Student performance on smoking cessation counseling with standardized patients

Gaps in medical school education exist for the leading preventable cause of morbidity and mortality in the United States--cigarette smoking. This report is on an innovative medical student curriculum of smoking cessation with a high-stakes required performance assessment during a third-year clerkship in family medicine addressing the following questions: (1) Can medical students consistently achieve high levels of performance providing smoking cessation advice with standardized patients and (2) Is the performance on standardized patients associated with other concurrent cognitive test performance on comprehensive topics relevant to family medicine?

From 1997--2002 (Cohort 1), 470 students completed a focused assessment with standardized patients on smoking cessation counseling. From 2003--2007, 277 students completed a revised, complex shared decision making assessment on smoking cessation with standardized patients. Associations between student performance on standardized patients and concurrent cognitive examinations were analyzed.

High levels of student performance were sustained on standardized patients and were inconsistently associated with other concurrent (written and oral) cognitive examinations.

These findings further substantiate a need for broadening the range of assessing medical student competency beyond cognitive evaluations alone. Medical students can consistently achieve high levels of smoking cessation counseling with standardized patients regardless of the complexity of approach or performance on other concurrent examinations.