Feasibility of using a standardized patient encounter for training chiropractic students in tobacco cessation counseling

Objective: Although tobacco cessation training is included in many health professions programs, it is not yet routinely incorporated into chiropractic education. The purpose of this study was to assess the feasibility of incorporating a problem based learning tobacco cessation activity into a lecture course whereby chiropractic students performed a tobacco cessation consultation, using standardized patients. Methods: Seventy-two students were assigned to participate in two 1-hour faculty-driven lectures on health promotion counseling and tobacco cessation followed by an experiential student-driven lab session using standardized patients, at various stages of dependency and willingness to quit. The intervention was based on the Transtheoretical Model and the 5 A's of counseling (Ask, Advise, Assess, Assist, Arrange). Outcomes were assessed via: 1) questionnaires completed by the standardized patients regarding the students' use of the 5A's and 2) questionnaires completed by the students using a 5-point Likert scale of “strongly disagree” to “strongly agree” on the acceptability of this method of learning. Descriptive statistics were computed. Results: Sixty-eight students (94%) completed the activity, spending a median of 2.5 minutes with patients. Over 90% addressed 4 of the 5A's: 99% asked if they smoke; 97% advised them to quit; 90% assessed if they were willing to quit; and 99% offered assistance in quitting. Only 79% arranged a follow-up visit. Conclusions: Overall, students expressed a positive response to the experience; 81% said it increased their confidence in being able to advise patients and 77% felt it would be valuable for use in their future practice.