Table 2.
Proportion of trainees who responded correctly to knowledge assessment at the pre- and post-assessments
| Variables | Pre n (%) | Post n (%) | 95% Cl* | p** |
|---|---|---|---|---|
| Knowledgea | ||||
| Nicotine addiction Module 1 | ||||
| For most smokers, tobacco use is… | 186 (42.3) | 394 (89.5) | 0.420–0.525 | <0.001 |
| Nicotine is as addictive as other drugs such as heroin or cocaine. | 350 (79.5) | 424 (96.4) | 0.129–0.208 | <0.001 |
| Which of the following are common withdrawal symptoms experienced when someone quits smoking? | 369 (83.9) | 432 (98.2) | 0.107–0.179 | <0.001 |
| How soon may someone begin to experience withdrawal symptoms when they go without a cigarette? | 149 (33.9) | 386 (87.7) | 0.482–0.595 | <0.001 |
| Which of the following are not true about nicotine withdrawal symptoms? | 192 (43.6) | 373 (84.8) | 0.356–0.466 | <0.001 |
| What proportion of smokers report night wakening or difficulty sleeping after they quit? | 230 (52.3) | 417 (94.8) | 0.373–0.477 | <0.001 |
| The majority of patients who quit smoking experience irritability, restlessness, and depression? | 332 (75.5) | 420 (95.5) | 0.157–0.243 | <0.001 |
| Which of the following are not true about people who are fast nicotine metabolizers? | 311 (70.8) | 419 (95.4) | 0.198–0.294 | <0.001 |
| What are the most common reasons people return to smoking in the first few weeks after quitting? | 336 (76.4) | 428 (97.3) | 0.166–0.252 | <0.001 |
| People who quit smoking will have more, less, or the same amount of stress? | 185 (42.0) | 399 (90.5) | 0.434–0.537 | <0.001 |
| How to help patients quit Module 2 | ||||
| Tobacco treatment should be delivered with the same rigor and clinical importance as any other major chronic risk factor. | 418 (94.6) | 436 (98.6) | 0.019–0.062 | <0.001 |
| A clinician’s advice to quit is not very effective in motivating patients to quit. | 327 (74.0) | 425 (96.2) | 0.176–0.268 | <0.001 |
| Advice to quit smoking should be… | 348 (78.7) | 429 (97.1) | 0.143–0.223 | <0.001 |
| Offering patients your support with quitting has been shown to increase patient motivation to quit. | 409 (92.5) | 439 (99.3) | 0.042–0.094 | <0.001 |
| If a patient informs you they are not ready to quit, what should you do? | 396 (89.6) | 437 (98.9) | 0.064–0.122 | <0.001 |
| Which of the following questions are important pieces of information gathered as part of the smoking history? (check all that are correct) | 382 (86.4) | 435 (98.4) | 0.086–0.153 | <0.001 |
| Which of the following are important pieces of information to discuss with patients when developing a motivational intervention or personalized quit plan? | 383 (86.8) | 434 (98.4) | 0.082–0.149 | <0.001 |
| Patients that have higher levels of nicotine dependence can be assessed by… | 262 (59.3) | 390 (88.2) | 0.236–0.344 | <0.001 |
| For patients who report they are interested in quitting smoking, evidence has shown that the most effective evidence-based treatments are… | 324 (73.3) | 418 (94.6) | 0.170–0.255 | <0.001 |
| It is recommended that follow-up be scheduled 2–8 weeks, following the patient’s initial consultation, to review progress and response to therapy and make any adjustments to the plan. | 371 (84.3) | 432 (98.2) | 0.102–0.176 | <0.001 |
| Which of the following are not true about follow-up support for individuals who are quitting smoking? | 301 (68.3) | 414 (93.9) | 0.209–0.303 | <0.001 |
| Behavioral counseling Modules 3 and 4 | ||||
| The main goals of behavioral counselling are to… | 349 (79.0) | 419 (94.8) | 0.117–0.199 | <0.001 |
| There is no evidence that counselling helps patients to quit smoking. | 365 (82.6) | 429 (97.1) | 0.107–0.183 | <0.001 |
| Which of the following are true? | 385 (87.3) | 430 (97.5) | 0.070–0.134 | <0.001 |
| How long does a craving typically last? | 231 (52.3) | 426 (96.4) | 0.392–0.490 | <0.001 |
| The 4Ds strategies are the recommended approach for dealing with cravings to smoke and include. | 319 (73.0) | 427 (97.7) | -1.397–0.985 | 0.734 |
| Recent quitters are still vulnerable to relapse, especially in the first three to six months after quitting. | 412 (93.2) | 428 (96.8) | 0.007–0.066 | 0.016 |
| Motivational interviewing is… | 233 (52.8) | 394 (89.3) | 0.311–0.419 | <0.001 |
| The goal of motivational interviewing is not necessarily to get the patients to change but rather to get the patient talking and thinking about changing their smoking behavior. | 353 (80.0) | 436 (98.6) | 0.150–0.226 | <0.001 |
| Motivational interviewing techniques clinicians should use, include… | 358 (81.0) | 431 (97.5) | 0.127–0.203 | <0.001 |
| Developing discrepancy between a patient’s current behavior and expressed priorities, values and goals is a strategy used as part of motivational interviewing. This can be done by… | 180 (40.7) | 344 (77.8) | 0.117–0.199 | <0.001 |
| Pharmacotherapy Module 5 | ||||
| Are nicotine replacement therapies contraindicated for people with cardiovascular disease? | 318 (72.6) | 426 (97.3) | 0.203–0.290 | <0.001 |
| Is it safe to continue to smoke while using nicotine replacement therapy? | 201 (45.7) | 427 (97.0) | 0.464–0.563 | <0.001 |
| Nicotine replacement therapy should only be used for a maximum of 12 weeks. | 244 (55.5) | 399 (90.7) | 0.299–0.406 | <0.001 |
| You may use any form of nicotine replacement therapy alone but they should not be used in combination. | 248 (56.5) | 431 (98.2) | 0.369–0.465 | <0.001 |
| A patient smokes 1 pack of cigarettes per day and smokes within 5 minutes of waking in the morning. What dose of NRT should he be started on? | 206 (46.8) | 342 (77.7) | 0.255–0.363 | <0.001 |
| A patient is using NRT but reports severe cravings and is concerned he/she may return to smoking. What do you recommend? | 244 (55.5) | 402 (91.4) | 0.307–0.411 | <0.001 |
| A woman using Bupropion reports a variety of side effects since beginning the medication. What do you recommend to address this issue? | 242 (55.0) | 396 (90.0) | 0.298–0.402 | <0.001 |
| Bupropion is contraindicated among… (Click all that apply) | 353 (80.2) | 427 (97.0) | 0.128–0.208 | <0.001 |
| What is the most common side effects of Varenicline? | 300 (68.5) | 425 (96.2) | 0.232–0.325 | <0.001 |
| Which of the following strategies can be used for patients who report experiencing nausea while using Varenicline? | 229 (52.0) | 378 (85.9) | 0.280–0.397 | <0.001 |
| Patients using Varenicline should be advised to quit smoking how many weeks after using the treatment? | 22 (50.9) | 339 (77.0) | 0.206–0.317 | <0.001 |
| For patients using Varenicline who experience vivid dreams it can be recommended that they… | 333 (75.9) | 428 (97.5) | 0.175–0.258 | <0.001 |
| It is safe to use Varenicline for 6-month period or longer? | 247 (56.3) | 371 (84.5) | 0.225–0.340 | <0.001 |
| Which are the most effective medications in terms of increasing success rates | 355 (80.7) | 433 (98.4) | 0.139–0.216 | <0.001 |
a
Multiple choice questions.
*
95% confidence interval of difference between pre- and post-assessments.
**
McNemar-Bowker test.