Author Affiliations: Department of Family and Community Medicine (Drs Spangler and Crandall) and Department of Public Health Sciences (Dr Foley), Wake Forest University School of Medicine, Winston-Salem, NC; and Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, Houston (Ms George).
Context Research has documented that US medical schools inadequately teach tobacco
Objective To examine effective training methods for tobacco intervention in undergraduate
Data Sources Using indexing terms related to tobacco intervention and medical education,
we searched MEDLINE (1966–June 2002) and the Cochrane Database of Systematic
Reviews (through issue 2, 2002). Reference lists of relevant articles were
also read to identify additional articles. Because of their importance to
tobacco intervention, we also reviewed Ockene and colleagues' tobacco education
research and the tobacco treatment guidelines of the United States Public
Health Service and the United States Preventive Services Task Force.
Study Selection All study designs that incorporated process or outcome evaluation of
tobacco intervention educational methods for medical students were included
in this review. Of an initial 1241 articles retrieved, 82 included medical
students. Reviewing abstracts and references of these articles identified
13 pertinent studies.
Data Extraction Quality criteria for inclusion consisted of explicit evaluation of the
educational methods used. Data extraction identified all evaluations and any
problems in program implementation.
Data Synthesis Enhanced instructional methods (eg, the use of patient-centered counseling,
standardized patient instructors, role playing, or a combination of these)
are more effective for teaching tobacco intervention than are traditional
didactic methods alone and can be effectively inserted into medical school
Conclusions Various educational methods have been used to train medical students
in tobacco intervention. Nonetheless, gaps still exist within undergraduate
medical education, including a lack of integration of tobacco dependence information
throughout all 4 years of medical school curricula, specific training in smokeless
tobacco intervention, tobacco intervention training that addresses cultural
issues, and long-term studies showing that such training is retained.
Spangler JG, George G, Foley KL, Crandall SJ. Tobacco Intervention TrainingCurrent Efforts and Gaps in US Medical Schools. JAMA. 2002;288(9):1102-1109. doi:10.1001/jama.288.9.1102