Introduction Current smoking cessation training in U. K. medical schools fails to equip junior doctors with the skills necessary to effectively combat the leading preventable cause of death and disease.1 Here I present a novel teaching method using an electronic Case-Based Discussion (eCBD) which streamlines the process of workplace-based assessments, facilitates high-quality learning and provides new insights into what students know about this critically important subject.
Methods An electronic learning module was developed by the author based on existing NICE guidelines.2 Candidates described a case of a smoker they had seen and were quizzed about the case by the learning module with some instant feedback, then deeper discussion with the author via e-mail. When the candidate was ready a CBD form was completed. Finally feedback was collected using an anonymous, online feedback form.
Results Thirty students and junior doctors have completed the eCBD. The eCBD had excellent feedback with 94% rating the eCBD as “very useful” and 100% feeling more confident in giving smoking cessation advice. Ninety-four percent rated the eCBD as “easier” or “much easier” to arrange and 53% rated it “much better” at assessing knowledge than conventional CBDs.
Analysis of responses revealed deficiencies in knowledge of medications to treat tobacco dependence; 97% knew of nicotine replacement therapy (NRT) but knowledge of some formulations was poor (none mentioned oral strips, 3% microtabs, 17% lozenges); 43% knew of varenicline and 40% bupropion. Only 37% thought that combination NRT was safe and effective and thematic analysis revealed widespread concerns about the risks of overdose. 57% would consider recommending e-cigarettes for selected patients although only 7% had already recommended them to patients.
Conclusions The eCBD can be an effective method of encouraging learning in important and neglected subject areas. It also illustrates an often-wasted opportunity to collect data from online learning modules that could guide curriculum development and facilitate better training in future.
References 1 Raupach T, Al-Harbi G, McNeill A, Bobak A, McEwen A. Smoking cessation education and training in U. K. Medical schools: a national survey. Nicotine Tob Res. 2015;17(3):372–375
2 National Institute for Health and Clinical Excellence. Smoking cessation in secondary care: acute, maternity and mental health services. PH48. London: NICE, 2013