Teaching about tobacco in medical schools: A worldwide study
Teaching about tobacco in medical schools: A worldwide study
复制标题
DOI：
10.1111/j.1465-3362.2009.00105.x
复制
发表时间：
2009-09-01
影响因子：
3.8
通讯作者：
Hyslop, Fran
中科院分区：
文献类型：
--
作者：
Richmond, Robyn;Zwar, Nicholas;Hyslop, Fran
简介和目标。作为未来的医生，医学生应该学习烟草控制策略和戒烟干预措施。通过将烟草教育纳入医学课程，他们可以了解烟草使用对健康的影响，并学会帮助吸烟者戒烟。我们的研究旨在估计全世界医学院关于烟草和戒烟技术的教学程度，并与我们 10 年前报告的结果进行比较，以确定课程内容和教学形式的范围，并找出医学院烟草教学的障碍和解决方案。设计和方法。对 171 个国家的所有现有医学院（n = 2090）进行了横断面调查。设计、翻译并发送了一份调查问卷给所有医学院。主要成果指标包括是否以及如何教授烟草；与10年前的调查进行比较；课程中的烟草内容；教学形式；以及教学障碍和解决方案。结果。来自109个国家的665所医学院完成了完整的调查问卷，其中64%的国家的医学院和64%的国家的医学院的答复率为31.8%，其中发达国家的医学院占39%，欠发达国家的医学院占28%。另外 67 所医学院回答了关于是否教授烟草知识的单一问题。总回复率为 35%。在 561 所回答有关教学选择问题的医学院中，27% 的医学院教授了有关烟草的特定模块，而我们十年前对医学院进行的调查中只有 11%； 77% 的人将烟草教学与其他主题相结合，而 10 年前这一比例为 40%； 31% 的人在话题出现时非正式地教授烟草知识（相对于 58%），4% 的人没有教授烟草知识（相对于 12%）。最常见的教授主题是：吸烟对健康的影响（94%）、被动吸烟对健康的影响（84.5%）、烟草使用的流行病学（81%）、尼古丁依赖（78%）和吸烟史（75%）。最流行的教学方法是讲座（78％）、案例研究讨论和基于问题的学习练习（51％）、课堂阅读46％、在临床环境中与真实患者一起（45％）、特殊项目和作业（45％）以及以患者为中心的教学方法，例如角色扮演（31％）。值得注意的是，欠发达国家（> 60%）发现了更多的教学障碍，包括：医学项目中缺乏可用的教学时间、纳入新科目的组织能力有限、缺乏教学人力资源、缺乏引入烟草课程的当前计划、缺乏支持和组织教学的关键人物、缺乏财政资源以及缺乏教学激励或优势。大多数人描述了这些问题的解决方案。介绍了整个医学课程中烟草教育的案例研究。讨论和结论。我们发现，过去 10 年来，医学院的烟草教学范围出现了令人鼓舞的增长。我们报告说，尽管全世界医学院在解决烟草教学问题上已经取得了进展，但还需要付出更多努力才能使烟草教育成为医学课程的一个持续组成部分。教学内容一般以循证戒烟指南为基础。 [Richmond R、Zwar N、Taylor R、Hunnisett J、Hyslop F。医学院烟草教学：一项全球研究。药物酒精修订版 2009；28：484-497]。
Introduction and Aims. As medical practitioners of the future, medical students should be taught about tobacco control strategies and smoking cessation interventions. By including education about tobacco in the medical curricula, they can be informed about the health effects of tobacco use and learn to assist smokers to quit. Our study aimed to estimate the extent of teaching about tobacco and smoking cessation techniques in medical schools worldwide and compare with results we reported 10 years ago, to determine the content of curricula and range of teaching formats and to identify barriers to teaching about tobacco in medical schools and solutions. Design and Methods. A cross-sectional survey of all existing medical schools (n = 2090) in 171 countries was conducted. A questionnaire was designed, translated and sent to all medical schools. Main outcome measures included whether and how tobacco is taught; comparisons with the survey conducted 10 years ago; tobacco content in the curriculum; format of teaching; and barriers to teaching and solutions. Results. 665 medical schools from 109 countries completed the full questionnaire, with a response rate of 31.8% from medical schools and 64% of countries and consisting of 39% of medical schools in developed and 28% in less developed countries. A further 67 medical schools responded to a single question on whether they taught about tobacco. The total response rate was 35%. Of 561 medical schools responding to questions on teaching options, 27% of medical schools taught a specific module on tobacco compared with only 11% in our survey of medical schools conducted a decade ago; 77% integrated teaching on tobacco with other topics compared with 40% 10 years ago; 31% taught about tobacco informally as the topic arose (vs. 58%) and 4% did not teach about tobacco (vs. 12%). Most common topics taught were: health effects of smoking (94%), health effects of passive smoking (84.5%), epidemiology of tobacco use (81%), nicotine dependence (78%) and taking a smoking history (75%). Most popular method of teaching was by lectures (78%), case study discussions and problem-based learning exercises (51%), class readings 46%, in the clinical setting with real patients (45%), special projects and assignments (45%) and patient-centred teaching approaches, such as role plays (31%). Significantly, more barriers to teaching were identified by less developed countries (> 60%) including: lack of available teaching time in the medical program, limited organisational ability to include new subjects, lack of staff resources to teach, lack of current plans to introduce a tobacco curriculum, lack of a key person to champion and organise teaching, lack of financial resources and lack of incentives or advantages to teach. A majority described solutions to these problems. A case study of education on tobacco throughout the medical curriculum is presented. Discussion and Conclusions. We found an encouraging increase in the extent of teaching on tobacco in medical schools over 10 years. We report that although progress has been made to address the teaching of tobacco in medical schools worldwide, there is a great deal more effort required so that education on tobacco is an ongoing part of medical curricula. The teaching content is generally based on evidence-based smoking cessation guidelines. [Richmond R, Zwar N, Taylor R, Hunnisett J, Hyslop F. Teaching about tobacco in medical schools: A worldwide study. Drug Alcohol Rev 2009;28:484-497].