Going against the herd: psychological and cultural factors underlying the 'vaccination confidence gap'

By far the most common strategy used in the attempt to modify negative attitudes toward vaccination is to appeal to evidence-based reasoning. We argue, however, that focusing on science comprehension is inconsistent with one of the key facts of cognitive psychology: Humans are biased information processors and often engage in motivated reasoning. On this basis, we hypothesised that negative attitudes can be explained primarily by factors unrelated to the empirical evidence for vaccination; including some shared attitudes that also attract people to complementary and alternative medicine (CAM). In particular, we tested psychosocial factors associated with CAM endorsement in past research; including aspects of spirituality, intuitive (vs analytic) thinking styles, and the personality trait of openness to experience. These relationships were tested in a cross-sectional, stratified CATI survey (N = 1256, 624 Females). Whilst educational level and thinking style did not predict vaccination rejection, psychosocial factors including: preferring CAM to conventional medicine (OR .49, 95% CI .36 .83, 95% CI .71 to vaccination. Furthermore, for 9 of the 12 CAMs surveyed, utilisation in the last 12 months was associated with lower levels of vaccination endorsement. From this we suggest that vaccination scepticism appears to be the outcome of a particular cultural and psychological orientation leading to unwillingness to engage with the scientific evidence. Vaccination compliance might be increased either by building general confidence and understanding of evidence-based medicine, or by appealing to features usually associated with CAM, e.g.–.66), endorsement of spirituality as a source of knowledge (OR–.96), and openness (OR .86, 95% CI .74–.99), all predicted negative attitudes‘strengthening your natural resistance to disease’

Patients' perceptions of medical students in a longitudinal family medicine clerkship.

Although educational characteristics of ambulatory clinical environments are becoming clearer, less is known concerning patient opinions about participating in medical student instruction in ambulatory settings. Such perceptions may have an important influence on recruitment and retention of community faculty.Surveys were administered to 121 patients seen by medical students during a longitudinal family medicine clerkship. The survey explored patients' opinions regarding the extent of direct student involvement in their care, students'competence, and patient feelings about participating in medical student instruction.Patients felt that students were highly involved in providing care and that they performed competently and professionally. Patients found participation in medical education enjoyable, not excessively time-consuming or disruptive, and believed that students' participation improved the quality of care they received.Patients in our family medicine clerkship do not have negative perceptions about their participation in medical student education. In fact, this study suggests that such participation may actually enhance patient satisfaction

Attitudes and knowledge regarding health care policy and systems: a survey of medical students in Ontario and California.

BackgroundCanada and the United States have similar medical education systems, but different health care systems. We surveyed medical students in Ontario and California to assess their knowledge and views about health care policy and systems, with an emphasis on attitudes toward universal care.MethodsA web-based survey was administered during the 2010-2011 academic year to students in 5 medical schools in Ontario and 4 in California. The survey collected demographic data and evaluated attitudes and knowledge regarding broad health care policy issues and health care systems. An index of support for universal health care was created, and logistic regression models were used to examine potential determinants of such support.ResultsResponses were received from 2241 students: 1354 from Ontario and 887 from California, representing 42.9% of eligible respondents. Support for universal health care coverage was higher in Ontario (86.8%) than in California (51.1%), p < 0.001. In California, females, self-described nonconservatives, students with the intent to be involved in health care policy as physicians and students with a primary care orientation were associated with support for universal coverage. In Ontario, self-described liberals and accurate knowledge of the Canadian system were associated with support. A single-payer system for practice was preferred by 35.6% and 67.4% of students in California and Ontario, respectively. The quantity of instruction on health care policy in the curriculum was judged too little by 73.1% and 57.5% of students in California and Ontario, respectively.InterpretationMedical students in Ontario are substantially more supportive of universal access to health care than their California counterparts. A majority of students in both regions identified substantial curricular deficiencies in health care policy instruction

Patients' perceptions of medical students in a longitudinal family medicine clerkship.

Although educational characteristics of ambulatory clinical environments are becoming clearer, less is known concerning patient opinions about participating in medical student instruction in ambulatory settings. Such perceptions may have an important influence on recruitment and retention of community faculty.Surveys were administered to 121 patients seen by medical students during a longitudinal family medicine clerkship. The survey explored patients' opinions regarding the extent of direct student involvement in their care, students'competence, and patient feelings about participating in medical student instruction.Patients felt that students were highly involved in providing care and that they performed competently and professionally. Patients found participation in medical education enjoyable, not excessively time-consuming or disruptive, and believed that students' participation improved the quality of care they received.Patients in our family medicine clerkship do not have negative perceptions about their participation in medical student education. In fact, this study suggests that such participation may actually enhance patient satisfaction

The impact of tie strength in online and offline social networks on social attitudes and the moderating role of epistemic authority

Social networks, both online and offline, have a profound impact on people&#39;s daily life. We measured online (WeChat) and offline social network tie strength and investigated their effects on social attitudes. In addition, the moderating role of epistemic authority in the relationship between tie strength and social attitudes was examined. In a pilot study with 163 people, two tie strength scales (for online and offline social networks, respectively) both including four sub-dimensions were formed. In addition, a proper target social issue (delayed retirement) was selected for the formal study. In the formal study, 33 participants and their 264 &#39;friends&#39; from 8 groups participated and their attitudes towards delayed retirement policy were measured. We employed a 2 (offline tie strength: strong vs. weak) x 2 (online tie strength: strong vs. weak) x 2 (epistemic authority: high vs. low) design. Attitude agreement scores defined as the attitude discrepancy between the core person and their 8 types of &#39;friends&#39; were dependent variables. Results showed that the main effect of offline tie strength and epistemic authority were significant, as well as the interaction between offline tie strength and epistemic authority. That is, the stronger the offline tie strength, the higher the attitude agreement between core persons and their &#39;friends&#39;. And this effect was more significant when epistemic authority was low as compared to high. On the other hand, online tie strength had no direct impact on attitude agreement. However, it might indirectly enhance the attitude agreement in offline social networks. The implications of online and offline social networks for social attitude change are discussed.</p