An evaluation of a smoking cessation training program for medical residents in an inner-city hospital.

Thirty-four medical residents at a hospital serving a predominantly black inner-city area were trained to counsel their patients to quit smoking. They were tested before the training session and again 4 months later with questionnaires assessing smoking knowledge, attitude, and clinical practice. The training consisted of two 1-hour lectures, printed materials, and a 1.5-hour Objective Simulated Clinical Exam. Most of the residents were males (88.2%), in internal medicine (87.5%), under the age of 35 (79.4%), and foreign-born (76.5%). Asians (44.1%) comprised the largest racial group, followed by whites (29.4%) and blacks (20.6%). The impact of the training was assessed by comparing the pre- and posttests using paired Student's t tests. Overall score increased from 69.3 to 89.1 (P = .0001) out of a maximum of 131. Scores increased significantly for attitudes and beliefs (38 to 52; P = .0001), knowledge (5.3 to 6.6; P = .0001), and usual practices with smoking patients (25 to 30; P = .002). These data provide evidence that training increased the confidence, motivation, and reported practice of these residents in intervening with their patients, the majority of whom are black. This has special significance because physicians are least likely to advise black patients and those in lower socioeconomic groups to quit smoking. The demographic profile of our residents is characteristic of many inner-city hospitals.