Simulation and Vaccination: A Combination for Public Health

Simulation and vaccination: an innovative combination in the training of doctors in Hygiene and Preventive Medicine. At the Catholic University of the Sacred Heart and the Gemelli Training Center, three training modules allowed residents to experiment with vaccination practices, communication with hesitant patients, and the management of post-vaccination emergencies. An immersive approach that strengthens technical and communication skills, improving confidence and awareness in daily clinical practice.

You are a doctor in specialist training in Hygiene and Preventive Medicine, on duty for the first time at your hospital’s vaccination center, facing a hesitant patient who is wary of vaccines. Every scientific argument seems to slip away, while uncertainty shines through their eyes. Shortly after, a patient you have just vaccinated begins to show signs of an allergic reaction: their heart rate accelerates and their breathing becomes labored. Are you ready to intervene?

Vaccination is not just a matter of technique, but also of communication and, fortunately, only in rare cases, of emergency management.

Introduction

Vaccination has been recognized as one of the greatest medical discoveries in history. This preventive measure has contributed significantly to the reduction of infectious diseases, their complications, and associated mortality. [1]

However, in recent years, a growing portion of the population perceives vaccination as unsafe and unnecessary. This attitude of mistrust toward vaccinations, known as “vaccine hesitancy,” poses a threat to public health.

In this context, it is essential that healthcare professionals be adequately trained to improve public awareness of the safety and efficacy of vaccines.[2]

To date, numerous studies have investigated students’ level of knowledge and attitudes towards vaccination, as well as the effectiveness of specific training interventions [3,4]. In Italy, significant results have been achieved in recent years by conducting various training programs to improve vaccination preparedness for both healthcare students and residents in Hygiene and Preventive Medicine. [5,6]

However, these training activities have mainly used a lecture-based approach, while simulation has been used less frequently as a teaching methodology. Furthermore, the pedagogical approaches used to date have mainly focused on vaccine hesitancy, rather than on vaccination techniques and emergency management. [7]

For this reason, the School of Specialization in Hygiene and Preventive Medicine at the Catholic University of the Sacred Heart, in collaboration with the Gemelli Training Center (GTC) of the Policlinico Gemelli Foundation (FPG) in Rome, has developed a vaccination simulation program for 26 first- and second-year residents, consisting of three modules covering:

• vaccination technique,
• vaccine hesitancy, and
• the management of post-vaccination anaphylactic shock.

In addition, the training experience included the completion of self-assessment questionnaires on learning before and after each module, and at the end of each session, an evaluation of the effectiveness of simulation as a methodology [8].

The experience at the center

Through a structured course consisting of three integrated modules, the trainees were able to enjoy immersive and interactive experiences that reproduced the daily challenges of vaccination centers. From administration techniques to managing vaccine hesitancy, to simulating anaphylactic shock, each phase offered an opportunity to learn by doing, in a safe, realistic, and supervised environment.

Module 1: Introduction to Vaccination Techniques

The first step was to understand the indications, mechanisms of action, and side effects of each vaccine and their administration techniques. Then, after a brief theoretical lesson, which also included an explanation of the forms, disposal procedure, and use of medical devices, there was a practical demonstration of vaccination with vaccine preparation and its risks. participants were able to immediately put what they had learned into practice. Guided by the faculty, they experimented with intramuscular injections on wearable simulators (pads), thus refining their technique and manual skills.

In addition, they were able to practice dosing and preparing some of the vaccines used within the FPG.

The result? Greater confidence in vaccination techniques, vaccine dose preparation, and dealing with potential risks.

Module 2: Managing vaccine hesitancy

It is not enough to know how to vaccinate; you also need to know how to communicate effectively. This module offered trainees the opportunity to put themselves in the shoes of a doctor dealing with a hesitant patient. Initially, two short lectures were given: one

on the topic of vaccine hesitancy, and another

with a professional coach, on feedback, active listening, and empathic communication. Subsequently, a simulation was designed using role-playing

with realistic doctor-patient scenarios, where participants explored effective communication strategies, learning to handle objections with empathy and scientific data.

This exercise highlighted how crucial dialogue is in vaccination practice and how accurate information can make a difference in vaccination uptake.

Module 3: Anaphylactic Shock Simulation

Finally, the module on post-vaccination emergency management. Participants had the opportunity to immerse themselves in a post-vaccination anaphylactic shock scenario using an advanced simulator.

Then, after a brief lecture on the clinical management algorithm for critical situations [9] and the opportunity to see and touch the emergency trolley, under the careful supervision of FPG anesthetists, participants were able to familiarize themselves with their patient. After this phase, the trainees, divided into teams, actively participated in the scenario in which post-vaccination anaphylactic shock had to be managed by applying the previously shared algorithm. The facilitators then conducted a debriefing for each group using the PEARLS methodology.

The adrenaline was not only pharmacological, but also experienced by the participants in having to make decisions under pressure; at the end of the scenario, the debriefing allowed them to reflect on the experience and consolidate the skills they had acquired.

Conclusion: An Experience to Remember

After three intensive modules, participants left the GTC with a more solid knowledge base and greater confidence in managing vaccinations. The added value of this experience was the opportunity to learn by doing, in a safe and supervised environment.

The simulation approach has once again proven to be an irreplaceable ally in the training of healthcare professionals, offering a perfect mix of theory, practice, and reflection.

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