Despite years of warnings about the dire health consequences of tobacco use, more than 20 percent of American adults still smoke, and tobacco-related diseases continue to be the leading cause of premature deaths in the United States. Because a brief intervention—tobacco dependence counseling—is shown to be quite effective, UMass Medical School is leading a grant-funded study that bolsters the training of medical students to learn how to effectively intervene with their patients who smoke.
"Each year, more than 450,000 Americans die of tobacco-related diseases, and we know that lives are saved when people stop using tobacco,” said Judith K. Ockene, PhD, the Barbara Helen Smith Chair in Preventive & Behavioral Medicine, professor of medicine and principal investigator of the grant. “However, few physicians feel they are skilled to do appropriate and effective counseling of their patients who use tobacco, and many report that they received little or no such training in medical school.”
With funding from the National Cancer Institute, UMMS, in partnership with the Harvard School of Public Health and Ohio State University, is working with 10 other medical schools across the country to develop and test a novel teaching approach, Multi-Modal Education (MME), aimed at enhancing students’ skills in treating their future patients’ tobacco addiction.
Through the $3.8 million study, “A Randomized Controlled Trial to Improve Tobacco Treatment Skills of Medical Students,” now in its second year, five of the 10 schools will provide their students with MME, which includes a web-based tobacco treatment education program coupled with traditional educational methods. The web-based program is self-paced and focuses on understanding tobacco dependence, understanding and guiding behavior change, and using medication to help patients stop smoking. The web-based program has an interactive component that allows the student to observe successful tobacco treatment. The intervention also includes classroom role-play and “academic detailing” through which the students’ clinical preceptors receive personalized training to first teach and then model ideal treatment skills in the clinical setting. This is the first randomized trial ever to test different methods of intervention delivery in medical schools.
The first phase of the intervention will be launched in early January at Georgetown University School of Medicine, which will make available the web-based training program to their first-year medical students, who also will participate in the classroom role-play activity. The other four medical schools participating in the MME model will roll out their programs in the new year as well.
In the traditional tobacco education arm of the study, the remaining five medical schools will continue to use their own tobacco education program, which includes lectures, reading materials and role-plays.
Study outcomes will be measured when the students are in their third year, using the Objective Structured Clinical Examination (OSCE), the standard method for evaluating medical student clinical skills at all U.S. medical schools. The OSCE uses standardized patient interactions to evaluate students.
Participating medical schools include: