Improving medical student performance in smoking health promotion: effect of a vertically integrated curriculum

The majority of medical schools have curricula that address the health effects of smoking. However, there are many gaps in smoking education, especially in relationship to vertical integration. The authors aimed to determine whether medical students would better address adolescent smoking within a vertically integrated curriculum in comparison with the previous traditional curriculum. They studied two groups of fifth-year students; one group received a specific smoking intervention. Each group consisted of the entire cohort of students within the Child and Adolescent Health rotation of a newly designed medical curriculum. Two groups of students from the previous traditional undergraduate curriculum were available for direct comparison, one of which had received the same teaching on adolescent smoking. An objective structured clinical examination station was used to measure adolescent smoking enquiry. Intervention students in the new curriculum were more likely to enquire about smoking in the objective structured clinical examination than students who did not receive the intervention (p<0.005). New curriculum students performed better than students from the previous curriculum, whether or not they had received the smoking intervention (p<0.001). This study suggests that integrated undergraduate teaching can improve student clinical behaviours with regard to opportunistic smoking enquiry in adolescents.