The Pediatric Residency Training on Tobacco Project: baseline findings from the resident tobacco survey and observed structured clinical examinations.
BACKGROUND
Residency training is an ideal time to prepare pediatricians to address tobacco, although few programs provide the necessary training. Barriers to training include competing priorities, lack of resources, and unavailability of expertise. Solutions for Smoking, a hybrid CD-ROM and web site training program for pediatric residents, may enable training directors to overcome these barriers and to include training on tobacco in their curriculum. The Pediatric Residency Training on Tobacco Project is a 4-year randomized prospective study that compares the effectiveness of a special training program, with Solutions for Smoking as the main teaching tool, to a standard training program in 15 pediatric residency-training programs.


METHODS
Fifteen pediatric residency-training programs were assigned randomly to special and standard training conditions. Evaluation instruments include baseline and follow-up resident tobacco surveys and observed structured clinical examinations (OSCEs), patient tobacco surveys, and parent or guardian tobacco surveys.


RESULTS
The present report describes the Pediatric Residency Training on Tobacco Project, the special and standard training conditions, and Solutions for Smoking, a hybrid CD-ROM and web site training program on tobacco for pediatric residents. Data from the baseline resident tobacco survey and OSCEs also are presented. While residents believed that pediatricians should play a leadership role in tobacco prevention and control, few had formal training in tobacco intervention, most were skeptical about the efficacy of intervention, and they were more likely to ask about tobacco and advise change than to help patients and parents to modify their behavior.


CONCLUSIONS
The baseline findings underscore the importance of the proposed research, and the special training program may serve as a useful model for training pediatric residents to address tobacco in the future.
Department of Psychiatry, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA. hymowitz@umdnj.edu
Norman
N
Hymowitz
Joseph
J
Schwab
Christopher Keith
CK
Haddock
Karen M
KM
Burd
Sara
S
Pyle
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D003479:Curriculum; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education; D011446:Prospective Studies; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014481:United States; D014026:Nicotiana