inject mistrust. in provider-patient relationships.

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Misinformation has long been a problem for healthcare professionals who often struggle to convince skeptical patients about the safety of vaccines and the effectiveness of certain treatments.

But Covid-19 has made the situation worse. Much worse.

“This is the scenario that bothers students the most — where the patient tries to educate the provider,” said Alison Vargovich, professor of behavioral medicine at UB Jacobs School of Medicine, who watched the simulation with Bucholz on camera from another room.

“It’s about knowing when to stop banging your head against the wall, that this person is not ready to change and that you don’t want to argue with them. It’s a totally different conversation than what we are used to having in our usual practice.

In 2019, even before the Covid-19 outbreak, the World Health Organization identified vaccine hesitancy as a potential threat to global health. Since then, rampant misinformation about Covid-19 and the Covid-19 vaccine has posed new challenges for healthcare professionals and the schools that train them.

UB is one of five medical schools nationwide whose proposals for training medical professionals to dispel medical misinformation were recently selected for funding by the American Association of Medical Colleges and the National Centers for Control and disease prevention.

Vargovich and his co-investigator, UB pharmacy professor Nicholas Fusco, received a $35,000 grant to pilot their program as an interprofessional education experiment that brings together medical, nursing, and other health sciences to combat misinformation by fostering trust between students and the patients they serve.

Alison Vargovich, professor of behavioral medicine at UB’s Jacobs School of Medicine, discusses the new program.

Fusco and Vargovich said a key part is approaching conversations with patients with respect and always leaving the door open for more conversations, no matter how frustrating the lies can be.

Their program has three parts – an online learning segment that prepares students for simulated patient interactions, virtual simulations that allow them to view recorded interactions from the provider’s perspective, and choose from various patient responses , and in-person simulations with actors like Bucholz.

Student responses to simulated interactions are recorded and discussed, and in-person scenarios can be viewed live on monitors in a separate room, or later as videos. The standardized patient actors also give feedback on how they felt in relation to the student’s responses. Students are not graded on exercises.

“This is a pilot program, and we want it to be a low-stakes experience for our students,” Fusco said. “We want to create an environment where they can experiment and learn to have these conversations.”

For recent in-person simulations, students from different disciplines were paired up and sent to testing rooms to experience each of the three scenarios.

In one, a patient who received the first vaccine had a reaction that made him fear the second. In another, a parent wondered if the vaccine was safe for children. In the third, the team was asked to staff a Covid-19 vaccine “information table” at a farmers market. That’s where Bucholz came in, with her Trader Joe’s shopping bag and divisive arguments.

Each scenario was seven minutes long, with a two-minute disclaimer at the end so they could wrap up the conversation in the most positive way possible. The students were armed with CDC handouts containing information about the Covid-19 vaccine and tip sheets with suggestions such as “Ask the individual to share their concerns (empathy and curiosity): ‘Help me understand this makes you reluctant to get vaccinated.’ ”

In most scenarios, students worked together to calmly answer questions and offer information. Subsequently, several gave their opinion on how it happened.

A team said it was difficult to reassure a mother that the vaccine was safe for her 10-year-old child because she had not read specific studies on children beforehand – which she planned to do in the future.

The same team performed well when the actor asked, “Do YOU ​​have kids?”

“I don’t have children, but I have a little sister who had the vaccine with no ill effects, and I’m glad she got it and is protected from getting infected or spreading the virus. Covid,” replied the student.

In the room where the alleged patient had a reaction to the first vaccine, the student team explained that a day or two of side effects is far better than a full-blown Covid-19. One of the students said he had chills and fatigue after the first shot and planned to take a day off after the second just in case.

“That seems like the best course of action,” the patient actor replied. “I think it’s a good solution.”

Even in the case of the belligerent anti-vaxxer, Vargovich said students are told the purpose of the conversation is not to get the patient to accept the vaccine, but to set the stage for an ongoing relationship.

“A lot of times people ask you to be part of the problem, to be one more person who is part of the conspiracy,” she said. “We want to dance, not fight. So if you feel like you’re struggling, you need to be able to gracefully end the conversation.

As part of their research, the researchers will examine which approaches seemed most effective in helping students tackle medical misinformation with patients. Vargovich said the AAMC and CDC want to continue to build on this research, “so it’s very exciting. This is an area of ​​research that desperately needs to be addressed.

Creating the project as an IPE experience also meets UB’s goal of creating more interprofessional education opportunities to improve healthcare through collaboration. Several students said they found this approach helpful, especially those in fields like pharmacy, where students don’t have simulation in their regular curriculum.

Ryan Stehlin, a nurse practitioner student, said he had been through many simulations while studying to become a registered nurse and nurse practitioner, but had not considered dealing with parents who thought the vaccine Covid would make their child sterile.

“It was a good reminder of ways to approach and engage with people to have a conversation about what’s true and can improve the quality of their lives,” he said.

Jenny Rohlin, a public health nurse studying to become a family nurse practitioner, said she practices in a rural area and frequently faces misinformation.

“I found the simulations very realistic,” she said. “It’s good to be ready to react effectively. This program has been a good experience, very well organized and adapted to today’s challenges.

Standardized patient actor Hannah Bucholz stars as a conspiracy theorist trying to convince UB graduate students Caden Jones (pharmacy), left, and Jordan Holmes (public health) that the Covid-19 vaccine is dangerous under a UB pilot program in misinformation medicine. (photo added)

Sandra Kicman

Patient actor Bucholz said the project made him realize how widespread medical misinformation is on social media, radio shows and in everyday dialogue. She didn’t have to study too hard for her misinformed role.

“I read the documents they gave me,” she said, “but all I had to do was channel the people I knew.”


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