Genomics education for medical specialists: case-based specialty workshops and blended learning

Abstract

Aim: To develop and evaluate genomics education programs for health professionals to expedite the translation of genomics into healthcare.

Methods: Our co-design team of genetic specialists, expert medical specialist peers, and genomics educators developed two continuing genomics education programs for health professionals: stand-alone, specialty-specific workshops and a generic blended learning course, combining online learning with workshops. Both programs referenced adult learning theories; workshops included case-based learning and expert peer-led discussion. Longitudinal surveys evaluated changes in confidence and understanding of genomic testing processes and clinical practice.

Results: We delivered eleven specialty workshops (414 attendees) and a blended learning course comprising four self-directed online modules (61 users) and workshops (71 attendees) for mixed-specialty groups with adult, pediatric, or oncology cases. Surveys (214 workshops; 63 blended) showed that both programs significantly increased confidence and understanding of genomic testing processes. Blended learning participants showed additional gains in confidence after attending a workshop following online learning. Workshop discussions with experts were valued, particularly regarding interpreting and applying results. At follow-up, gains in confidence and understanding were maintained for both programs and 81% of respondents had performed a new genomics activity in clinical practice.

Conclusion: Scalable education is needed. Our results suggest that specialty-specific genomics education may not be required to meet the needs of multiple specialties across a health system. Online learning can meet foundational learning needs but may not be sufficient to apply learning to practice. Blended learning offers flexible, continuing education pathways for dispersed national audiences as genomics becomes increasingly used across varied specialties.

Keywords

Workforce / genomic medicine / physician / continuing education / professional development / evaluation / case-based learning / blended learning

References

[1] ManolioTA,Al-MullaF.Global implementation of genomic medicine: we are not alone.Sci Transl Med2015;7:290ps13 PMCID:PMC4898888

[2] DoughertyMJ,JohansenTaber KA.Challenges and opportunities for genomics education: insights from an institute of medicine roundtable activity.J Contin Educ Health Prof2016;36:82-5

[3] MartynM,LynchE. Theories and models for genomics education and training. In Genomic medicine skills and competencies, Kumar D, editor. London, UK: Elsevier; 2022. pp. 1-13.

[4] HylandK,DasguptaS.From helices to health: undergraduate medical education in genetics and genomics.Per Med2019;16:211-20

[5] Human Genetics Society of Australasia. Core Capabilities in genetics & genomics for medical graduates. 2022. Available from: https://www.hgsa.org.au/Web/Web/Consumer-resources/Policies-Position-Statements.aspx?hkey=c2f311f1-5dc0-4c89-805b-39a4430ddc30 [Last accessed on 23 May 2023]

[6] McClarenBJ,JaninskiM.Preparing medical specialists for genomic medicine: continuing education should include opportunities for experiential learning.Front Genet2020;11:151 PMCID:PMC7063730

[7] PanequeM,JacksonL,HouwinkE.A systematic review of interventions to provide genetics education for primary care.BMC Fam Pract2016;17:89 PMCID:PMC4957387

[8] TalwarD,FosterM,ChenLS.Genetics/genomics education for nongenetic health professionals: a systematic literature review.Genet Med2017;19:725-32

[9] Australian Institute of Health and Welfare. Australia’s health 2018, in Australia’s Health Series. Canberra: Australian Institute of Health and Welfare; 2018.

[10] GaffC,ForrestS.Preparing for genomic medicine: a real world demonstration of health system change.NPJ Genom Med2017;2:16 PMCID:PMC5677913

[11] TaylorN,MartynM.A transformative translational change programme to introduce genomics into healthcare: a complexity and implementation science study protocol.BMJ Open2019;9:e024681 PMCID:PMC6429849

[12] BrettGR,CreedET.Genetic counseling in the era of genomics: what’s all the fuss about?.J Genet Couns2018;27:1010-21

[13] MartynM,JaninskiM,CunninghamF.“It’s something I’ve committed to longer term”: the impact of an immersion program for physicians on adoption of genomic medicine.Patient Educ Couns2021;104:480-8

[14] GreenhalghT,MacfarlaneF,KyriakidouO.Diffusion of innovations in service organizations: systematic review and recommendations.Milbank Q2004;82:581-629 PMCID:PMC2690184

[15] BishopM,McPhersonA,SutherlandS.Genomic education at scale: the benefits of massive open online courses for the healthcare workforce.Front Genet2019;10:1094 PMCID:PMC6863921

[16] TaylorDC.Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83.Med Teach2013;35:e1561-72

[17] McLeanSF.Case-based learning and its application in medical and health-care fields: a review of worldwide literature.J Med Educ Curric Dev2016;3:S20377 PMCID:PMC5736264

[18] CrellinE,NisselleA,GaffC.Preparing medical specialists to practice genomic medicine: education an essential part of a broader strategy.Front Genet2019;10:789 PMCID:PMC6749815

[19] NisselleA,McClarenB,MetcalfeS.Australian Genomics Workforce & Education Working GroupMeasuring physician practice, preparedness and preferences for genomic medicine: a national survey.BMJ Open2021;11:e044408 PMCID:PMC8273463

[20] SandersEB.Co-creation and the new landscapes of design.CoDesign2008;4:5-18

[21] ShannonS.Facilitating learning groups in CME.Lancet2004;363:826

[22] HarrisPA,ThielkeR,GonzalezN.Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform2009;42:377-81 PMCID:PMC2700030

[23] StataCorp. Stata statistical software. College Station, TX: StataCorp LLC; 2019.

[24] PattonMQ. Qualitative research & evaluation methods: integrating theory and practice. Thousand Oaks, CA: SAGE Publications; 2014.

[25] ReedEK,IngramNissen T.What works in genomics education: outcomes of an evidenced-based instructional model for community-based physicians.Genet Med2016;18:737-45

[26] HouwinkEJ,vanTeeffelen SR.Effect of comprehensive oncogenetics training interventions for general practitioners, evaluated at multiple performance levels.PLoS One2015;10:e0122648 PMCID:PMC4383330

[27] JaninskiM,NisselleA. Perspectives of education providers on education & training needs of non-genomic health professionals. Melbourne: Australian Genomics; 2018.

[28] HajekC,GalbraithLN.Improved provider preparedness through an 8-part genetics and genomic education program.Genet Med2022;24:214-24 PMCID:PMC9121992

[29] EastKM,KelleyWV.Education and training of non-genetics providers on the return of genome sequencing results in a NICU setting.J Pers Med2022;12:405 PMCID:PMC8949881

[30] ChenLS,StelzigD.Development and evaluation of a genomics training program for community health workers in Texas.Genet Med2018;20:1030-7

[31] GaffCL,FlourisA.A model for the development of genetics education programs for health professionals.Genet Med2007;9:451-7

[32] JacksonL,PanequeM.The gen-equip project: evaluation and impact of genetics e-learning resources for primary care in six European languages.Genet Med2019;21:718-26 PMCID:PMC6752302

[33] LocockL,ChambersD.Understanding the role of opinion leaders in improving clinical effectiveness.Soc Sci Med2001;53:745-57

[34] RogersEM. Diffusion of innovations. Great Britain: Free Press; 2003.

[35] Genomic literacy, education, and engagement (GLEE) Initiative 2017 strategic visioning meeting. Available from: www.genome.gov/Pages/About/OD/ECIB/GLEE/GLEE_white_paper_ProviderEducation.pdf [Last accessed on 23 May 2023].

[36] NisselleA,JordanH.Ensuring best practice in genomic education and evaluation: a program logic approach.Front Genet2019;10:1057 PMCID:PMC6857516

[37] CornelMC.Evidence-based genetic education of non-genetic-expert physicians: experiences over three decades in amsterdam.Front Genet2019;10:712 PMCID:PMC6687771

[38] GleesonM,MeiserB.The development and evaluation of a nationwide training program for oncology health professionals in the provision of genetic testing for ovarian cancer patients.Gynecol Oncol2020;158:431-9

[39] CarrollJC,SemotiukK.Hereditary colorectal cancer screening: a 10-year longitudinal cohort study following an educational intervention.Prev Med Rep2020;20:101189 PMCID:PMC7581973

[40] Michaelson-CohenR,Sukenik-HalevyR.Teaching clinicians practical genomic medicine: 7 years’ experience in a tertiary care center.Genet Med2020;22:1703-9

[41] EmeryJ,GoodchildR.The GRAIDS trial: a cluster randomised controlled trial of computer decision support for the management of familial cancer risk in primary care.Br J Cancer2007;97:486-93 PMCID:PMC2360348

[42] WilsonBJ,MollisonJ.Cluster randomized trial of a multifaceted primary care decision-support intervention for inherited breast cancer risk.Fam Pract2006;23:537-44

[43] CarrollJC,AllansonJ.GenetiKit: a randomized controlled trial to enhance delivery of genetics services by family physicians.Fam Pract2011;28:615-23

[44] HouwinkEJ,MuijtjensAM.Sustained effects of online genetics education: a randomized controlled trial on oncogenetics.Eur J Hum Genet2014;22:310-6 PMCID:PMC3925286

[45] NisselleA,MartynM.Ensuring best practice in genomics education and evaluation: reporting item standards for education and its evaluation in genomics (RISE2 Genomics).Genet Med2021;23:1356-65