Personalized cancer genetics training for personalized medicine: Improving community-based healthcare through a genetically literate workforce

Abstract

Purpose To assess the impact of a multi-modal interdisciplinary course in genetic cancer risk assessment (GCRA) and research collaboration for community-based clinicians. Clinicians are increasingly requested to conduct GCRA, but many are inadequately prepared to provide these services. Methods A prospective analysis of 131 participants (48 physicians, 41 advanced-practice nurses and 42 genetic counselors) from community settings across the U.S. The course was delivered in three phases: distance didactic learning, face-to-face training and 12 months of Web-based professional development activities to support integration of skills into practice. Cancer genetics knowledge, skills, professional self-efficacy and practice changes were measured at baseline, immediate- and 14-months-post course. Results Knowledge, skills and self-efficacy scores were significantly different between practice disciplines; however, post scores increased significantly overall and for each discipline (p<.001). Fourteen-month practice outcomes reflect significant increases in provision of GCRA services (p=.018), dissemination of cancer prevention information (p=.005) and high-risk screening recommendations (p=.004) to patients, patient enrollment in research (p=.013), and educational outreach about GCRA (p=.003). Conclusions Results support the efficacy of the multi-modal course as a tool to develop a genetically literate workforce. Sustained alumni participation in Web-based professional development activities has evolved into a distance-mediated Community of Practice in clinical cancer genetics, modeling the lifelong learning goals envisioned by leading CME stakeholders.

Prevalence of Hispanic BRCA1 and BRCA2 mutations among hereditary breast and ovarian cancer patients from Brazil reveals differences among Latin American populations

“…This is due primarily to the high costs for genetic testing, insufficient training of health care professionals and a paucity of clinical and laboratory personnel trained in cancer genetics. Coupled with clinical training [15], the use of a rapid and affordable mutation screening panel could be advantageous as it could be offered to a large number of patients at a low cost, depending on the proportion of mutations in a given population that are represented in the panel.…”

Effectiveness of a Web-based genomics training for health educators in Texas

“…The study's design was a pre-and posttest design. Although preand posttest design is a commonly used approach in genomics education programs for health professionals, 20,24,25 such a design is not as rigorous as a randomized controlled trial study. Because this was the first-of-its-kind training for heath educators (to the best of our knowledge), we were unsure whether we would be able to recruit sufficient numbers of health educators for the training.…”

What works in genomics education: outcomes of an evidenced-based instructional model for community-based physicians

“…Our results add to the evidence that this approach was successful. 13,14,32 In Medicine's Future, knowledge and confidence in practice skills related to risk assessment, development of a genetic testing strategy, interpretation of results, and application of results to patient care all improved significantly. These improvements were sustained over the 10-month duration of the course and, for some skills, for 6 months following the course.…”

“…Our findings are consistent with those from other education programs that show sustained improvements when the program includes substantial learnwork-learn time. 13,32 For skills in which improvements were not sustained, the low frequency of opportunities to use such skills in daily clinical routines may be an explanation. For example, determining when genetic counseling is indicated is a skill that can be practiced with nearly every patient, but the need to interpret genetic test results arises much less frequently.…”

“…5,7 Many groups have developed continuing education programs designed to address these topics. [13][14][15][16] Historically, though, much continuing medical education (CME) has been passive and didactic. 17 Programs that are grounded in evidence-based principles of adult learning and medical education have a greater impact on physician performance than programs that do not incorporate such principles.…”