Core Competencies In Genetics Research Articles

Core competencies in genetics for healthcare professionals: results from a literature review and a Delphi method

BackgroundAdvances in genetics and genomics require that healthcare professionals manage and incorporate new technologies into the appropriate clinical practice. The aim of this study was to identify core competencies in genetics for non-geneticists, both physicians and non-physicians.MethodsWe performed a literature review by searching MEDLINE, SCOPUS, and ISI Web of Science databases to identify studies reporting competencies in genetics in terms of knowledge, attitudes and abilities for non-genetic healthcare professionals. Furthermore, we conducted a survey according to a modified Delphi method, involving genetics experts to evaluate the competencies to be included as items of the curricula.ResultsThree eligible documents were identified and 3 Delphi rounds were carried out to reach a consensus on the competencies to be incorporated in the curricula. With reference to the curriculum for physicians, 19 items were included in the knowledge domain, 3 in the attitudes and 10 in the abilities domain. We developed two different curricula for non-physicians: one specific for those working in genetic services (20 items in the knowledge domain, 3 in the attitudes and 12 in the abilities) and one for those not working in genetic services (10 items in the knowledge domain, 3 in the attitudes and 2 in the abilities).ConclusionsWe developed 3 curricula in genetics addressed to non-genetic healthcare professionals. They differ in the “knowledge” and “abilities”, while the “attitudes” are the same for all the healthcare professionals. Although some concerns about the generalizability of the findings could arise due to the Italian perspective, we envisage the curricula can be used for genetics educational programs in several contexts.

M12 - PAVING THE WAY FOR PRECISION MEDICINE IN PSYCHIATRY – DESIGN AND IMPLEMENTATION OF A UNIFIED RARE GENETICS CURRICULUM

Background This is an exciting time in psychiatry. For the last few years, we have been witnessing an accelerated pace of genetic discoveries that are redefining our understanding of mental health disorders spanning from autism to schizophrenia. Insights have come from common and rare genetics alike, fueled by techniques that have a higher resolution and a lower cost. However, most psychiatrists were trained in an era that preceded this cutting-edge work, and psychiatry residency and fellowship programs have not yet integrated this new information into their curricula. Current challenges include determining unified content areas that should be known by psychiatrists, as well as implementing the delivery and teaching of these concepts using principles of adult learning. Here, we describe joint efforts to address this practice gap, using rare genetics as a vehicle. Methods Multiple stakeholders have gotten together to address this issue. The Education Taskforce of the International Society of Psychiatric Genetics (ISPG) was formed to identify and standardize key content areas that should be covered in psychiatry training programs across the globe, while the National Neuroscience Curriculum Initiative (NNCI) has focused on implementing the delivery of this content. As a joint effort, we have developed an interactive case conference tailored towards teaching principles and applications of rare genetics in psychiatry, using autism as an example to provide clinical correlation and applicability of this knowledge. We designed the module using the NNCI standards, and included supporting media and guidance for facilitators to allow for this material to be free-standing and independent from local expertise for its delivery. We administered this exercise to 300 psychiatry residents, fellows, and psychiatry program directors at diverse settings, and obtained pre and post knowledge assessments, as well as qualitative data on impressions and utility of the module. Results Our preliminary results showed an overall low genetic literacy among all surveyed groups in the pre-assessments, followed by a high retention of content after the exercise, with detailed analyses underway. We also obtained positive qualitative feedback, which included an increased appreciation for the clinical relevance of this knowledge and satisfaction with the method of delivery. Discussion Our results were in agreement with our hypothesis of low genetic literacy across psychiatry, which justifies the need for increased efforts to standardize and deliver this knowledge. We showed that the module was well received and feasibly applied with local resources within diverse settings, and led to increased genetics knowledge in participants. This highlights the importance of blending key content with sound pedagogical methods and maintaining the clinical grounding of exercises, and underscores the relevance of modest and attainable learning objectives. The approach used here, for which collaborations between the ISPG Education Taskforce and the NNCI were key, could easily be adapted and broadly generalized for other core competencies in genetics.

Invited commentary: The need for human genetics and genomics in dental school curricula.

Invited commentary: The need for human genetics and genomics in dental school curricula.

Improving nurse practitioners' competence with genetics: Effectiveness of an online course.

The purpose of this study was to assess the effectiveness of an online genetics course for improving nurse practitioners' knowledge, competence, and comfort with genetic principles and their application to clinical practice. A genetics knowledge test and survey were administered to 232 nurse practitioner students, between 2011 and 2013, before and after completing a 15-week online genetics course taught by a multidisciplinary team of instructors at a private east coast U.S. university. The 65-item survey allowed participants to rate competence regarding genetic principles, diseases, and terminology, as well as comfort performing various clinical tasks related to genetics. The 21-item knowledge test contained multiple choice questions regarding core competencies in genetics. Paired t-tests were used to compare mean pre- and postscores. Participants significantly increased postcourse knowledge (p < .001) and comfort with genetic core competencies and clinical skills related to genetics (p < .001). This study demonstrates the effectiveness of an online genetics course for increasing nurse practitioners' knowledge, competence, and confidence with genetics and identifies specific topics educators should consider when designing curricula for nurse practitioners. Findings from this study can improve genetics education for nurse practitioners, which will in turn improve patient health.

Holistic Nursing in the Genetic/Genomic Era.

Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base.

Genetics Education Is Viewed as Important, but Not a Priority in Physical Therapist Education

Background and purpose. Little is known about genetics education in physical therapist (PT) education programs. The purpose of this study was to assess the status and perception of genetics education in accredited United States (US) PT education programs. Methods. Two electronic surveys were sent to the following recipients: (1) 205 program directors of PT education programs (PD), and (2) 3,177 subjects drawn from faculty lists of PT education programs and American Physical Therapy Association (APTA) Education Section members (PTED). The 18-item PD survey sought to identify the status of genetics education in PT education programs. The 32-item PTED survey sought to assess genetics perspectives relative to the National Coalition for Health Professional Education in Genetics (NCHPEG) core competencies in genetics. Results. There were 118 respondents (57.6%) to the PD, and 602 respondents (18.9%) to the PTED. Respondent exposure to genetics literacy came primarily from outside reading (PD and PTED = 53%), while 19% of PD and 26% of PTED had no exposure to genetics literacy. Genetics information was included in courses of 85% of programs, while 15% reported no genetics instruction as a part of the curriculum. Over 60% of respondents believed that genetics literacy was important in the treatment of patients, but > 50% believed genetics education was a priority for PT students and clinicians. PTED respondents noted a mean agreement of 73.7% to the 3 NCHPEG baseline competencies, 83% to the 11 NCHPEG knowledge competencies, 60% to the 5 skill competencies, and 96.5% to the 2 attitude competencies. Discussion and Conclusion. PT educators agree about the importance of genetics literacy in rehabilitation, but most don't see genetics education as a priority for PTs. Increasing PT educator awareness about the impact of genetics on rehabilitation is necessary to alter the apparent disparity between genetics literacy and education among PTs.

Genetic Services for Hereditary Breast/Ovarian and Colorectal Cancers – Physicians’ Awareness, Use and Satisfaction

Objectives: In 2000, the Ministry of Health in Ontario, Canada, introduced a publicly funded program to provide genetic services for hereditary breast/ovarian and colorectal cancers. We surveyed physicians to determine their awareness, use and satisfaction with this program. Methods: A self-administered questionnaire was mailed to a random sample of 25% of Ontario family physicians and all gynecologists, oncologists (radiation, surgical and medical), gastroenterologists and general surgeons. Results: Response rate was 49% (n = 1,427). Awareness of genetic testing for breast/ovarian cancer was high (91%) but less for colorectal cancer (60%). Use of services was associated with physician age of 40 or greater, urban location, confidence in knowledge of referral criteria and core competencies in genetics, and awareness of the program and where to refer. Almost half were dissatisfied with notification about the program. Conclusions: Ontario physicians are aware of cancer genetics services, and use is associated with increased knowledge of services, and confidence in skills. They would like more timely services and education about hereditary cancers and susceptibility testing.

Health visitors’ perceived priority needs in relation to their genetics education

There is a growing recognition, nationally and internationally of the need to increase the genetics education of health professionals. Nurses in primary care are expected to be an important link between people undergoing genetic investigation and regional clinical genetic centres. Core competencies in relation to genetics for all nurses, midwives and health visitors have recently been identified within the United Kingdom. This paper reports a study that sought to investigate health visitors' views on the components of these core competencies in genetics and their self reported educational needs in the area of genetics. A questionnaire based survey of 345 health visitors was undertaken in Northern Ireland, as one region of the United Kingdom during late 2003. Completed questionnaires were returned by 194 health visitors (56.2% response). Respondents largely supported the components of the core competencies now endorsed by the Nursing and Midwifery Council and reported their need for further education in relation to genetics. However, they had a limited view on their role in supporting parents of children undergoing genetic investigation. Further action needs to be taken to provide health visitors with the necessary genetic knowledge and skills in order that they are in stronger position to provide 'collateral' support for people undergoing genetic investigation.

Pharmacogenetics and Pharmacogenomics Instruction in Schools of Pharmacy in the USA: is it Adequate?

The provision of pharmaceutical care has been incorporated into the mission statements of virtually every pharmaceutical organization in the USA. It is defined as ‘the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life’ [1]. As such, the evolving fields of pharmacogenetics and pharmacogenomics complement the mission of pharmaceutical care by helping pharmacists to optimally individualize the shared responsibility of drug therapy with their patients [2]. The significant anticipated opportunities and challenges that pharmacogenetics/pharmacogenomics will bring to healthcare was the catalyst for an Academic Affairs Committee of the American Association of Colleges of Pharmacy (AACP) report in 2002 [3]. The committee reported the potential impact that pharmacogenetics/pharmacogenomics might have on the future roles of pharmacists [3]. In addition, the committee reported how pharmacy education might respond to this evolving knowledge base, in order to meet the needs of the profession and society. Guided by the National Coalition for Health Professional Education (NCHPEG) recommendations regarding health professional core competencies in genetics, the committee identified educational strategies and curricular outcomes, and addressed faculty development and resource implementation issues [3,4]. The AACP Academic Affairs Committee reported that the opportunities presented by pharmacogenetics and pharmacogenomics are significant, by stating: “the process will be to collect a single blood sample from each patient, submit an aliquot of the sample to a reference laboratory for analysis of a panel of genotypes, and test for those established to be important determinants of drug disposition and effects. The results of this one panel of tests would be electronically deposited into a secure database, into and out of which data can be accessed only with the patient’s authorization” [3]. Pharmacogenetics/pharmacogenomics present tremendous opportunities for pharmacists because of their potential to result in a true patient-specific customization of drug therapy that will optimize the provision of pharmaceutical care. The committee concluded that most disciplines in pharmacy education will be affected by pharmacogenetics/pharmacogenomics, and faculties will require requisite skills and knowledge in order to provide the latest research information to students regarding optimal applications and treatment choices [3]. They identified three salient domains, and several skills and competencies within each, in which pharmacists should be proficient. The domains included: the genetic basis of disease, drug discovery and disposition, ethical applications, and social and economic implications.

Incorporating human genetics into dietetics curricula remains a challenge

This descriptive survey was undertaken to assess integration of genetics into undergraduate didactic dietetic education. The response rate was 35% (n=82) of all directors (N=232) of accredited or approved Didactic Programs in Dietetics. Although most directors (n=58 of 82) agreed that genetics is an important component of dietetics education, they expressed concerns about already-crowded curricula and lack of time, resources, and knowledge. Thirty-eight directors indicated that they had no familiarity with the core competencies in genetics for all health professionals. Genetics is included in some way in 69 of the 82 programs that responded. Courses in which genetics was most likely to be incorporated included nutrition, physiology, microbiology, and biochemistry. Only four directors reported a required course entirely devoted to genetics. Programs were most likely to meet the knowledge competency of the role of genetic factors in maintaining health and preventing disease and least likely to address the genetic counseling process and indications for referral to specialists. Applications of genetics in dietetics will continue to grow in importance. Evidence from this study indicates that current curricula provide little to no genetics content. Nutrition faculty must become more knowledgeable about genetics before being expected to increase genetics content in entry-level dietetics curricula.

Genetics Content in the Graduate Audiology Curriculum

Astounding progress has been made in the identification and characterization of genes for hearing loss, which has led to an increasing role of genetics evaluation and testing in the diagnostic process for children with hearing loss. The importance of health professionals such as audiologists gaining core competencies in genetics has been recognized. The current report describes a survey of academic programs in audiology designed to determine the extent to which genetics content is included in the curriculum. Responses from 56% of existing academic programs indicate that 95% include some genetics content in their programs, with the total number of classroom hours ranging from 2 to 65. Most programs included information on basic genetic mechanisms, syndromes, and interpreting family history information, while many fewer reported covering the molecular basis of hearing loss, genetic testing, or ethical or legal issues. The results of this survey demonstrate the need to incorporate more genetics content into audiology curricula and suggest strategies for assisting audiology faculty with this process.