Evaluation of Tobacco Education at 12 US Medical Schools

Evaluation of Tobacco Education at 12 US Medical Schools

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

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