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Tobacco cessation and prevention practices reported by second and fourth year students at US medical schools.

ABSTRACT: Tobacco dependence counseling is recommended to be included as core curriculum for US medical students. To date, there has been little information on students' self-reported skills and practice opportunities to provide 5A's (Ask, Advise, Assess, Assist, and Arrange) counseling for tobacco cessation.We conducted anonymous surveys of second year and fourth year students at multiple US medical schools between February 2004 and March 2005 (overall response rate 70%). We report on the tobacco control practices of the 860 second year and 827 fourth year students completing the survey.Fourth year students reported multiple opportunities to learn tobacco counseling in case-based discussions, simulated patient encounters, and clinical skills courses. They reported more instruction in family medicine (79%) and Internal Medicine (70%) than Pediatrics (54%), Obstetrics/Gynecology (41%), and Surgery clerkships (16%). Compared with asking patients about smoking, advising smokers to quit, and assessing patient willingness to quit, fourth year students were less likely to have multiple practice opportunities to assist the patient with a quit plan and arrange follow-up contact. More than half of second year students reported multiple opportunities for asking patients about smoking but far fewer opportunities for practicing the other 4 As.By the beginning of their fourth year, most students in this group of medical schools reported multiple opportunities for training and practicing basic 5A counseling, although clear deficits for assisting patients with a quit plan and arranging follow-up care exist. Addressing these deficits and integrating tobacco teaching through tailored specific instruction across all clerkships, particularly in Surgery, Pediatrics, and Obstetrics/Gynecology is a challenge for medical school education.

SUBMITTER: Geller AC

PROVIDER: S-EPMC2517923 | biostudies-other | 2008 Jul

REPOSITORIES: biostudies-other

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Project description:ObjectivesThis study aimed to identify the extent of tobacco cessation training content, including the introduction of a comprehensive programme; and the presence of tobacco-related topics, including new tobacco products, school years and course of training, educators, and attitudes and policies relevant to tobacco education in pharmacy schools in Japan.DesignA cross-sectional survey.SettingAll pharmacy schools in Japan with a 6-year course of training were invited to participate.MethodsPharmacy schools in Japan that agreed to participate in a web-based survey asking about tobacco cessation training, and attitudes and policies relevant to tobacco education.Primary and secondary outcome measuresThe primary outcome was the number of pharmacy schools that introduced comprehensive tobacco cessation training in their curriculum. The secondary outcome was to clarify the curriculum coverage of 9 basic knowledge and 10 tobacco cessation-specific topics, including new tobacco products.ResultsOf the 75 pharmacy schools with a 6-year course in Japan, 52 (74%) responded to the survey. While 27 (52%) schools reported that comprehensive tobacco cessation training would be beneficial, only 1 school had introduced it as a one-credit elective course in the fifth year. Basic knowledge topics for tobacco cessation listed in or related to the Model Core Curriculum were covered by 44%-65% of the schools, while practical skills were covered in 10%-19% of the schools. Only seven schools (14%) introduced the topic of new tobacco products in their curriculum.ConclusionsThis study revealed that comprehensive tobacco cessation training is not generally offered in pharmacy schools in Japan. The Model Core Curriculum should revise its standards to implement updated tobacco cessation training programmes to keep up with new tobacco products and to train pharmacy students on counselling users of such products.Trial registration numberTokyo University of Pharmacy and Life Sciences No. 17 - 14.

Project description:BackgroundSmoking is the largest preventable cause of mortality in Brazil. Education Against Tobacco (EAT) is a network of more than 3500 medical students and physicians across 14 countries who volunteer for school-based smoking prevention programs. EAT educates 50,000 adolescents per year in the classroom setting. A recent quasi-experimental study conducted in Germany showed that EAT had significant short-term smoking cessation effects among adolescents aged 11 to 15 years.ObjectiveThe aim is to measure the long-term effectiveness of the most recent version of the EAT curriculum in Brazil.MethodsA randomized controlled trial was conducted among 2348 adolescents aged 12 to 21 years (grades 7-11) at public secondary schools in Brazil. The prospective experimental design included measurements at baseline and at 6 and 12 months postintervention. The study groups comprised randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes in the same schools (no intervention). Data were collected on smoking status, gender, social aspects, and predictors of smoking. The primary endpoint was the difference in the change in smoking prevalence between the intervention group and the control group at 12-month follow-up.ResultsFrom baseline to 12 months, the smoking prevalence increased from 11.0% to 20.9% in the control group and from 14.1% to 15.6% in the intervention group. This difference was statistically significant (P<.01). The effects were smaller for females (control 12.4% to 18.8% vs intervention 13.1% to 14.6%) than for males (control 9.1% to 23.6% vs intervention 15.3% to 16.8%). Increased quitting rates and prevented onset were responsible for the intervention effects. The differences in change in smoking prevalence from baseline to 12 months between the intervention and control groups were increased in students with low school performance.ConclusionsTo our knowledge, this is the first randomized trial on school-based tobacco prevention in Brazil that shows significant long-term favorable effects. The EAT program encourages quitting and prevents smoking onset, especially among males and students with low educational background.Trial registrationClinicalTrials.gov NCT02725021; https://clinicaltrials.gov/ct2/show/NCT02725021.International registered report identifier (irrid)RR2-10.2196/resprot.7134.

Project description:ProblemThe World Health Organization calls on all with quality medical information to share it with the public and combat health misinformation; however, U.S. medical schools do not currently teach students effective communication with lay audiences about health. Most physicians have inadequate training in mass communication strategies.ApproachIn August 2018, a novel 90-minute class at the University of Minnesota Medical School introduced fourth-year medical students to basic skills for communicating with lay audiences through mass media. Instructors were physicians with experience interacting with the general public via radio, op-ed articles, social media, print media, television, and community and legislative advocacy. After a 20-minute lecture and sharing of instructors' personal experiences, students completed two 30-minute small-group activities. They identified communications objectives and talking points for a health topic, drafting these as Tweets or an op-ed article outline, then presented talking points in a mock press conference with their peers, practicing skills just learned. Pre- and postsurveys documented students' previous engagement and comfort with future engagement with mass media messaging.OutcomesOver 1 week, 142 students participated in 6 separate classes, and 127 completed both pre- and postsurveys. Before the course, only 6% (7/127) of students had comfortably engaged with social media and 14% (18/127) had engaged with traditional media in their professional roles. After the course, students self-reported an increase in their comfort, perceived ability, and likelihood of using specific communications skills to advocate for their patients (all P < .001).Next stepsThe course will be expanded into a 5-session thread for third- and fourth-year medical students spread over 2 years. This thread will include meeting physicians who engage with lay audiences, identifying best practices for mass health communication, identifying bias and misinformation, "dos and don'ts" of social media, and communication skills for legislative advocacy.

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Tobacco cessation and prevention practices reported by second and fourth year students at US medical schools.

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