Primary care physicians have almost no training in genetics, nor in the ethical, legal and social implications (ELSI) of genetic testing, diagnosis and therapy. Further, mere provision of curricular content fails to impact physician behavior. However, programs with elements that are based on established educational and adult learning principles have been shown to effective in affecting behavioral change. We propose to evaluate whether participation in a web-based curriculum focusing on the ethical legal and social issues in primary care genetics will improve primary care physicians'approach to genetic issues. Specifically, we will assess whether participation will improve physician knowledge, attitudes, and practice-behaviors. We will recruit 120 PCPs across five health systems in California (UC Davis, Rural Health Network, UC Los Angeles, Kaiser Permanente, Sutter Medical Group Sacramento). PCPs will be randomized by practice site to control (paper curriculum) or active intervention with an interactive web-based curriculum previously developed with funding from the NHRGI. This curriculum utilizes visual tools, video clip vignettes, and other interactive content to illustrate key points about risk assessment, genetic screening, and SDM. PCPs encounters with Announced Standardized Patients Learning objectives will be used to assess PCP's ELSI related behavioral change. Evaluation will also include the effectiveness of the curriculum for genetic knowledge (testing of knowledge), skills (self-report, follow-through with learning plan), and attitudes (survey and self-efficacy assessments). If proven effective, these web-based tools can be easily disseminated around the country, and internationally, to improve knowledge and attitudes about genetic screening among physicians and patients.
Most primary care physicians have almost no training in genetics, nor in the ethical, legal and social implications (ELSI) of genetic testing, diagnosis and therapy. This project evaluates a novel web-based curriculum focusing on the ethical legal and social issues in primary care genetics in order to improve primary care physicians'understanding of the implications of genetic disorders in patients'lives. If proven effective, these web-based tools can be easily disseminated to improve physician's knowledge of the social context of genetics and improve their ability to engage in shared decision-making with patients about genetic screening.
|Wilkes, Michael S; Day, Frank C; Fancher, Tonya L et al. (2017) Increasing confidence and changing behaviors in primary care providers engaged in genetic counselling. BMC Med Educ 17:163|
|Bell, Robert A; McDermott, Haley; Fancher, Tonya L et al. (2015) Impact of a randomized controlled educational trial to improve physician practice behaviors around screening for inherited breast cancer. J Gen Intern Med 30:334-41|