Training Medical Student Counselors for the Rochester Model, a Hospital Tobacco Treatment Program.

Abstract

Providing effective tobacco dependence treatments to hospitalized patients remains a challenge. Prior to 2021, the Rochester Model program used staff nurses for both bedside and post-discharge counseling necessary to maintain abstinence. When nurse shortages and elevated job stress occurred during the COVID Pandemic, we proposed that medical students learn to counsel patients at the bedside and after discharge. Due to COVID restrictions, first- and second-year medical students trained using remote Zoom sessions. The total training time was 2.5 hr without role-play or additional evaluations. A survey measured the students' satisfaction, confidence, and counseling barriers. A smoking patient on a participating hospital unit can enroll in the program. Students delivered bedside counseling, then provided follow-up treatment and outcome calls along with New York State Quitline counselors. The survey demonstrated that 89% of the students were satisfied with the training. The bedside counseling confidence was greater than the phone counseling confidence. All students felt the program experience has value to them as future physicians. 124 smoking patients enrolled, and outcomes followed out to 6 months. The 7-day point prevalence quit rates using the as-treated (patients contacted) analysis were 57% at 4 weeks, 48% at 3 months, and 43% at 6 months. The 7-day point prevalence quit rates using the intent-to-treat (all patients) analysis were 31% at 4 weeks, 16% at 3 months and 14% at 6 months. Medical students given minimal training are effective tobacco cessation counselors at no cost to the hospital system. The Rochester Model program using student counseling benefits patients, the students, and the health-care system.