Teaching smoking-cessation counseling to medical students using simulated patients

Objective: Our objective was to evaluate the effectiveness of using simulated patient instructors and the Ockene method to instruct third-year medical students in smoking-cessation counseling techniques. Design: We used a clinical exercise with self-study preparation and simulated patient instructors. Methods: One hundred fifty-nine students participated in a smoking-cessation counseling session in which cognitive and behavioral endpoints were assessed by simulated patient instructors and the students themselves. Results: Student performance in the cognitive and behavioral components of model smoking-cessation counseling was acceptable. Specific areas of weakness, such as the tendency of students to underemphasize the personal and social benefits of smoking cessation, and to overestimate their competence on a number of skill items, were identified. Student evaluation of the exercise was positive. Conclusions: Smoking-cessation counseling can be taught effectively to third-year medical students by simulated patient instructors during a clinical clerkship.