Tough habit to break: professor awarded $1.6 million to create 'virtual patients,' continue tobacco cessation work

December 19, 2014  


Hudmon tobacco

A medical student works with a standardized patient during a simulation of a clinical experience. (Photo courtesy of Albany Medical College/Mark McCarty)
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WEST LAFAYETTE, Ind. — A project led by a Purdue University professor will create "virtual patients" and educational assessments to help medical, nursing and pharmacy students learn how to counsel patients to quit smoking.

Karen Hudmon, a professor of pharmacy practice at Purdue, leads the project, which received $1.6 million from the National Institutes of Health. The teaching and learning tools developed through the project will be available for free to health professional schools and the public.

"Tobacco use is the primary known preventable cause of disease and death in the United States and results in enormous health care costs," Hudmon said. "It is well established that the most effective method to quit is a combination of counseling from a health care provider and the use of medication to alleviate the symptoms of withdrawal, but most health professional schools are not adequately preparing students for this role."

It is estimated that 42.1 million people in the United States smoke, according to the Centers for Disease Control and Prevention, and 70 percent of smokers would like to quit. However, fewer than 5 percent of those who try to quit on their own have long-term success.

Karen Hudmon

Karen Hudmon (Purdue University photo)

The project builds on Hudmon's successful education program Rx for Change: Clinician-Assisted Tobacco Cessation, which began in 1999 as a collaboration with the University of California San Francisco and is now used to teach tobacco cessation counseling to students in health care fields throughout the United States and in 46 other countries.

"Our goal is to foster a collaborative approach to tobacco cessation – all types of health care providers should be active in helping patients quit, because the more types of clinicians from whom a patient receives assistance, the more likely he or she is to quit successfully," Hudmon said. "My mother died at the age of 50 from lung cancer, years after she had quit smoking. The risk of cancer can't be eliminated, but it certainly can be reduced, and many of the other negative health consequences of smoking can be reversed among patients who quit.  It's never too late to quit – patients can benefit from quitting at any age – but sooner is always better."

The new project offers additional educational tools to help teach effective counseling and to test what students have learned.

In collaboration with colleagues at Hudson Simulation Services, Hudmon and her team will create three "virtual patients," which students can access online at any time to practice what they learn in class. The virtual patients will possess detailed histories and personalities and will respond to students' questions in real time. Virtual patients have been shown to improve clinicians' confidence, decision making and communication skills, she said.

"Even at the best schools, only about 6 hours are dedicated to training students to approach and counsel a patient who smokes," Hudmon said. "In addition to making sure this time counts, we want to offer resources and an opportunity for students to learn outside of the classroom. Clinicians' confidence in their ability to provide tobacco cessation counseling is an important predictor of whether they will integrate routine tobacco cessation counseling into their professional practice."

Working in partnership with Albany Medical College, the team will develop standardized patient scenarios. Standardized patients are people who have been trained to act as a patient with a specific medical history and personality. A standardized patient can play the same clinical scenario for each of the students in a class, while a professor observes and assesses the interactions. Both the standardized patient and the professor serve as educators in the process, providing feedback to the student about his or her counseling performance. The trained patients also can give their impression about the communication skills of each student participant. Each patient scenario will include criteria that faculty will use to score their students' competency in tobacco cessation counseling, she said.

To insure that program outcomes are met, Albany Medical College will help the group develop an Objective Structured Clinical Exam. The exam is composed of clinical scenarios, portrayed by standardized patients to test the outcome objectives of the educational program.

The project also includes development of a Web-based continuing education program through New York Wired to prepare faculty and staff at health professional schools across the U.S. and abroad to integrate the new tools into a class curriculum and the creation of a publicly available website with all of the materials and tools.

The new tools will first be part of a pilot program at Albany Medical College and then at six additional schools including two medical, two nursing and two pharmacy programs.

In addition to Purdue, Albany Medical College and Hudson Simulation Services, partners in the project include Hudson Valley Community College, New York Medical College, New York Wired and UCSF School of Pharmacy. 

Writer: Elizabeth K. Gardner, 765-494-2081, ekgardner@purdue.edu 

Source: Karen Hudmon, 317-880-5427, khudmon@purdue.edu 

Additional media contact: 

Sue Ford, Manager of Media Relations for Albany Medical Center, 518-262-3421, fords@mail.amc.edu 

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