Background
Tobacco use is undertreated in the medical setting. One driver may be
inadequate tobacco use disorder treatment (TUDT) training for clinicians in
specialties treating tobacco-dependent patients.
Objective
We sought to evaluate the current state of TUDT training for diverse
professionals and how these skills are assessed in credentialing exams.
Methods
We performed a focused review of current educational practices,
evidence-based strategies, and accreditation exam contents focused on
TUDT.
Results
Among medical students, participants in reviewed studies reported anywhere
from 45 minutes to 3 hours of TUDT training throughout their
4-year programs, most often in the form of didactic sessions. Similarly,
little TUDT training was reported at the post-graduate (residency,
fellowship, continuing medical education) levels, and reported training was
typically delivered as time-based (expected hours of instruction) rather
than competency-based (demonstration of mastery) learning. Multiple studies
evaluated effective TUDT curricula at varied stages of training. More
effective curricula incorporated longitudinal sessions and active learning,
such as standardized patient encounters or proctored patient visits.
Knowledge of TUDT is minimally evaluated on certification exams. For
example, the American Board of Internal Medicine blueprint lists TUDT as
<2% of one subtopic on both the internal medicine and
pulmonary exams.
Conclusion
TUDT training for most clinicians is minimal, does not assess competency, and
is minimally evaluated on certification exams. Effective, evidence-based
TUDT training incorporating active learning should be integrated into
medical education at all levels, with attention paid to inclusion on
subsequent certifying exams.