Pharmacy Professor Trains Future Change Agents

Mariette Sourial, PharmD (right), with Palm Beach Atlantic University colleagues Jay Jackson, PharmD (center), and Erenie Guirguis, PharmD (left), collaborated to design a training program for student pharmacists to learn how to engage with vaccine hesitant patients.

Mariette Sourial, PharmD (right), with Palm Beach Atlantic University colleagues Jay Jackson, PharmD (center), and Erenie Guirguis, PharmD (left), collaborated to design a training program for student pharmacists to learn how to engage with vaccine hesitant patients.

Early on during the COVID-19 vaccine rollout, faculty and student pharmacists at Palm Beach Atlantic (PBA) University, Lloyd L. Gregory School of Pharmacy, in West Palm Beach, Florida, encountered vaccine hesitant members in their community. In response, Mariette Sourial, PharmD, Associate Professor of Pharmacy Practice, and colleagues took action to support the students and improve vaccine acceptance in the community.

With the support of a National Association of Chain Drug Stores grant, Sourial in concert with colleagues Jay Jackson, PharmD, Assistant Dean of Students, and Erenie Guirguis, PharmD, Associate Professor of Pharmacy Practice, conducted a literature search on why members of certain minority and underserved populations refused COVID-19 vaccines. The educators used their findings to design a novel training program for students at PBA University’s Lloyd L. Gregory School of Pharmacy.

Under the leadership of Sourial and her colleagues, 18 student pharmacists volunteered to participate in a training program on addressing COVID-19 vaccine hesitancy. Part of the training involved a group Objective Structured Clinical Examination (OSCE). Hired actors performed as standardized patients and presented the students with tough, realistic scenarios about getting a COVID-19 vaccine.

In one case scenario, an actor told the student pharmacists that the mRNA vaccines would change her DNA.

“When the actors brought up specific concerns like that, the students would pause and say, ‘Oh, I really need to learn more about this and build a stronger case that the vaccine isn’t going to change your DNA. It’s not enough to just tell them that it won’t,’” Sourial said.

“It’s one thing to teach motivational interviewing in our pharmacy curriculum. It’s another to teach motivational interviewing in the context of patients who are vaccine hesitant, and it’s another when their hesitation is about COVID-19 vaccines,” Sourial said. “It’s a multilayered issue.”

As the student pharmacists rotated through various case scenario stations, they met a “patient” who wouldn’t take the vaccine because she feared the side effects would cause her to miss work, and she couldn’t afford not to go to her job. Another case involved concerns about long-term side effects that might surface months or years in the future. Another standardized patient expressed religious beliefs that forbid her from taking a vaccine that she believed contained components of aborted fetuses.

The student pharmacists didn’t win over or convince the actors every time.

“It was definitely an eye opener for the students to see that some patients are going to hold onto whatever it is that they believe about the vaccine no matter how you approach them,” Sourial said. “The important thing is that we try, and we continue to try at every encounter.”

Practice Pearl

Patient education can be improved by going beyond one-way communication. Each encounter between a pharmacist and a patient is meant to be an interaction, an exchange.

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During the debriefing at the end of the OSCE, “Aha!” moments took place. Actors shared their perspectives of the interactions. They told the students when too much medical jargon was used and which counseling points were the most and least convincing.

“The students got to learn that we are not just there to inundate people with information,” Sourial said. “The patients are human too, and this is an interaction.”

After completing the training, the student pharmacists took what they had learned out into the field. They talked with and vaccinated patients at a local health fair, food bank, and pharmacy, specifically targeting minority and underserved populations. The student pharmacists entered these settings feeling better prepared for questions or concerns that might come their way—and feeling ready to change a few minds.

“They can apply these lessons to any vaccines they want to administer or any patient care situation in the future,” Sourial said. “We’ve trained the future agents of change.”

Resources to Educate Your Health Care Team and tools to help Answer Common Questions about COVID-19 vaccines are available at APhA’s Vaccine Confident microsite.