Mona Amin, DO, was a resident at Albany Medical Center in Albany, New York, in 2014 when she got her first glimpse at the toll misinformation can take.
A distraught mother appeared in the emergency department with a listless and bruised baby. At first, doctors suspected child abuse. Tests revealed bleeds in the child’s brain and spinal column — the result of a vitamin K deficiency that is often preventable with a routine shot at birth. Fearful of rumored side-effects, the parents had refused that shot. The baby lived but left the hospital with a long recovery ahead.
“When you see a case like that, it just doesn’t ever leave you,” said Amin, a Florida-based board-certified pediatrician.
Health misinformation still abounds, now supercharged by social media influencers and an erosion of public trust in medicine. More recently, Amin has listened to claims that acetaminophen causes autism, that “pharma shills” push vaccines solely for financial gain, and that inhaling hydrogen peroxide fends off infection.
She’s pushing back now, using social media platforms to post weekly videos that warn of misinformation circulating online and provide counter-information grounded in solid science. She also hosts a popular podcast, Pedsdoctalk, where bunk health claims are a frequent theme.
“I was spending so much time trying to debunk misinformation in my office,” she said, “but there’s only so much you can do during a 15-minute visit.”
Studies show that while as many as 94% of physicians report encountering medical misinformation from their patients, only about 18% have had any formal education on how to respond. Despite a flurry of initiatives launched at US medical schools during the pandemic, offerings today remain slim.
“There is very little being done to train physicians to address this right now,” said Alexander Sheng, MD, residency program director for Emergency Medicine at Brown University Health in Providence, Rhode Island.
Sheng and Amin are among a small group of doctors, researchers, and health institutions proactively confronting what has been termed an “infodemic” of health misinformation.
Some use a psychological strategy known as “pre-bunking” to essentially inoculate people against fake news. Others use subtler in-person methods to show empathy, build trust, and share science-backed information.
As the misinformation infodemic continues to spread, experts say these and other strategies may be the best antidote.
An Inoculation Against Misinformation
The concept of pre-bunking dates back to the Korean War. Yale psychologist William McGuire expressed concerns about communist forces brainwashing US service members. To help them resist, McGuire suggested what he termed a psychological “inoculation.”
The idea went like this: Expose soldiers to small or weakened bits of propaganda, akin to the weakened virus present in some vaccines, and an explanation of the manipulation tactics being used to try to spread them. Follow with a strong fact-based rebuttal.
Soon the soldiers’ “mental immune system” would develop antibodies against future brainwashing attempts. An occasional booster shot (a reminder of the facts or manipulation tactics) might be required. Once the soldiers told their friends what they’d learned, herd immunity against brainwashing would take hold.
McGuire’s theory never made it beyond the lab. But a group of social psychologists revived it about a decade ago as a tactic for fact checking an increasing number of false claims on social media and elsewhere.
Sander van der Linden, a professor of social psychology at University of Cambridge, Cambridge, England, was one of them. He coined the term “pre-bunking.”
“It is really difficult to come in afterward and try to debunk misinformation because it continues to influence the way we see the world even after we have been told that it is false. You cannot un-ring the bell,” said van der Linden. “Pre-bunking is about trying to prevent people from encoding misinformation into their brains in the first place.”
A Pre-Bunking Primer
Physicians and public health institutions use different approaches for pre-bunking.
Amin, for example, might show a clip of a questionable video beginning to circulate online, then acknowledge what it got right (if anything) and use the latest scientific literature to fact-check the rest.
For example, in one recent post she shares a clip of a mom, her infant tucked into a front-pack, as she grinds watermelon chunks in a blender. The claim: Watermelon juice should be used instead of “chemically filled and unnatural” sunscreen.
The facts: Watermelon does contain the antioxidant lycopene, and a few small trials have shown that diets rich in lycopene can modestly counteract free-radical damage from sun exposure. But it does not block ultraviolet rays. “Eat the watermelon. I love watermelon,” Amin tells her followers. “But put the sunscreen on too.”
Other techniques are seeking to train people how to spot misinformation more broadly.
For instance, in one experiment, van der Linden and colleagues designed a game called Bad News in which players take on the role of a fake news producer. Through a 20-minute, deep-dive simulation, players learn to master six techniques used to spread misinformation: stoking political polarization; invoking outrage or empathy; spreading conspiracy theories; trolling people online; discrediting credible sources; and impersonating experts.
A study of 15,000 people, published in Nature, showed that when those who played the game just once were exposed to misinformation online immediately afterward, they were better able to spot and resist it.
In another study involving 30,000 people, van der Linden’s team developed five 30-to-60-second pre-bunking videos. The next day, people who watched the videos were better able to discern trustworthy vs untrustworthy content and less likely to share fake news.
Subsequent studies showed that those who played a game or watched a video still resisted misinformation 1-3 months later.
Pre-bunking is also cheap to scale, noted van der Linden, with the average cost for each video on social running a tiny $0.05.
For years, pre-bunking was primarily used in the context of climate change denial and political misinformation. But during the COVID pandemic, public health institutions took notice.
The World Health Organization (WHO) launched a 5-minute online pre-bunking game called “Go Viral” on social media and shared an educational pre-bunking video.
“Debunking, or correcting false claims, was our go-to during the Covid-19 pandemic because the volume of misinformation was so high,” said Diya Banerjee, the WHO’s team lead for social media. “We also wanted to tell people how to look for credible sources of information, what to watch out for, when your alarm bells should ring, and when you should pause before sharing.”
The United Nations (UN) also launched a program called UN verified, which posted frequent reminders (essentially pre-bunking booster shots). For instance, one post, titled “Before you share, think,” urges people to ask: Who made it? What’s the source? Where did it come from? Why are you sharing it? When was it published? In all, the UN Verified campaign reached a billion people worldwide with more than 5000 pieces of content in 60 languages.
Van der Linden noted that pre-bunking interventions have been shown to work across many languages and cultures, educational and personality types, and political persuasions.
“We are not here to tell people what to do. We just want to empower them to understand the manipulation techniques and fear mongering that are so common,” he said.
Rebuilding Trust in Person
While pre-bunking can be powerful, it has its limitations.
Research shows that, like biological vaccines, misinformation inoculation wears off over time as people lose motivation to resist, get sucked back into their political echo chambers, or forget the facts.
And while pre-bunking works particularly well when it is targeting a specific subject — say, the idea that vitamin K shots cause cancer — research shows it’s tough to inoculate people against all forms of misinformation.
“Pre-bunking is unlikely to be a silver bullet, but if you use it in addition to other things, like debunking and factchecking, it offers an important layer of protection,” said van der Linden.
Pre-bunking can work well on social media and in public health but it’s also important that doctors re-evaluate their interactions with patients, said Sheng.
“The traditional way of practicing medicine, of being very top down and paternalistic, probably led us to where we are a little,” said Sheng.
He advises doctors not to refute and dismiss misinformation right off the bat. Research shows that doing so further alienates patients and can lead them to dig in even more.
“Part of our job as physicians is to actively listen, re-engage our patients, hear their side and come up with a plan together,” said Sheng.
Doctors Training Doctors
In 2022, the Association of American Medical Colleges and the CDC launched an initiative to address medical misinformation and mistrust by better educating doctors and doctors-to-be. The effort led to a flurry of new pilot offerings at US medical schools, and the development of suggested curricula.
But today, many programs have been scaled back or discontinued. Some experts quietly attribute a decline in interest in misinformation training to recent Trump administration funding cuts targeting such research. Others say that with the existing, packed curriculum for today’s medical students, it can be hard to find an appetite for yet another class.
To fill the gap, some internet-savvy doctors now visit grand rounds at medical schools to offer seminars on how to combat misinformation.
Amin is one of them. Between educating peers, hosting her podcast, and becoming a full-fledged influencer with nearly 2 million followers, she was so busy she recently left in-person clinical practice. She also serves as chief medical officer for the pediatric telehealth startup Poppins.
“I knew I couldn’t split my energy between two places and still give this new chapter what it deserved,” she said.
Sheng recently organized a consensus conference on how emergency department physicians can rebuild patient trust and mitigate the impact of unreliable health information.
Meanwhile, Kristina Krohn, MD, an internal medicine doctor at the University of Minnesota Medical School, Minneapolis, is still doing what she’s been doing for the past 6 years.
In 2020, she helped launch the school’s first misinformation training class, then an elective for about 100 students. In 2026, the class was required for all fourth-year medical students.
Krohn teaches doctors-to-be how to spot and pre-bunk misinformation — including AI-generated misinformation — on social media, how to call it out without jeopardizing their mental health, and how to use motivational interviewing skills to increase patient trust in person. But before she does any of that, she has them take a hard look at themselves.
“Students learn a lot in medical school, but they are not immune to misinformation,” she said, pointing to research suggesting they may be more susceptible to it than older generations of doctors. “Once people understand that it helps give them some compassion as they learn to respond to it.”
Sources cited in this article had no relevant disclosures.
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