Long-term retention of smoking cessation counseling skills learned in the first year of medical school

Background: Tobacco use is a significant cause of preventable morbidity and mortality in the United States, yet clinicians underutilize smoking cessation counseling. Medical schools are increasingly including training for smoking cessation skills in preclinical curricula. Information about long-term retention of these skills is needed. Objective: To assess retention of smoking cessation counseling skills learned in the first year of medical school. Desing: Retrospective review of data collected for routine student and curriculum assessment. Participants: Two cohorts of medical students at the University of Connecticut School of Medicine (total N=112) in 1999-2001 and 2002-2004. Measurements and Main Results: Scores by standardized patients were compared from first and fourth-year assessments, based on checklist items corresponding to the 5 strategies recommended by the U.S. Public Health Service (Ask, Advise, Assess, Assist, Arrange). In study cases, 97% of first-year students asked about smoking and retained this skill in fourth year (p=.08). Ninety-four percent of first-year students assessed readiness to quit and retained this skill (p=.21). Ninety-six percent of first-year students advised smokers to quit and retained this skill (p=.18). Eighty-six percent of first year students assisted smokers in quitting and retained this skill (p=0.10). Eighty-one percent of first year students arranged follow-up contact and performance of this strategy improved in the fourth year to 91% (p=.03). Conclusions: Smoking cessation counseling skills demonstrated by first year medical students were, with brief formal reinforcement in the third year, well retained into the fourth year of medical school. It is appropriate to begin this training early in medical education.