Utilizing Cases in Pharmacogenetics Education of Undergraduate Medical Students

Abstract

Pharmacogenetics should have an integral role in undergraduate medical education as personalized medicine is the end goal of treating individual patients effectively. Increasingly, practitioners are being asked to incorporate patient genotypes when considering therapy options, including drug choice and dosing, particularly for drugs that exhibit significant morbidity in patients with a specific genotype. To improve student comprehension of the interplay between pharmacology and genetics, we sought to expose first‐year medical students to the core concepts and practice of pharmacogenetics through a case‐based discussion (CBD) within their pharmacology course.The CBD included a short, pre‐recorded lecture (~13 min) on the pharmacogenetics of warfarin, as preparatory material. During the session, 3 mini‐cases with different indications for warfarin therapy were presented. Students in small groups answered questions related to the patient's warfarin sensitivity, bleeding/clotting risk, warfarin dose optimization and patient counseling issues. After working through the cases in groups, answers were elicited using voting cards, and students were asked to defend their answers in the large group setting. Anonymous pre and post session surveys were administered to determine student satisfaction and understanding of pharmacogenetics concepts. The session's effectiveness at improving students' knowledge in pharmacogenetics was assessed in the end of course final exam. Survey results indicated that 80% of students listened to the pre‐recorded lecture. 20% of students agreed that prior to the pharmacogenetics activity, they had not previously considered that genotypes could play a role in drug metabolism and response. 90% of students agreed or strongly agreed that the CBD increased their awareness of how different genotypes may affect drug metabolism and response and 92% of students agreed or strongly agreed that the CBD increased their awareness of the fact that drug response is due both to drugs acting on target proteins as well as drugs being metabolized and/or excreted by the body. 98% of the students agreed or strongly agreed that this CBD was effective at integrating and applying pharmacogenetics to clinical presentations and 93% agreed or strongly agreed this session increased their level of confidence to be able to anticipate and discuss how pharmacogenetics can be used in clinical care and drug prescriptions.The CBD was well‐received, and informal polling of voting responses revealed that the majority of groups came to the correct answers during the CBD. The clinical relevance and interactive nature of the exercise resulted in excellent student engagement and satisfaction. Students' high performance on pharmacogenetics exam questions (mean of 81%) revealed a clear grasp of the pharmacogenetics concepts taught in the course. We believe that the combination of the presession recording followed by the student discussion of disparate cases of warfarin treatment were responsible for student comprehension.Support or Funding InformationThis study was not supported by a grant and has been approved by FIU IRB.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.