Rapidly evolving genetic/genomic technologies have revolutionized our approach to genetic cancer risk assessment (GCRA), screening, prevention and targeted cancer therapies, heralding the era of personalized medicine. Clinical testing is available for many hereditary cancer genes, and technologies are bringing whole exomes within reach. GCRA, an interdisciplinary practice, uses genetic/genomic tools and empiric risk models to identify high-risk individuals. Direct-to-consumer marketing has accelerated the demand for GCRA services from community-based clinicians, who are often inadequately prepared to select, apply and interpret genetic tests. An intensive GCRA training course was conducted to promote practitioner-level competence. The multimodal course included distance mediated didactics and face-to-face workshops, and enabled piloting of post-course professional development activities. There were significant pre-to-post increases among participants in GCRA knowledge, skills and professional self-efficacy (p<.001). Interestingly, some alumni continued to participate in professional development after fulfilling course requirements. Demand for the course [across the U.S. and internationally] exceeded capacity several-fold. These experiences and ongoing inquiries indicate a need to make GCRA training more accessible globally, and the curriculum needs to address clinical translation of new genomics. Action research identified the face-to-face component as a capacity barrier, and endorsed creation of all-distance and specialty GCRA training tracks. Comparative analysis indicated that a CME-accredited GCRA web conference series might provide effective case-based GCRA training. This project proposes the development of an innovative global Clinical Cancer Genetics Community of Practice (CCGCoP) to help address the demand for cancer genetics/genomics training and evidence-based patient care. Working from the theoretical framework of situated learning, the proposed project leverages the resources and expertise of the City of Hope, University of Chicago and U.S. Oncology Network to accomplish the following aims: Develop web-based tools, activities and collaborations to support the CCGCoP learning environment; enlist international thought leaders to create a new curriculum that includes rapidly-evolving cancer genetics/genomics content [and addresses domestic and global access issues]; develop full spectrum and all- distance subspecialty tracks as training options, and support integration of newly-trained participants into the CCGCoP through continuing professional development activities that promote GCRA skills development and evidence-based practice. The innovative design and evaluation plan encompasses longitudinal assessments of skills, practice change and patient outcomes, aligned with reformed standards of excellence in CME accountability. The ultimate goal of the CCGCoP is to increase the number of clinicians who are able to translate advances in genetics/genomics into personalized medicine globally.

Public Health Relevance

To help address the significant global demand for cancer genetics and genomics education, training and evidence-based patient care, this project proposes the development of a novel, multifaceted global Clinical Cancer Genetics Community of Practice. The project works from the theoretical framework of situated learning and leverages the combined resources, expertise and professional networks of the City of Hope, University of Chicago, and U.S. Oncology to deliver flexible, accessible genetic cancer risk assessment training and professional development support for community-based clinicians. The ultimate goal is to help realize the promise of personalized medicine by promoting best practices in the delivery of genetic cancer risk assessment services in the United States and internationally.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Education Projects (R25)
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Subcommittee I - Transistion to Independence (NCI)
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Korczak, Jeannette F
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Beckman Research Institute/City of Hope
United States
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