James J. Brokaw, PhD, MPH, Rhonda J. Eubanks, MD, Elizabeth A. Kalb, PhD, Donald R. Koritnik, PhD, Joseph L. Rayburn, MD, and Beat U. Raess, PhD. Indiana University School of Medicine, 635 Barnhill Drive, MS-164, Indianapolis, IN 46202-5120, 317-278-2891, jbrokaw@iupui.edu

Although a physician’s advice to quit smoking has been shown to have a positive impact on smoking cessation rates among patients, medical students are infrequently taught the appropriate techniques for counseling smokers. We developed a program to teach smoking cessation techniques at the Indiana University School of Medicine, a distributed system of medical education comprised of eight regional campuses, in addition to the main campus at Indianapolis. Students at the regional campuses complete their first two years of medical school before transferring to Indianapolis for their 3rd and 4th years. This system is ideal for piloting curricular innovations at one location before system-wide adoption. One site (Evansville) was selected to pilot the program, while another (Ft. Wayne) was selected to provide a comparison for internal validity. Tobacco-related educational activities were conducted at the Evansville campus during the 2002-2003 and 2003-2004 academic years and included both didactic and experiential components. Particular emphasis was placed on using the 5A’s (ask, advise, assess, assist, arrange) and 5R’s (relevance, risks, rewards, roadblocks, repetition) during the doctor-patient encounter. Program effectiveness was assessed with pre- and post-program surveys administered to students at the beginning of their first year and at the end of their second year. These were intended to measure knowledge, beliefs, and attitudes about tobacco use and cessation. For comparison, the same surveys were given concurrently to the Ft. Wayne students. Details about the program curriculum and the evaluation results from this first cohort of students will be presented.

Learning Objectives:

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• Describe the components of an educational program designed to teach medical students smoking cessation techniques. (
• Discuss the use of “standardized patients” (actors) in training medical students to counsel smokers. (
• Explain how the 5A’s differ from the 5R’s.

Keywords: Smoking, Health Education Strategies

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: This presentation will describe an educational program of the Indiana University School of Medicine.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.