Environmental health education in the medical school curriculum

Objective.- To collect baseline data of environmental history-taking skills and clinical toxicology knowledge and examine the effects of a lecture on environment on students' history-taking skills. Methods.-An anonymous survey was distributed to third-year medical students prior to an asthma lecture that strongly emphasized environmental triggers . Fourteen questions assessed students' practices and attitudes toward envi ronmental history taking. Six multiple-choice questions assessed clinical t oxicology knowledge. Histories written by students were reviewed to determi ne the group's actual performance before and after a lecture on environment al health. Results.-Although students reported that an environmental history was impor tant, few asked about environmental history topics other than smoking and p ets. Occupational histories were included for adult patients, but few stude nts asked about parental occupations for pediatric patients. Students recog nized the correct antidotal therapy for iron and acetaminophen toxicity but were less proficient at identifying clinical features of lead and organoph osphate poisoning. Student history performance, when students were consider ed as a group, was similar to reported performance, with the presence of pe ts being the only significant postlecture change in history-taking behavior (P = .01). Conclusions.-Students have a positive attitude toward the need for an envir onmental history, but in self-reported practice and in actual practice, the y explore few major environmental history issues. Data were insufficient to prove that one lecture changed history-taking practices.