ICM 1: Nutrition & Health Promotion

Smoking Cessation Counseling Skills Lab

StudentTasks:

first,identifythereasonforthepatientsvisit,andbrieflyobtainandintervalmedical
history,recenthealthissues,orotherfollowupinformationsincethepatientslastvisit;
thisshouldonlytakeafewmoments,andshouldnotbecomethefocusofdiscussion.

identifyaconnectionbetweenthepatientspresentingconcernandtheirtobaccouse
(somepatientsmaypresentspecificallyforsmokingcessationcounseling,othersmay
not),andindicatetothepatientthatyouwanttofocusontheirtobaccousefortodays
visit

obtaininformationregardingtheirtobaccousehistory,priorquitattempts,andbarriersto
smokingcessation
obtainsufficientinformation,accordingtothechecklist,todeterminetheirstageof
readinesstochangeforsmokingcessation
basedontheirstageofreadinesstochange,provideadditionalappropriatecounseling
stepsasdescribedinthechecklistbelow
forpatientsintheactionstage,brieflydescribeappropriatestepsincludinguseof
pharmacologicagentssuchasnicotinereplacementormedicationstoreducecravings;
fulldosingrecommendationsetc.arenotexpectedatthispoint

whenyouaredone,writeyourprogressnoteintothechartusingatypicalSOAPformat,
usingtheblankProgressNotedocumentprovided
usethechecklistdocumentasaguide,butdontuseitasyourprogressnote
makesuretodocumenttherelevantdetailsofthepatientssmokinghistory,quit
attempts,stageofchange,andplantoeitherpursuequittingorrecognizebarriers,impact
ofsmoking,etc.
completethepostsessionemailassignmenttosendyourpatientanotewithsimple
followuporencouragementfortheirplantoaddresstobaccouseorsmokingcessation

Evaluation
Evaluationitemsforthissessionwillincludethefollowing:

attendance&completionoftheLSPinterview

gradedhistorytakingandcommunicationschecklistbyLSP;willbereviewedwith
studentaftertheSPinterview
Eachcommunicationskillitemisgradedasdone(correctlyorwell),improve(done,but
needstobeimprovedinfuturelabs),ornotdone(atall).
Ofthe10possiblepointsforthislab,5pointsaregivenforattendanceandcompletionofthe
skillslab;5pointsareearnedbydemonstratinggoodcommunicationskills.ICM/SPPstaffwill
addthenumberofdone(correctly)items(upto15),anddividethisby3todeterminethe
communicationpointsearned.StudentsshouldworkwiththeirSPtoimprovetheother
communicationskillsinsubsequentlabs.
Overallpointsforthissession:
Item

Points

ICM 1: Nutrition & Health Promotion

Smoking Cessation Counseling Skills Lab
CompletionofSPinterviewandSOAPnote
5
Communicationsskills
upto5points
Total
upto10pointstotalforSPlab
PatientInteraction&GeneralCommunicationSkills
Note:SeeCommunicationSkillsandPerformanceCriteriadocument.
CommunicationSkillItem
1.
greetthepatient,acknowledgeprior
contactorvisits
2.
demonstratefamiliaritywithpatients
medicaland/orsocialhistory
3.
demonstratethatyouhavereviewed
currentandpriorchartinformation
4.
useopenendedquestions
appropriately*
5.
onlyrepeatquestionstoclarifyor
confirm*
6.
asksinglequestionsandallowtimeto
answer*
7.
usenonverbalcommunicationskills
(e.g.eyecontact)toshowattentionisonpatient*
8.
usefacilitationquestions,e.g.tellme
more
9.
avoidorexplainmedicaljargon*
10.
demonstrateempathyandsensitivity
forthepatientsconcerns*
11.
organizepatientinterview
appropriately*
12.
pacepatientinterviewappropriately*
13.
usetransitionstatementsinpatient
interview*
14.
focusattentiononpatient,notchartor
notes
15.
noothercommunicationconcerns

Done

Improve

NotDone

Chiefcomplaint:
16. _____ askopenendedquestionsuchasWhatbringsyou
heretoday?HowcanIhelpyou?etc.
17. _____ facilitationaskasecondopenendedquestionsuch
asCanyoutellmeaboutyour
Interval Medical History
18. _____
19. _____
20. _____
21. _____

askaboutanyupdateinhealthstatus,recenthealthevents,etc.
askaboutanyrecenthospitalizations,ERvisits
askaboutanychangetomedications(ifany)includinganynew
medications
askaboutanyproblemswithcurrentmedications(ifany)

ICM 1: Nutrition & Health Promotion

Smoking Cessation Counseling Skills Lab
22. _____

23. _____
Checklistcontinuesbelow.

askaboutanychangeinjob,socialsituation,orfamilyhealth
statuswhateverisrelevanttopatientssituation(e.g.Areyou
stillworkingat,Howisyourmotherdoingwithherhealth
problems,etc.)
askaboutanychangeinsmokingstatus,alcoholuse,dietary
factors,etc.whicheverisrelevanttopatientssituation

ICM 1: Nutrition & Health Promotion

Smoking Cessation Counseling Skills Lab
Studentshouldperformthefollowinghistorytakingandcounselingstepscorrectly,buttheyneednot
performallstepsineverypatientshouldfocusonstepsgermanetopatientsreadinesstoquitnotall
questionswillapplytoeverypatient
Clarifiessmokinghistoryandlevelofaddiction:
25.
_____asksnumberofcigarettes(orpacks)perday
26.
_____askstimeoffirstcigaretteoftheday
27.
_____askshowlongpatienthassmoked
28.
_____asksabouturgetosmokewhereprohibited
29.
_____identifiessymptomsofwithdrawal
Discussespriorquitattempts&barrierstoquitting:
30.
_____askspatientiftheywanttostopsmoking
31.
_____identifiespreviousquitattempts
32.
_____identifieswhypreviousquitattemptshavefailed
33.
_____asksabout(anticipates)problemsthepatientwillhavewithquitting
34.
_____asksaboutsituationswherefailure(i.e.smoking)likelytooccur
35.
_____problemsolvesfordenial(e.g.parentssmokeduntildeathatage90)
Advisesonneedtoquit,describeshealthimpact:
(mostimportantforprecontemplationorcontemplationphase)
36.
_____advisescessationinclearandunequivocalmanner
37.
_____discussescontinuedhealthrisksfromjustcuttingback
38.
_____askspatienttoidentifyadverseeffectsofsmokingthatapplytothem
39.
_____personalizesadvicebydescribingharmsfromsmokinggermanetothepatient,e.g.:

statingtheharmfuleffectsofpassivesmoketosignificantothers

emphasizingincreasedcardiovascularrisk

indicatingthatpatientcanstillbenefitfromquittingdespitelungdamage
40.
_____discussesthefinancialcosttothepatientoftobaccouse
Providesgeneralinformationorsupportregardingquittingprocess:
(mostimportantforpreparationoractionphases)
41.
_____explainsnormalwithdrawalprocessandsymptoms
42.
_____tellspatient510lbweightgainnormal,addressesmeanstomitigateweightgain
43.
_____problemsolvesforfatalism(IguessIlltrybutIdontthinkitwillwork)
44.
_____helpspatientidentifypreparationsteps,whytheyaremotivatedtochange,etc.
45.
_____asksifpatientwillingtomakequitattempt
Discussescessationmethods&management:
(mostimportantforactionphase)
46.
_____acknowledgesandsupportspatientseffort
47.
_____helpspatientsetaquitdate
48.
_____advisespatienttothrowalltobaccoproductsaway
49.
_____advisespatienttogetsupportfromfamilyandfriends
50.
_____advisespatientthattotalabstinenceisnecessary
51.
_____discussestheroleanduseofnicotinereplacementtherapy
52.
_____discussestheroleandpossibleuseofmedicationstoreducecravings
53.
_____providesstrategiesfordealingwithwithdrawalortheurgetosmoke

ICM 1: Nutrition & Health Promotion

Smoking Cessation Counseling Skills Lab
WrapUp
54.
_____establishesclearplanforfollowupvisit