Document Type : Original Article

Authors

• MOHAMMAD ALIEF IQRA ^{1, 2}
• TITI SAVITRI PRIHATININGSIH ³
• MORA CLARAMITA ³

¹ Master's Program in Medical and Health Professions Education, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

² Portal Kesehatan Masyarakat (Portkesmas), Jakarta, Indonesia

³ Department of Medical Education, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Abstract

Introduction: Structured communication training may strengthen immunization education, but it remains limited in resource-constrained settings. Tana Toraja recorded South Sulawesi’s lowest full basic immunization coverage in 2024. We evaluated a one-day Greet–Invite–Discuss (GID)-based interpersonal communication training program for district immunization officers.
Methods: A single-group Kirkpatrick Levels 1–2 evaluation enrolled 24 facility-designated representatives through a facility-level census covering all 23 public primary health centers (Puskesmas) and one private maternal and child hospital. The 09:00–14:30 program provided 265 contact minutes: 110 minutes of didactic instruction/demonstration, 90 minutes of role-play (didactic-to-role-play ratio, 55:45), and 65 minutes of orientation, reflection, and application planning. A physician investigator delivered expert-reviewed slides, a standardized scenario, and a behaviourally anchored GID checklist under the supervision of two senior medical-education faculty members. Level 1 reactions were assessed post-training and Level 2a knowledge both before and after training. Non-normality (Shapiro–Wilk: pre W=0.877, p=0.007; post W=0.834, p=0.001) prompted Wilcoxon analysis. Immediately after training, three observers rated Level 2b video-recorded peer simulations using the 22-item checklist; this post-only assessment measured achievement rather than retention or behavioural change. Approval of the ethics committee was obtained from the Medical and Health Research Ethics Committee, Universitas Gadjah Mada (KE/FK/0302/EC/2026; 13 February 2026).
Results: The mean reaction score was 4.66±0.29/5.00. Median knowledge scores increased from 77.50 (IQR 45.00–90.00) to 95.00 (IQR 85.00–100.00; Z=−4.023, p<0.001, r=0.82); all domain scores increased (all p≤0.001), with a post-test ceiling effect. Post-training skills achievement was 67.80% overall (intraclass correlation coefficient [ICC]=0.831), highest for Greet (80.21%) and lowest for Invite (59.72%; ICC=0.574; 95% CI− 0.020 to 0.838). Knowledge change was not significantly associated with total or domain-specific skills achievement (all |ρ|≤0.221; all p≥0.300).
Conclusion: GID training was well received and associated with increased immediate knowledge, but the single-group design precluded causal attribution. Post-only skills do not establish improvement, retention, or workplace behaviour; these findings provide a baseline for refining the program; however, Invite-domain estimates should be interpreted with caution.

Highlights

MOHAMMAD ALIEF IQRA

Keywords

• Program evaluation
• Health personnel
• Primary health care
• Vaccination hesitancy
• Inservice training