SMOKING HISTORY-TAKING SKILLS - A SIMPLE GUIDE TO TEACH MEDICAL-STUDENTS

Many doctors rate themselves as ineffective smoking cessation counsell ors. It is logical to initiate training efforts with medical students. We incorporated smoking history-taking in the physical diagnosis cour se at the University of North Carolina at Chapel Hill using a simple m ethod to teach smoking history-taking skills and to assess its effecti veness as an educational intervention. The principal intervention was the distribution of a one-sheet Smoking-History Taking and Counseling Guide, adapted from the American Lung Association's Freedom From Smoki ng for You and Your Family self-help manual. The second intervention w as a single prompt for 50% of the course preceptors. Students' smoking history-taking skills were evaluated in the Objective Structured Clin ical Examination (OSCE) at the end of the course. Students who receive d the guide did significantly better on the OSCE, even after controlli ng for having discussed taking a smoking history with their preceptors . A simple guide combined with a one-time prompting of preceptors has a positive effect on the acquisition of smoking history-taking skills by the medical students. This strategy may also be useful for teaching and evaluating smoking-cessation counselling skills, for which good s moking history-taking is a necessary basis.