Evaluating the longitudinal effectiveness of a smoking cessation counselling course based on the 5A model for medical students in family medicine placement.

Background: Preparing students for their future roles in preventive medicine is relevant, especially on the subject of nicotine consumption. We implemented a longitudinal smoking cessation counselling course as a part of the subject "prevention and health promotion". Beginning with 6^th semester students were taught the 5A model, a widely used framework to support behavioural change. Four semesters later, we evaluated feasibility of the counselling in the family medicine placement.

Methods: In this evaluative follow-up study, we used online questionnaires with Likert-scales, closed and open questions. Students of the 10^th semester assessed feasibility and obstacles of counselling during placement in a family practice with real patients, their counselling confidence and professional attitudes. For examination of changes since 6^th semester we compared matched data. Data were analysed with t-tests and ANOVAs.

Results: Data of 114 students of the 10^th semester were analysed, 45 data could be matched to the 6^th semester. Results showed that the intervention was feasible under favourable conditions: half of the students did not perform a counselling because of lack of time or opportunity. Performing the counselling during the placement led to a greater increase in felt counselling competences compared to students who did not perform a counselling.

Conclusion: To improve communicative skills in the area of behavioural change, it is important to combine theoretical content and practical implementation. The 5A model has proven due to its simplicity. Promoting good framework conditions in family medicine, such as sufficient time, is essential to give students the opportunity to practice counselling and increase their felt competence.