Technological and therapeutic advances have generated an unprecedented infusion of genomic information into clinical practice, further fueling the need for a skilled workforce to navigate genomically-informed patient care. Recent national surveys document the continued gap between the need for, and availability of, skilled genomic cancer risk assessment (GCRA) clinicians. This R25 proposal is to continue the mission of the Clinical Cancer Genomics and Community of Practice (CCGCoP) to help address the growing demand for clinicians competent in evidence-based cancer genomics care. The CCGCoP uses the theoretical framework of situated learning, the resources and expertise of the academic cancer center, and a distinguished faculty of widely-recognized thought leaders to deliver a multimodal inter-professional course in GCRA to clinicians practicing in diverse communities with limited access to GCRA services. In the current project period we fully developed web-based GCRA case conferencing as the central source of case-based skills development for the course and converted the course delivery to a two-track model (full spectrum with face-to-face workshops, and full spectrum content via distance only), which enabled us to exceed projected scaled up accrual, while ensuring that all participants would receive content covering the full spectrum of cancer genetics syndromes. During the current project period, 411 clinicians from diverse practice settings have completed the course or are currently in session; 19% were underrepresented minorities (14% Hispanic, 5% African American) and 10% were Asian; 54% (223) provide clinical services to socio-economically underserved patient populations, and 12% (50) practice in low/middle income countries. Full accrual, with a strong evaluation component documenting significant gains in knowledge, skills and practice change, further support the efficacy of the CCGCoP as a powerful educational resource to help clinicians understand, interpret and integrate complex genomic information into patient care. Comparable gains by participants in both course tracks supports the potential to further increase capacity and reach of the CCGCoP through distance-only course implementation, assuming additional efficiencies in our learning management platforms. With R25 support, the CCGCoP has attained international recognition as a standard-bearer in GCRA professional education, facilitating improved patient access to GCRA services. The CCGCoP alumni represent a uniquely qualified community of clinicians across all 50 states and 27 countries. The proposal aims are: 1) Continue the established CCGCoP intensive course; 2) Review and update course curriculum, and map content to inter-professional GCRA competencies; 3) Evolve the collaborative learning portal and add additional academic GCRA case conference forums; 4) Update course assessment instruments and develop new competencies-based diagnostics to assess learning and impact on patient-centered outcomes. The CCGCoP initiative leverages the promise of genomic discovery to reduce the impact of hereditary cancers through professional learning that promotes quality care.
To help address the significant global demand for cancer genomics education, skills development and evidence-based patient care, this project proposes to continue a successful, 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, Dana Farber Cancer Institute and University of North Carolina to deliver flexible, accessible genetic cancer risk assessment skills development and practice centered 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.
|West, Allison H; Blazer, Kathleen R; Stoll, Jessica et al. (2018) Clinical interpretation of pathogenic ATM and CHEK2 variants on multigene panel tests: navigating moderate risk. Fam Cancer 17:495-505|
|Rebbeck, Timothy R (see original citation for additional authors) (2018) Mutational spectrum in a worldwide study of 29,700 families with BRCA1 or BRCA2 mutations. Hum Mutat 39:593-620|
|Chavarri-Guerra, Yanin; Blazer, Kathleen Reilly; Weitzel, Jeffrey Nelson (2017) Genetic Cancer Risk Assessment for Breast Cancer in Latin America. Rev Invest Clin 69:94-102|
|Komenaka, Ian K; Nodora, Jesse N; Madlensky, Lisa et al. (2016) Participation of low-income women in genetic cancer risk assessment and BRCA 1/2 testing: the experience of a safety-net institution. J Community Genet 7:177-83|
|Blazer, Kathleen R; Slavin, Thomas; Weitzel, Jeffrey N (2016) Increased Reach of Genetic Cancer Risk Assessment as a Tool for Precision Management of Hereditary Breast Cancer. JAMA Oncol 2:723-4|
|Slavin, Thomas P; Blazer, Kathleen R; Weitzel, Jeffrey N (2016) When Clinical Care Depends on the Answer: The Challenges of Assessing Germline Cancer Gene Variants. J Clin Oncol 34:4061-4063|
|Blazer, Kathleen R; Nehoray, Bita; Solomon, Ilana et al. (2015) Next-Generation Testing for Cancer Risk: Perceptions, Experiences, and Needs Among Early Adopters in Community Healthcare Settings. Genet Test Mol Biomarkers 19:657-65|
|Slavin, Thomas Paul; Niell-Swiller, Mariana; Solomon, Ilana et al. (2015) Clinical Application of Multigene Panels: Challenges of Next-Generation Counseling and Cancer Risk Management. Front Oncol 5:208|