Evaluation of Tobacco Education at 12 US Medical Schools Catherine A. Powers, EdD Jane Zapka, ScD Pathways and Barriers to Curricular Change at Twelve US Medical Schools Non-tobacco Behavioral Intervention Teaching II. Faculty Development and Preparation III. Student Knowledge and Skills IV. Barriers to Tobacco Education V. Tobacco Education-The Vision Thing I. NON-TOBACCO BEHAVIORAL INTERVENTION TEACHING Non-Tobacco Behavioral Intervention Skills 12 11 10 9 8 7
6 5 4 3 2 1 0 12 10 Patient Communication Patient Counseling Non-Tobacco Behavioral Intervention Skills - Years Taught 12 11 10 9 8 7 6 5 4
3 2 1 0 10 10 9 3 Year I Year II Year III Year IV 12 11 10 9 8 7
6 5 4 3 2 1 0 Non-Tobacco Behavioral Intervention Skills - Teaching Techniques 10 10 9 9 7 3 FACULTY DEVELOPMENT AND PREPARATON Areas of Faculty Training for Tobacco Prevention & Cessation
YES 12 11 10 9 8 7 6 5 4 3 2 1 0 12 NO 12 10 10 10
9 3 2 0 Tobacco CME's 2 2 0 Prevention Counseling Workshops Prevention/ Cessation Guidelines Pharmacologic Therapy Mentors/Master
Teachers Instructional Development Seminars High Level of Institutional Commitment for Faculty Development 12 11 10 9 8 7 6 5 5 4 4 3
3 2 1 0 0 STRONGLY DISAGREE DISAGREE AGREE STRONGLY AGREE High Level of Faculty Support for Workshops Integrating Tobacco Prevention and Cessation Into Coursework 12 11 10 9 8 7 6
5 4 3 2 1 0 10 1 1 0 STRONGLY DISAGREE DISAGREE AGREE STRONGLY AGREE STUDENT KNOWLEDGE AND SKILL
Skill Level of Graduating Students in Prevention Counseling PI Survey Administrators' Survey 12 11 10 9 8 8 7 6 6 5 4 3 3
3 2 2 1 1 1 0 0 POOR AVERAGE VERY GOOD EXCEPTIONAL Skill Level of Graduating Students in Cessation Counseling PI Survey Administrators' Survey
12 11 10 9 8 8 7 6 6 5 4 3 2 3 3 2 1
1 1 1 0 POOR AVERAGE VERY GOOD EXCEPTIONAL Students Knowledge of the Stages of Change Model, Intervention at Various Stages and Knowledge of Referrals 12 11 11 Yes 10
10 9 8 7 6 6 5 4 3 2 1 0 Stages of Change Model Knowledge Intervention Knowledge Referral Knowledge Students Knowledge of Public Health & Public Policy Related to Tobacco PI Survey Administrators' Survey
12 11 10 9 8 8 7 7 6 5 4 3 2 2 1 2 2
1 1 0 0 POOR AVERAGE VERY GOOD EXCEPTIONAL BARRIERS AND CHALLENGES TO TOBACCO EDUCATION Faculty Related Issues (PI Survey vs. Administrators Survey) Major/Moderate 12 11 10 9 8
7 6 5 4 3 2 1 0 Minor/No 11 9 9 9 7 6 6 5 3
3 3 1 PI Admin. Faculty Resistance PI Admin. Faculty Members' Low Priority on Prevention PI Admin. Faculty Turnover Student and Administrative Barriers
(PI Survey vs. Administrators Survey) Major/Moderate 12 11 10 9 8 7 6 5 4 3 2 1 0 Minor/No 11 10 8 8 4
4 2 1 PI Admin. Student Resistance PI Admin. Administrative Resistance Other Barriers and Challenges to Tobacco Innovation (PI Survey vs. Administrators Survey) Major/Moderate 12
11 10 9 8 7 6 5 4 3 2 1 0 10 Minor/No 10 10 9 3 2 2
PI Admin. No Champions for Tobacco 2 PI Admin. Accrediting Requirements Institutions Willingness to Integrate Tobacco Cessation into Cultural Competency PI Survey 12 11 10 9 8 7 6 5
4 3 2 1 0 Administrators' Survey 7 6 4 3 1 1 0 Unwilling 0 Intended in future In past not currently
Unknown THE VISION THING Visioning for New Tobacco Education 12 11 Number of Schools 10 9 8 7 6 6 6 5 5 4 3
3 2 2 1 1 0 Adding cases to currently existing courses Greater opportunities for practice Web-based teaching/ technology Pediatrics
Faculty development Public health initiatives Summary Non-Tobacco Behavioral Intervention - Patient communication and counseling are very promising areas to include new tobacco information. - They are taught across all four years and include a variety of teaching methodologies Faculty Development and Preparation - Need for improvement in faculty training for tobacco prevention - Strong levels of institutional commitment for faculty development - Faculty resistance to tobacco workshops is a significant barrier - Need to explore other methods for faculty tobacco training
Student Knowledge and Skills - Need for improvement in students prevention and cessation skills - Need for improvement in students knowledge of public health and public policy related to tobacco - Students have knowledge of behavioral intervention and stages of change, but need improvement in patient referral Barriers to Tobacco Education - Faculty resistance and low priority on prevention topics present major barriers - The good news is that student and administrative barriers are minimal Educational Vision - Majority of schools envision adding new cases to existing courses and adding greater opportunities for practice - The existing patient communication and counseling curriculum may provide a perfect opportunity for achieving these objectives
