Training Medical Student Counselors for the Rochester Model, a Hospital Tobacco Treatment Program

Abstract

John C Grable,1,* Kevin Shan,1,* Matthew Wang,1,* Daniel D Han,1,* Kristen Sportiello,1,* Melissa Chang,1,* Justin R Sysol,1,* Doris Bugbee,2,* Kenneth Peltzer1,* 1Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA; 2Department of Nursing, University of Rochester School of Medicine, Rochester, NY, USA*These authors contributed equally to this workCorrespondence: John C Grable, University of Rochester School of Medicine, 601 Elmwood Avenue, Rochester, NY, 14642, USA, Tel [phone], Fax [phone], Email [email protected]: Providing effective tobacco dependence treatments to hospitalized patients remains a challenge. Prior to 2021, the Rochester Model program used staff nurses for both bedside and post-discharge counseling necessary to maintain abstinence. When nurse shortages and elevated job stress occurred during the COVID Pandemic, we proposed that medical students learn to counsel patients at the bedside and after discharge.Patients and Methods: Due to COVID restrictions, first- and second-year medical students trained using remote Zoom sessions. The total training time was 2.5 hr without role-play or additional evaluations. A survey measured the students’ satisfaction, confidence, and counseling barriers. A smoking patient on a participating hospital unit can enroll in the program. Students delivered bedside counseling, then provided follow-up treatment and outcome calls along with New York State Quitline counselors.Results: The survey demonstrated that 89% of the students were satisfied with the training. The bedside counseling confidence was greater than the phone counseling confidence. All students felt the program experience has value to them as future physicians. 124 smoking patients enrolled, and outcomes followed out to 6 months. The 7-day point prevalence quit rates using the as-treated (patients contacted) analysis were 57% at 4 weeks, 48% at 3 months, and 43% at 6 months. The 7-day point prevalence quit rates using the intent-to-treat (all patients) analysis were 31% at 4 weeks, 16% at 3 months and 14% at 6 months.Conclusion: Medical students given minimal training are effective tobacco cessation counselors at no cost to the hospital system. The Rochester Model program using student counseling benefits patients, the students, and the health-care system.Plain Language Summary: Hospitalization is an opportunity to help smokers quit. Successful programs require both bedside counseling and post-discharge contacts beyond a month. Cost remains the major issue for treating hospitalized smokers. Prior to the COVID Pandemic, the Rochester Model program used hospital nurses as bedside, post-discharge call counselors and champions. However, during the Pandemic, nurse shortages and work stress reduced their participation. Medical students seeking early patient contact trained as counselors, and the program shows promising quit rates at no cost. The Rochester Model supports the real-world application of medical students in hospital tobacco treatment programs.Keywords: tobacco dependence treatment, medical students, nurse counseling, quit-line counseling

Keywords

• tobacco dependence treatment
• medical students
• nurse counseling
• quit-line counseling.