Background
Despite the unique health and epidemiological aspects of smokeless tobacco use, medical education regarding this topic is virtually lacking.
Methods
Using a National Cancer Institute cancer education grant, we have developed a model curriculum for medical schools that includes specific instruction in basic and clinical sciences as they relate to both smoked and smokeless tobacco. The curriculum was informed by a thorough review of the literature and includes eight modules in basic and clinical sciences that are evaluated by pre-test/post-test increases in knowledge as well as standardized patient encounters and process evaluation. We report preliminary data analysis.
Results
Pre-test/posttest data indicate that students increased knowledge on specific smokeless tobacco questions (e.g, correct answers on prevalence of smokeless, nicotine dosage in smokeless tobacco, cancer risk, and carcinogen components; all increased at p<0.001) Students also scored well on interactions with standardized patients using the Tobacco Intervention Risk Factor Interview Scale, a validated instrument to assess medical students’ tobacco counseling skills. Process evaluation data indicate that modules were generally well received.
Conclusion
This Web-based, comprehensive curriculum—the only curriculum we are aware of treating the topic of smokeless tobacco use—appears to be effective and well-received. Medical education must devote more attention to instruction in smokeless tobacco use, given its adverse health effects including cancer and cardiovascular disease.
possessed by the employee. This concept implies an understanding of "jobs for the eyes" and "eyes for specific jobs." Placement of employees with the application of this concept is not universal. If our contemplated program can be developed and adopted, we believe that there will be not only an increase in production efficiency but also an improvement in the health, contentment and happiness of employees. 5. Health Factors and Vision.-The state of one's general health directly affects visual health and efficiency and, vice versa, visual health has a direct influence on general health. Space and time do not allow of further elaboration of this statement. It is made here to call attention to the intimate connection between vision and health. Also there are problems of housing, recreation, domestic relations and nutrition which have a bearing on health and which need further consideration. At the present time .much investigation is being made to discover the influence that vitamins may have on general health and particularly on visual efficiency, but no satisfactory conclusion has been arrived at.6. The Program.-To carry out a satisfactory program of testing, examining and correcting of visual defects, there must be complete coordination of activities between management, employees, medical departments, ophthalmologists and opticians. When the value of a completely coordinated program is comprehended, the desired cooperation between all interested parties will not be difficult to secure.
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