Improving medical student performance in smoking health promotion: effect of a vertically integrated curriculum

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Practice points
• Most undergraduate curricula address smoking but with little focus on the vertical integration of smoking education.
• This study uses an evidence-based smoking and health intervention to determine, first, whether students within a new medical curriculum perform better than previous cohorts taught using a traditional curriculum, and second, to assess the effect of vertical integration of smoking education within the new curriculum.
• New curriculum students performed better than students from the previous curriculum, whether or not they had received the smoking intervention (p < 0.001).
• Within the new vertically integrated curriculum, students who received a specific smoking intervention were more likely to enquire about smoking in an objective structured clinical examination than those who did not receive the intervention (p < 0.005).
• Clinically integrated teaching can improve knowledge, skills and clinical behaviour in relationship to smoking health promotion.

Table 1.  Study design

	Current curriculum	Previous curriculum
Specific teaching onadolescent smoking(intervention groups)	Group 1 (n = 65)	Group 3 (n = 56)
No specific teaching onadolescent smoking(comparison groups)	Group 2 (n = 59)	Group 4 (n = 58)

Figure 1. Effect of specific teaching about adolescent smoking on OSCE performance (smoking enquiry) within the current medical curriculum compared with the previous curriculum.