Strayer Scott M, Pelletier Sandra L, Martindale James R, Rais Salehin, Powell Jon, Schorling John B
Departments of Family Medicine and Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA.
Fam Med. 2010 May;42(5):350-7.
There is little research on training medical students in smoking cessation counseling (SCC). This study aimed to determine if a personal digital assistant (PDA)-based SCC tool can improve medical student SCC.
We conducted a randomized, controlled trial with third-year medical students. SCC behaviors, comfort, and knowledge were assessed using a validated survey before students attended a workshop on SCC. Student groups were then randomized to receive a paper-based reminder tool or the reminder plus a PDA-based SCC tool. The validated survey was repeated upon clerkship completion, and a videotaped standardized patient interview was assessed by trained reviewers using a 24-item SCC checklist. Focus groups assessed satisfaction with the PDA tool, usability, and barriers to use.
SCC behaviors, knowledge, and comfort increased among all participants, with no statistical differences between groups. The PDA tool group performed 62% of key SCC activities during the videotaped interview, while the control group performed 69%. Students reported discomfort using the PDA with patients, lack of time, and lack of training as barriers to use of the tool.
We demonstrated improvement of SCC skills by third-year medical students using a workshop combined with a supplemental reference tool. However, a PDA-based tool did not increase key SCC behaviors compared with a paper-based reminder. For a PDA intervention to be effective in this setting, the tool must be simplified and additional training provided.
关于培训医学生进行戒烟咨询（SCC）的研究较少。本研究旨在确定基于个人数字助理（PDA）的SCC工具是否能提高医学生的SCC能力。
我们对三年级医学生进行了一项随机对照试验。在学生参加SCC研讨会之前，使用经过验证的调查问卷评估SCC行为、舒适度和知识水平。然后将学生组随机分为接受纸质提醒工具组或提醒工具加基于PDA的SCC工具组。在实习结束时再次进行经过验证的调查，并由经过培训的评审人员使用24项SCC清单对录像的标准化患者访谈进行评估。焦点小组评估了对PDA工具的满意度、可用性和使用障碍。
所有参与者的SCC行为、知识和舒适度均有所提高，两组之间无统计学差异。在录像访谈中，PDA工具组进行了62%的关键SCC活动，而对照组进行了69%。学生们报告称，在与患者使用PDA时感到不适、缺乏时间以及缺乏培训是使用该工具的障碍。
我们证明了三年级医学生通过参加研讨会并结合补充参考工具，其SCC技能得到了提高。然而，与纸质提醒相比，基于PDA的工具并没有增加关键的SCC行为。要使PDA干预在这种情况下有效，必须简化工具并提供额外培训。
