Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA.
Prev Med. 2013 Aug;57(2):81-6. doi: 10.1016/j.ypmed.2013.04.006. Epub 2013 Apr 25.
To determine factors associated with tobacco cessation counseling in medical school clerkships.
Third-year medical students at 10 medical schools across the United States completed a 100-item survey, measuring the frequency with which they experienced their preceptors providing clinical teaching components: clear instruction, feedback, modeling behavior, setting clear objectives, and responding to questions about tobacco dependence counseling as well as frequency of use of tobacco prompts and office systems. Our primary dependent measure was student self-reported skill level for items of tobacco dependence treatment (e.g. "5As").
Surveys were completed by 1213 students. For both family medicine and internal medicine clerkships, modeling and providing clear instruction on ways to provide tobacco counseling were reported most commonly. In contrast, providing feedback and clear objectives for tobacco dependence treatment lagged behind. Overall, students who reported preceptors' provision of optimal clinical teaching components and office system prompts in both family medicine and internal medicine clerkships had higher self-reported skill (P<0.001) than students with no exposure or exposure during only one of the clerkships.
Future educational interventions intended to help students adopt effective tobacco dependence treatment techniques should be engineered to facilitate these critical precepting components.
确定医学实习中与戒烟咨询相关的因素。
美国 10 所医学院的三年级医学生完成了一份 100 项的调查，调查内容包括他们的导师提供临床教学的频率：清晰的指导、反馈、行为示范、设定明确的目标，以及对有关烟草依赖咨询的问题的回应，以及烟草提示和办公系统的使用频率。我们的主要因变量是学生自我报告的烟草依赖治疗项目（如“5A”）的技能水平。
共有 1213 名学生完成了调查。家庭医学和内科实习都报告了最常见的行为：示范和提供清晰的烟草咨询方法。相比之下，提供反馈和明确的烟草依赖治疗目标则落后。总体而言，报告在家庭医学和内科实习中都有导师提供最佳临床教学和办公系统提示的学生，其自我报告的技能水平（P<0.001）高于没有接触或仅在一个实习中接触的学生。
未来旨在帮助学生采用有效的烟草依赖治疗技术的教育干预措施，应该设计成促进这些关键的指导因素。
