The recent proliferation in the number of measles cases nationwide has prompted a re-examination of how vaccination is taught in medical school, how technology can be used to improve vaccination processes, and how patients are informed in a clinical setting about the need to vaccinate. While the modern-day vaccination process has been one of the safest and most successful medical advances in history, the growth in the number of parents who are now choosing to not vaccinate their children places the efficacy of this process in jeopardy.
What Are We Teaching DO Medical Students?
Are we giving DO medical students all the tools and information they need to keep up with the changes in immunization best practices and to effectively educate patients about the safety of vaccines in modern medicine? How do DO students receive instruction in the subject of vaccination and immunization? Each college of osteopathic medicine (COM) customizes its approach to teaching this curriculum, and various aspects of immunization pathophysiology, epidemiology and clinical implementation are part of many areas of curriculum, including immunology, microbiology, pharmacology, public health, pediatrics, and family medicine.
While each COM customizes its educational approach to some extent, they all follow basic standards set by COCA (The Commission on Osteopathic College Accreditation), and utilize recommendations and best practices established by the U.S. Centers for Disease Control and Prevention. Most notably, despite the variety of curriculum designs, one common trend across the COMs is to incorporate available information technologies to enhance students’ understanding of and access to the latest information available on immunization.
Examples of the kinds of technologies recommended for use and adoption include the CDC’s smartphone “app,” (CDC Vaccine Schedules App for Clinicians and Other Immunization Providers) as well as the information that is encoded in patients’ electronic medical records, which are often pre-programmed to alert the physician when vaccines are due. Using an Electronic Health Record (EHR) system to automate the immunization data shared between health providers and public health agencies enables physicians to assist individual patients faster and more effectively, while also providing more immediate, cohesive community data to the agencies tasked with promoting public health.
Vaccination and Public Health
Perhaps the most widely recognized body of experts on vaccination and the public health is the Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States. The ACIP recommendations stand as public health standards to reduce and prevent the incidence of vaccine-preventable diseases and increase the safe use of vaccines and related biological products. This group’s recommendations are incorporated into the CDC “app” mentioned previously, and are kept current as a result of quarterly updates and changes in immunization best practices.
As a Liaison Representative to the ACIP and a passionate vaccination advocate, Stanley E. Grogg, DO, brings a wealth of specialized knowledge and experience to the current debate around vaccination. Dr. Grogg is a professor emeritus in the Department of Pediatrics at Oklahoma State University Center for Health Sciences College of Osteopathic Medicine (OSU-COM) in Tulsa, OK and former medical director of clinical research and interim president and dean of the college of osteopathic medicine. When asked about the current immunization issues, Dr. Grogg stated:
“Today’s vaccination issues are complex, but they can only be addressed through the use of evidence-based medicine. This is the only way that immunization should be taught, and it should be based solely on science and fact. We do not rely on experts. We rely on studies. The ACIP is very strict in its recommendations, and this is how it should be. Our primary challenge lies in dealing with the rapid rate of change, and ensuring that these frequent updates in best practices are disseminated to medical school faculty, students, physicians, and patients. Without exception, the CDC app should be on the smartphone of everyone who needs to know the latest vaccination information.”
Teaching the science of vaccines and vaccination has not changed considerably; it is a topic that crosses many fields and specialties in the medical science curriculum. The current crisis with the rise in national measles cases highlights the need to review and supplement our teaching processes in health education curricula to match the population’s health care needs. Knowledge of vaccines and vaccination protocols is only the beginning for our learners.
Today’s students need to know how vaccines work from a microbiological perspective and how vaccination is viewed and implemented from a public and prevention perspective for overall population health. Additionally, they must now be able to use information technology, health care implementation science, and evidence-based data analysis to assess their own skills and ability in educating their patients to make wise health decisions regarding vaccination. Similarly, students must be informed about data systems to perform personal and reflective quality improvement and quality assurance with their personal patient panels. This will then empower them to evaluate their ability to realize positive outcomes regarding patient vaccination. Knowledge alone is no longer enough; targeting disease prevention and population health maintenance is foremost.