A substantial literature, including many ELSI-funded projects, indicates that currently the health care system has only a fraction of the needed clinicians experienced in delivery of genetic services. Most primary care clinicians are unprepared both in the science of clinical genetics and in the genetic counseling skills that are so important to the patients who are increasingly forced to make difficult decisions. This project will develop, produce, disseminate and evaluate a one-hour educational videotape for primary care clinicians (physicians, nurses, others) on the clinically relevant science and counseling skills needed to provide accurate and sensitive clinical genetic services. Specific goals are to: 1) Provide basic scientific information about genetic medicine 2) Increase awareness of how patients understand and use probabilistic information 3) Motivate clinicians to make attitudinal and behavioral adjustments required by the psychosocial complexity of genetic medicine 4) Provide specific clinical techniques for patient decision-support 5) Serve as a catalyst for the development of ethical, legal and clinical standards in genetic services. Based on health education research and theory, the educational approach will use techniques empirically shown to be effective in promoting dissemination of complex information and creating change in clinical practice based on skill acquisition. Specific cases will be presented through interviews with clinicians and their patients, interspersed with round table discussion by a multi-disciplinary panel of experts about generalizable principles and specific, applicable clinical approaches. The program will be developed with substantial input from this multi-disciplinary panel and disseminated by cable broadcast, hospital satellite hook up, continuing medical education (CME)/ continuing education (CE) courses, professional association meetings, and videocassette distribution. It will be accompanied by a printed viewer's guide to facilitate further self directed or group education.
