Rotation in a Smoking Cessation Clinic Improves Nicotine Dependence Treatment Provided by First-Year Internal...

Area of Science:

• Medical Education
• Public Health
• Nicotine Dependence Treatment

Background:

• Physicians are pivotal in aiding smoking cessation, with over 70% of smokers seeking annual medical care.
• Residency training is crucial for equipping physicians with effective nicotine dependence treatment strategies.

Purpose of the Study:

• To evaluate if experiential learning in a smoking cessation medical clinic (SCMC) rotation improves internal medicine (IM) interns' smoking cessation practices.
• To assess the impact of SCMC on interns' outpatient and inpatient smoking cessation interventions.

Main Methods:

• Prospective study at a university-affiliated hospital involving 40 IM interns rotating through SCMC.
• Interns received lecture, then treated patients under supervision, with practices assessed via chart review pre- and post-rotation.
• Paired t tests analyzed changes in identifying smokers, offering pharmacotherapy, and counseling; confidence survey administered post-rotation.

Main Results:

• Significant increases observed in identifying smokers (7.1% to 18.7%), prescribing cessation therapy (6.5% to 18.0%), and counseling (30.9% to 42.3%) for outpatients.
• Inpatient nicotine replacement increased (12.9% to 37.4%), and therapy prescriptions upon discharge rose (5.7% to 16.1%).
• Interns reported increased confidence in providing smoking cessation counseling and treatment.

Conclusions:

• SCMC rotation significantly enhanced IM interns' smoking cessation treatment practices.
• Experiential learning in SCMC led to measurable improvements in clinical interventions for smoking cessation.