title: Tobacco dependence treatment teaching by medical school clerkship preceptors: survey responses from more than 1,000 US medical students.
abstract: OBJECTIVE
  To determine factors associated with tobacco cessation counseling in medical school clerkships.
  
  
  METHODS
  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").
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Future educational interventions intended to help students adopt effective tobacco dependence treatment techniques should be engineered to facilitate these critical precepting components.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA. ageller@hsph.harvard.edu
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.forename: Rashelle B
authors.initials: RB
authors.lastname: Hayes
authors.forename: Frank
authors.initials: F
authors.lastname: Leone
authors.forename: Linda C
authors.initials: LC
authors.lastname: Churchill
authors.forename: Katherine
authors.initials: K
authors.lastname: Leung
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.forename: Denise
authors.initials: D
authors.lastname: Jolicoeur
authors.forename: Catherine
authors.initials: C
authors.lastname: Okuliar
authors.forename: Michael
authors.initials: M
authors.lastname: Adams
authors.forename: David M
authors.initials: DM
authors.lastname: Murray
authors.forename: Qin
authors.initials: Q
authors.lastname: Liu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Waugh
authors.forename: Sean
authors.initials: S
authors.lastname: David
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
mesh_terms: D000328:Adult; D002982:Clinical Clerkship; D002983:Clinical Competence; D003376:Counseling / Q000592:standards* / Q000706:statistics & numerical data; D004504:Education, Medical, Undergraduate / Q000592:standards* / Q000706:statistics & numerical data; D004521:Educational Measurement; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011231:Preceptorship; D057566:Self Report; D016540:Smoking Cessation; D013337:Students, Medical / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000628:therapy*; D014481:United States
keywords: Education; Medical schools; Smoking