Improving medical student performance in adolescent anti-smoking health promotion.

Background: We developed a 1-hour teaching seminar for medical students on anti-smoking health promotion for adolescents. We report the development of the programme and a performance-based evaluation.
Aim: To develop a seminar for medical students with the objective of improving medical student inquiry into smoking and the delivery of advice accordingly for adolescent patients in routine consultations.
Method: The seminar was developed using principles of adult learning and delivered to a cohort of medical students (intervention group). Participants were Year 5 medical students in their paediatrics term. A comparison group of 58 medical students who did not receive the seminar was studied in the semester prior to the intervention. The primary outcome measure was a change in anti-smoking health promotion practice within an objective structured clinical examination (OSCE), where taking a smoking history and making links between smoking status and health were indicated in a 15-year-old simulated patient (SP) with poorly controlled asthma. This was part of the summative assessment in the paediatrics term.
Results: In the OSCE, 21 of 58 (36%) students in the comparison group asked the asthmatic SP about smoking, compared with 41 of 56 (73%) students in the intervention group (P = 0.0001). In all, 15 (26%) of the comparison group students addressed the patient's smoking, compared with 33 of the 56 (59%) intervention group students (P = 0.0004).
Conclusion: A carefully designed seminar addressing adolescent smoking can increase the frequency of smoking inquiry and advice by medical students.