Teaching smoking cessation skills to senior medical students: a block-randomized controlled trial of four different approaches.

Background: Medical practitioners have considerable untapped potential to assist patients in stopping smoking. However, marked deficits have been found in the amount and type of training medical practitioners receive in smoking cessation counseling with little attention paid to determination of effective training methods.

Method: A randomized controlled trial was conducted to examine the relative effectiveness of four different educational programs in teaching smoking cessation skills to 5th-year medical students in an Australian medical school. The four programs comprised: (a) a traditional didactic lecture mode (control group), (b) audio feedback through the use of audiotaped role plays, (c) role plays with peer feedback, and (d) video feedback. Students' smoking cessation intervention skills were assessed prior to training and at the end of term via videotaped interviews with simulated patients.

Results: Senior medical students demonstrated significantly improved skills in smoking intervention when exposed to any of the educational approaches other than traditional didactic teaching. No overall differences in smoking intervention skills were found between the three experimental training methods.

Conclusions: Specific training in smoking cessation techniques is necessary to increase the intervention skills of medical students. Traditional teaching methods are ineffective in developing smoking cessation intervention skills. Enhanced teaching, of an appropriate nature, at undergraduate and postgraduate levels is needed.