A Flipped Classroom and Case-Based Curriculum to Prepare Medical Students for Vaccine-Related Conversations with Parents

Publication ID Published Volume
10582 May 16, 2017 13

Download the Educational Summary Report


Introduction: Immunizations, one of the most significant public health successes in the last century, have recently been met with a resistance that has resulted in populations with falling immunity and outbreaks of vaccine-preventable diseases. In response to this, we conducted a needs assessment of medical students at the University of California, Los Angeles David Geffen School of Medicine to assess attitudes towards vaccines, knowledge of vaccines and vaccine-preventable diseases, and confidence in discussing vaccines. The results informed the development of this interactive, flipped-classroom and case-based curriculum for third-year pediatric clerkship students. Methods: In our two-part curriculum, students independently view a short podcast with an overview of vaccines and vaccine-preventable diseases, then participate in a case-based workshop. For the workshop, students divide into small groups and are presented with a case-based scenario surrounding a child with a parent who has concerns about recommended vaccines. Students discuss the case in small groups, find answers to directed questions, and present the case and findings to the larger group, with specific focus on their approach to the vaccine hesitant parent. Results: Anonymous student evaluations revealed that 93% of students enjoyed learning from this flipped classroom and case-based format. Likewise, 98% of students felt more confident in their approach to vaccine discussions. Discussion: Vaccine hesitancy is becoming an increasingly common and worrisome problem. Our curriculum provides students with knowledge about the importance of childhood immunizations as well as an opportunity to practice addressing common concerns and misconceptions they will encounter in clinical settings.


Coleman A, Lehman D. A flipped classroom and case-based curriculum to prepare medical students for vaccine-related conversations with parents. MedEdPORTAL Publications. 2017;13:10582. https://doi.org/10.15766/mep_2374-8265.10582

Educational Objectives

By the end of this session, learners will be able to:

  1. Recommend vaccines for a child based on age and vaccination history.
  2. Understand, justify, and explain the importance of vaccines and the consequences of vaccine-preventable diseases.
  3. Find and use reliable online sources to gather information about vaccine efficacy and safety.
  4. Become confident discussing vaccines with patients and their families.


  • Vaccine Hesitancy, Vaccination, Communication, Pediatrics


  1. Belkowitz J, Peter G. Immunization basics and case-based discussion. MedEdPORTAL Publications. 2014;10:9983. https://doi.org/10.15766/mep_2374-8265.9983

  2. Center for Disease Control. Recommended immunization schedule for children and adolescents aged 18 years or younger. https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf. Published October, 2016.

  3. Donahue KL, Stupiansky NW, Alexander AB, Zimet GD. Acceptability of the human papillomavirus vaccine and reasons for non-vaccination among parents of adolescent sons. Vaccine. 2014;32(31):3883-3885. https://doi.org/10.1016/j.vaccine.2014.05.035

  4. Dorell CG, Yankey D, Santibanez TA, Markowitz LE. Human papillomavirus vaccination series initiation and completion, 2008-2009. Pediatrics. 2011;128(5):830-839. https://doi.org/10.1542/peds.2011-0950

  5. McCauley MM, Kennedy A, Basket M, Sheedy K. Exploring the choice to refuse or delay vaccines: a national survey of parents of 6- through 23-month-olds. Acad Pediatr. 2012;12(5):375-383. https://doi.org/10.1016/j.acap.2012.06.007

  6. Morhardt T, McCormack K, Cardenas V, Zank J, Wolff M, Burrows H. Vaccine curriculum to engage vaccine-hesitant families: didactics and communication techniques with simulated patient encounter. MedEdPORTAL Publications. 2016;12:10400. https://doi.org/10.15766/mep_2374-8265.10400

  7. Nowalk MP, Zimmerman RK, Lin CJ, et al. Parental perspectives on influenza immunization of children aged 6 to 23 months. Am J Prev Med. 2005;29(3):210-214. https://doi.org/10.1016/j.amepre.2005.05.010

  8. Omer SB, Enger KS, Moulton LH, Halsey NA, Stokley S, Salmon DA. Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis. Am J Epidemiol. 2008;168(12):1389-1396. https://doi.org/10.1093/aje/kwn263

  9. Sadaf A, Richards JL, Glanz J, Salmon DA, Omer SB. A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine. 2013;31(40):4293-4304. https://doi.org/10.1016/j.vaccine.2013.07.013

  10. Szilagyi PG, Rodewald LE. Missed opportunities for immunizations: a review of the evidence. J Public Health Manag Pract. 1996;2(1):18-25. https://doi.org/10.1097/00124784-199600210-00005

Material Access

Please sign in to access this material.

Please register for an AAMC account if you do not have one.


  • Contact Us

Subscribe to Our Quarterly Newsletter

Receive featured content & announcements!

ISSN 2374-8265