Online Tool Equips Psychiatrists to Help Patients Quit Smoking

Online training for psychiatry residents could be a useful tool to address knowledge deficits in tobacco use disorder, according to a new study published in the American Journal of Addictions.

After comparing pretest and posttest results for 150 eligible psychiatry residents, the research team saw a significant increase in knowledge after the online training program was completed, with a mean gain in score of 35 points.

A $40 incentive was given to those who completed the posttest again, along with a three-month follow-up survey.

Of the 150 eligible, 91 completed the three-month follow-up measure (59.9%) and 89 of the participants completed a pretest, posttest and three-month posttest.

The mean score of the three-month posttest was 62.7% correct, and paired t-tests analyzed for 86 participants who completed a pretest and the three-month posttest showed a mean increase of 11.4 points.

Researchers suggest that this indicates that at least some knowledge was retained over time.

Overall, 98% of the participants reported that the program enhanced their professional experience somewhat or substantially and 82% would recommend the program to others.

Researchers in the department of psychiatry at Rutgers Robert Wood Johnson Medical School in N.J. and the University of Miami Miller School of Medicine developed 11 learning objectives that were compliant with the Accreditation Council on Graduate Medical Education Core Competencies for residency training. Objectives included recognizing evidence-based counseling strategies for treating tobacco use disorder and developing a treatment plan for tobacco use disorder combining pharmacological and psychosocial treatments to enhance outcomes.

Two general psychiatry residents helped develop the full curriculum and webinar materials.

Patient interviews were also a part of the course to demonstrate skills and reinforce key learning points.

There were three, one-hour lecture-style webinars included in the program, which focused on the prevalence and consequences of tobacco use disorder in individuals with behavioral health conditions, an assessment of tobacco dependence and overview of counseling strategies, and pharmacological treatment of tobacco use disorder.

The course took place on Sakai, the online learning platform at Rutgers University.

The team invited 161 allopathic general psychiatry residency programs to participate in the two-year study until the goal of resident participants was met.

Of the 761 residents invited to complete the course, 250 logged onto the course at least once — 230 residents and 16 faculty members. Close to 30% of the 761 residents actually went into the course materials, not just the homepage of the program, and visited the course from one to 81 times.

A total of 207 residents completed the pretest and 199 completed the attitudes survey.

The pretest consisted of 10 multiple choice questions that asked about the resident’s knowledge of tobacco use disorder, tobacco withdrawal symptoms and evidence-based counseling and medication treatments.

Mean pretest scores were 53% correct, with the need for improvement in every area.

The attitudes survey asked questions about participants’ attitudes about treating tobacco use disorder, including identifying barriers to helping patients stop smoking. Patients having more immediate problems to address, and patients not being motivated to quit were the two biggest reported barriers, with 95% of participants leaning that way.

While barriers are present, disregarding a patient’s smoking habits could be deadly. Tobacco use accounts for 50% of deaths among people with mental illness, according to the study.

The participants were able to freely use the online program, meaning if they wanted to, they could only view the third module on pharmacotherapy.

Close to 86% of participants completed the module one posttest, while 80.7% completed the second module posttest and 79.7% completed the third posttest.

There were 152 participants (73.4%) that completed the entire course — three webinar modules and posttest evaluations.

It was found that the mean posttest scores were 89.3% correct.

Paired t-tests were analyzed for 150 individuals who completed both the pretest and posttest, and the results indicated a significant increase in knowledge, with a mean increase of 35.1 points.

“This study shows that the live educational activities we have been delivering to professionals for years can be modified to a webinar format to reach bigger audiences like psychiatry residents,” said lead author Jill M. Williams, director of the division of addiction psychiatry at Rutgers Robert Wood Johnson Medical School.

Williams added that online training is a good way to teach more neglected areas of graduate medical education.

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