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J Gen Intern Med. 2007 Feb;22(2):223-7.

Medical students' use of the stages of change model in tobacco cessation counseling.

Author information

  • 1Department of Psychiatry, University of California, San Francisco, CA 94143-0984, USA. JProchaska@lppi.ucsf.edu

Abstract

BACKGROUND:

Many medical schools have incorporated the Stages of Change Model into their curricula with specific application to tobacco cessation.

OBJECTIVE:

This study examined the extent to which medical students were prepared to provide stage-based interventions to treat nicotine dependence.

DESIGN:

Using a quasi-experimental design, medical students' counseling interactions were evaluated with a standardized patient portraying a smoker in either the precontemplation or preparation stage of change.

PARTICIPANTS:

Participants were 147 third-year medical students at the University of California, San Francisco.

MEASUREMENTS:

Checklists completed by standardized patients evaluated students' clinical performance. Surveys administered before and after the encounters assessed students' knowledge, attitudes, confidence and previous experience with treating smoking.

RESULTS:

Most students asked about tobacco use (89%), advised patients of the health benefits of quitting (74%), and assessed the patient's readiness to quit (76%). The students were more likely to prescribe medications and offer referrals to patients in the preparation than in the precontemplation stage of change (P < 0.001); however, many students had difficulty identifying patients ready to quit, and few encouraged patients to set a quit date or arranged follow-up to assess progress. Students' tobacco-related knowledge, but not their attitudes, confidence, or previous experience predicted their clinical performance.

CONCLUSIONS:

The findings indicated evidence of students tailoring their counseling strategies to the patients' stage of change; however, they still could do more to assist their patients in quitting. Additional training and integration of cessation counseling into clinical rotations are needed.

PMID:
17356990
[PubMed - indexed for MEDLINE]
PMCID:
PMC1824739
Free PMC Article

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