Counseling to reduce road injuries and deaths

OBJECTIVE To study undergraduate learning of and current clinical practice on counseling to reduce road injuries and deaths. DESIGN Questionnaire on high-risk clinical scenarios. SETTING Canadian medical schools, one family medicine program, and a Toronto trauma centre. PARTICIPANTS Three groups: 338 final-year medical students from 12 Canadian universities; 183 family practice teachers from the Ontario-wide University of Toronto teaching network, and 45 trauma-team members from a Toronto regional trauma centre. MAIN OUTCOME MEASURES All health promotion items identified hy students as relevant to the clinical scenarios presented to them were tabulated to identify general knowledge of health promotion counseling and specific knowledge of road trauma prevention. The trauma-related counseling practices of family practice teachers were tabulated from their responses to one of the student scenarios. The same process tabulated the counseling that trauma-team members would expect family physicians to do in busy practices. RESULTS Students' knowledge about health promotion counseling sas generally good, except for road trauma prevention where counseling is seldom done unless heavily prompted. Family practice: teacher responses indicated that approximately 15% have not accepted road trauma counseling as part of clinical practice. Trauma-team members ranked trauma prevention items similarly to family practice teachers. but had higher expectations for performance. The neck is the most commonly injured site, but no group identified headrest adjustment as important. CONCLUSIONS Counseling to prevent road trauma is deficient both in practice and teaching.