Teaching tobacco dependence treatment and counseling skills during medical school: Rationale and design of the Medical Students helping patients Quit tobacco (MSQuit) group randomized controlled trial

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Abstract

Introduction

Physician-delivered tobacco treatment using the 5As is clinically recommended, yet its use has been limited. Lack of adequate training and confidence to provide tobacco treatment is cited as leading reasons for limited 5A use. Tobacco dependence treatment training while in medical school is recommended, but is minimally provided. The MSQuit trial (Medical Students helping patients Quit tobacco) aims to determine if a multi-modal and theoretically-guided tobacco educational intervention will improve tobacco dependence treatment skills (i.e. 5As) among medical students.

Methods/design

10 U.S. medical schools were pair-matched and randomized in a group-randomized controlled trial to evaluate whether a multi-modal educational (MME) intervention compared to traditional education (TE) will improve observed tobacco treatment skills. MME is primarily composed of TE approaches (i.e. didactics) plus a 1st year web-based course and preceptor-facilitated training during a 3rd year clerkship rotation. The primary outcome measure is an objective score on an Objective Structured Clinical Examination (OSCE) tobacco-counseling smoking case among 3rd year medical students from schools who implemented the MME or TE.

Discussion

MSQuit is the first randomized to evaluate whether a tobacco treatment educational intervention implemented during medical school will improve medical students' tobacco treatment skills. We hypothesize that the MME intervention will better prepare students in tobacco dependence treatment as measured by the OSCE. If a comprehensive tobacco treatment educational learning approach is effective, while also feasible and acceptable to implement, then medical schools may substantially influence skill development and use of the 5As among future physicians.

Abbreviations

MME
multi modal education
TE
traditional education
OSCE
Objective Structured Clinical Examination
MS1 MS2, MS3, MS4
1st–4th year medical students
AD
academic detailer
SP
standardized patient

Keywords

Tobacco dependence treatment and counseling
5As
Medical school education
Medical students
Tobacco control
Group randomized controlled trial

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Note: the work reported in this paper was completed prior to Dr. Murray joining NIH.