A Simulation-Enhanced Curriculum to Improve Resident Knowledge and Skills in Smoking Cessation Treatment

Abstract

Tobacco smoke exposure has significant health impacts on youth and opportunities exist to improve smoking cessation treatment education in residency training. This study sought to improve resident self-perceived knowledge and skills with a structured simulation-enhanced educational intervention. Pediatric and anesthesia residents participated in the smoking cessation treatment education on their pediatric pulmonary rotation. Residents received a pre-questionnaire about self-perceived knowledge and skills of smoking cessation treatment on a 5-point Likert scale. The intervention consisted of a didactic session on the 5 A’s (Ask, Advise, Assess, Assist and Arrange), referral to the quitline and nicotine replacement therapy (NRT). This was followed by two simulations with standardized patients followed by debriefing. Residents received a post-questionnaire immediately afterwards and follow-up questionnaires at 3 and 6 months after the simulation. Fisher’s exact test was used to compare responses at baseline between groups and the signed rank test was used to evaluate change in mean scores. Forty-seven (89%) of the 53 residents eligible participated and completed the pre and post-questionnaire between the study period of November 2014 and May 2016. Twenty-three (49%) and 13 (28%) of 47 questionnaires at 3 and 6 months, respectively, were completed. All question scores increased significantly (p < 0.001) on the post-intervention questionnaire in self-perceived knowledge and skills of smoking cessation treatment and remained significantly higher (p < 0.001) among the follow-up questionnaires completed. A structured simulation-enhanced educational intervention was successful in systematically exposing residents to smoking cessation treatment education and increased self-perceived knowledge and skills that persisted above baseline among those with follow-up although 6-month follow-up was sub-optimal.