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.
BACKGROUND
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
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.


CONCLUSIONS
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.
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: rashelle.hayes@umassmed.edu.
Rashelle B
RB
Hayes
Department of Society of Human Development and Health, Harvard School of Public Health, Boston, MA, United States. Electronic address: ageller@hsph.harvard.edu.
Alan
A
Geller
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: linda.churchill@umassmed.edu.
Linda
L
Churchill
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: denise.jolicoeur@umassmed.edu.
Denise
D
Jolicoeur
Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, United States. Electronic address: david.murray2@nih.gov.
David M
DM
Murray
Division of Biostatics, College of Public Health, The Ohio State University, Columbus, OH, United States. Electronic address: ashoben@cph.osu.edu.
Abigail
A
Shoben
Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States. Electronic address: spdavid@stanford.edu.
Sean P
SP
David
Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, United States. Electronic address: adams@gunet.georgetown.edu.
Michael
M
Adams
Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States. Electronic address: kokuyemi@umn.edu.
Kola
K
Okuyemi
Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States. Electronic address: rfauver@stanford.edu.
Randy
R
Fauver
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Georgetown University Hospital, Washington, DC, United States. Electronic address: rlg4@gunet.georgetown.edu.
Robin
R
Gross
Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: frank.tleone@uphs.upenn.edu.
Frank
F
Leone
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: rui.xiao@umassmed.edu.
Rui
R
Xiao
Department of Clinical and Diagnostics Sciences, UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, United States. Electronic address: waughj@uab.edu.
Jonathan
J
Waugh
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: sybil.crawford@umassmed.edu.
Sybil
S
Crawford
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: judith.ockene@umassmed.edu.
Judith K
JK
Ockene
D002982:Clinical Clerkship / Q000458:organization & administration; D002983:Clinical Competence; D004501:Education, Medical / Q000458:organization & administration*; D006801:Humans; D017145:Models, Educational; D012107:Research Design; D016540:Smoking Cessation / Q000379:methods*; D013337:Students, Medical; D014029:Tobacco Use Disorder / Q000175:diagnosis* / Q000628:therapy*
5As; Group randomized controlled trial; Medical school education; Medical students; Tobacco control; Tobacco dependence treatment and counseling