Teaching Medical Students to Help Patients Quit Smoking: Outcomes of a 10-School Randomized Controlled Trial
| Autor: | Robin Gross, Sean P. David, Denise G. Jolicoeur, Rashelle B. Hayes, Kristi J. Ferguson, Pat F. Bass, David M. Murray, Alan C. Geller, David W. Rudy, Catherine A. Okuliar, Jonathan B. Waugh, Frank T. Leone, Sybil L. Crawford, Ruth B. Greenberg, Judith K. Ockene, Michael Adams, Abigail B. Shoben, Kathryn N. Huggett, Linda C. Churchill, Kola Okuyemi |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Counseling
Clinical clerkship medicine.medical_specialty Students Medical Objective structured clinical examination medicine.medical_treatment Quit smoking law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Physicians Outcome Assessment Health Care Tobacco Internal Medicine Humans Medicine 030212 general & internal medicine Curriculum Original Research Self-efficacy 030505 public health business.industry Smoking Clinical Clerkship Tobacco Use Disorder Self Efficacy United States 3. Good health Editorial Family medicine Smoking cessation Smoking Cessation Clinical Competence Clinical competence 0305 other medical science business Computer-Assisted Instruction Education Medical Undergraduate |
| Zdroj: | Journal of General Internal Medicine. 31:172-181 |
| ISSN: | 1525-1497 0884-8734 |
| DOI: | 10.1007/s11606-015-3508-y |
| Popis: | Early in medical education, physicians must develop competencies needed for tobacco dependence treatment.To assess the effect of a multi-modal tobacco dependence treatment curriculum on medical students' counseling skills.A group-randomized controlled trial (2010-2014) included ten U.S. medical schools that were randomized to receive either multi-modal tobacco treatment education (MME) or traditional tobacco treatment education (TE).Students from the classes of 2012 and 2014 at ten medical schools participated. Students from the class of 2012 (N = 1345) completed objective structured clinical examinations (OSCEs), and 50 % (N = 660) were randomly selected for pre-intervention evaluation. A total of 72.9 % of eligible students (N = 1096) from the class of 2014 completed an OSCE and 69.7 % (N = 1047) completed pre and post surveys.The MME included a Web-based course, a role-play classroom demonstration, and a clerkship booster session. Clerkship preceptors in MME schools participated in an academic detailing module and were encouraged to be role models for third-year students.The primary outcome was student tobacco treatment skills using the 5As measured by an objective structured clinical examination (OSCE) scored on a 33-item behavior checklist. Secondary outcomes were student self-reported skills for performing 5As and pharmacotherapy counseling.Although the difference was not statistically significant, MME students completed more tobacco counseling behaviors on the OSCE checklist (mean 8.7 [SE 0.6] vs. mean 8.0 [SE 0.6], p = 0.52) than TE students. Several of the individual Assist and Arrange items were significantly more likely to have been completed by MME students, including suggesting behavioral strategies (11.8 % vs. 4.5 %, p 0.001) and providing information regarding quitline (21.0 % vs. 3.8 %, p 0.001). MME students reported higher self-efficacy for Assist, Arrange, and Pharmacotherapy counseling items (ps ≤0.05).Inclusion of only ten schools limits generalizability.Subsequent interventions should incorporate lessons learned from this first randomized controlled trial of a multi-modal longitudinal tobacco treatment curriculum in multiple U.S. medical schools. NIH Trial Registry Number: NCT01905618. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink