1. Conceptual Basis for Integrated Curriculum: Marianne N. Prout PACE (Prevention and Cessation Education)

2. Questions to ask about integrating curriculum  Why?  What?  When?  Content  Venues  Teaching methods

3. Why integrate tobacco control curriculum?  Tobacco control should be part of basic skills of ALL medical students  Core courses are venues for basic skills  Tobacco “tie ins” emphasize the diffuse impact of tobacco on anatomy, physiology, pathology, pharmacology, adult and pediatric medicine, ob-gyn, etc.

4. What is the conceptual framework for integrating tobacco control?  Connect with other chronic disease prevention issues  Teach with motivational interviewing skills  Include with addiction counseling  Pharmacologic approaches  Family systems

5. When can tobacco curriculum be integrated?  Layered, sequential learning…the onion  Acquisition of knowledge and skills early in medical school and reinforcement of skills at every opportunity  Clerkships to emphasize practice-based teaching so that tobacco control becomes routine for every student

6. How to assure all content is included  Carefully define learning objectives and specific content that needs to be covered  Determine the teaching time (in minutes!) required for specific objectives  Remember that redundancy will be quickly criticized by medical students

7. How to find venues for teaching tobacco control  Decide the timing in medical school most appropriate for the learning objectives…preclinical/clinical  Identify specific courses and instructors for learning objectives  Give something to get some teaching time…clinical correlations for anatomy, case materials for problem-based learning, guest lectures in specific courses

8. Teaching methods for integrated tobacco control  Lectures  Adding tobacco to cases…adults, pediatrics, and families  Tobacco as example in teaching material, e.g. in epidemiology, addiction  Skills development sessions/standardized patients  Clinical rotations…preceptor requirements

9. Pragmatic Reasons for integrated tobacco control curriculum  Offer to teach in existing courses: a valued favor  Time for new coursework: priceless

10. Limitations of integrated curriculum  Quality control of teaching…especially during clinical rotations  Focus may shift, requires constant supervision and attention

11. Lessons learned on integrating curriculum  Longstanding relationships improve feasibility  Advisory Committee provides critical allies To set standards for teaching and practice To identify and insert teaching into venues