Evaluation of student confidence in influenza immunization administration using a multi-modal teaching approach

The primary objective of this study was to evaluate changes in student confidence resulting from completion of the American Pharmacists Association (APhA) certification course, an immunization-based simulation, and practical experience in influenza immunization clinics during an Introductory Pharmacy Practice Experience (IPPE). Secondary objectives included evaluation of influences on student confidence such as campus location, prior APhA certification, and prior experience in preparing injectable medications. Methods An eight-question survey was administered to third-year pharmacy students in Fall 2011 to measure confidence in immunization skills and knowledge at four time points; before APhA certification, after APhA certification, after participation in the simulation, and after 12 hours of practical experience in influenza-based immunization clinics. The simulation consisted of case-based scenarios and a skill assessment. Results Upon IPPE completion, at least 86.6% of students reported either confidence or extreme confidence for all survey items. Student confidence increased significantly between time points and from baseline to IPPE completion. Students certified prior to Fall 2011 were significantly less confident at baseline in some of the legal issues and response to anaphylactic reactions; however, this difference became non-significant after completion of the simulation. Conclusions All three training modules are important in preparing students for immunization delivery in their future practice. Schools of pharmacy should consider increasing opportunities for development of student confidence in this area. The lack of initial confidence regarding legal requirements in students certified prior to Fall 2011 may indicate the need for recertification or mandatory immunization-based continuing professional development for immunizing pharmacists.