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Koh J, Park HY, Bae JM, Kang J, Cho U, Lee SE, Kang H, Hong ME, Won JK, Choi YL, Kim WS, Lee A. Establishing molecular pathology curriculum for pathology trainees and continued medical education: a collaborative work from the Molecular Pathology Study Group of the Korean Society of Pathologists. J Pathol Transl Med 2023; 57:265-272. [PMID: 37735877 PMCID: PMC10518246 DOI: 10.4132/jptm.2023.08.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/20/2023] [Accepted: 08/26/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND The importance of molecular pathology tests has increased during the last decade, and there is a great need for efficient training of molecular pathology for pathology trainees and as continued medical education. METHODS The Molecular Pathology Study Group of the Korean Society of Pathologists appointed a task force composed of experienced molecular pathologists to develop a refined educational curriculum of molecular pathology. A 3-day online educational session was held based on the newly established structure of learning objectives; the audience were asked to score their understanding of 22 selected learning objectives before and after the session to assess the effect of structured education. RESULTS The structured objectives and goals of molecular pathology was established and posted as a web-based interface which can serve as a knowledge bank of molecular pathology. A total of 201 pathologists participated in the educational session. For all 22 learning objectives, the scores of self-reported understanding increased after educational session by 9.9 points on average (range, 6.6 to 17.0). The most effectively improved items were objectives from next-generation sequencing (NGS) section: 'NGS library preparation and quality control' (score increased from 51.8 to 68.8), 'NGS interpretation of variants and reference database' (score increased from 54.1 to 68.0), and 'whole genome, whole exome, and targeted gene sequencing' (score increased from 58.2 to 71.2). Qualitative responses regarding the adequacy of refined educational curriculum were collected, where favorable comments dominated. CONCLUSIONS Approach toward the education of molecular pathology was refined, which would greatly benefit the future trainees.
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Affiliation(s)
- Jiwon Koh
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ha Young Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jeong Mo Bae
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Kang
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Uiju Cho
- Department of Pathology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seung Eun Lee
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Haeyoun Kang
- Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Min Eui Hong
- Department of Pathology, Chung-Ang University Hospital, Seoul, Korea
| | - Jae Kyung Won
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Youn-La Choi
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wan-Seop Kim
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - The Molecular Pathology Study Group of the Korean Society of Pathologists
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Pathology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
- Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
- Department of Pathology, Chung-Ang University Hospital, Seoul, Korea
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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2
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Fukuto HS, Nelepcu II, Necula S, Galli NE, Viboud GI. International health initiative: Development and pilot testing of a molecular diagnostics training program in Romania. Am J Clin Pathol 2023; 160:276-283. [PMID: 37196173 DOI: 10.1093/ajcp/aqad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVES The implementation of nucleic acid testing in laboratory medicine has revolutionized clinical diagnosis. Unfortunately, incorporation of these technologies in less developed countries remains a challenge. Despite Romania's recent economic growth, the country is in dire need of medical and laboratory staff trained in modern technologies. The aim of the study was to develop a curriculum that could easily be delivered to laboratory professionals in Romania and to pilot test the effectiveness of the training in increasing their understanding of molecular tests. METHODS The program was developed in accordance with the US Centers for Disease Control and Prevention's (CDC's) quality training standards. It was offered to 50 laboratory professionals and consisted of online, asynchronous lectures and optional synchronous review sessions. Training effectiveness was evaluated using CDC guidelines based on pre- and postassessment questions answered anonymously. RESULTS Forty-two people participated in the program, and 32 (81%) completed the training successfully. Based on 16 participants' self-assessment, the course was successful in improving learners' overall knowledge of molecular diagnostics-specifically, their understanding of molecular techniques and how to interpret results. Those participants were highly satisfied with the overall training. CONCLUSIONS The piloted platform presented here is promising and can be a foundation for future larger-scale studies in countries with developing health systems.
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Affiliation(s)
- Hana S Fukuto
- Department of Clinical Laboratory Science, Stony Brook University, Stony Brook, NY, US
| | | | | | - Nora E Galli
- Diagnostics Division, Roche Romania, Bucharest, Romania
| | - Gloria I Viboud
- Department of Clinical Laboratory Science, Stony Brook University, Stony Brook, NY, US
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3
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Patterson WG, Tribble LM, Hopkins CS, Fasolino TK, Ward LD. The State of Genetics and Genomics Education in US Physician Assistant Programs. J Physician Assist Educ 2023; 34:195-202. [PMID: 37467203 DOI: 10.1097/jpa.0000000000000519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
PURPOSE This study aimed to assess the current landscape of genetics-genomics education in physician assistant (PA) student training. METHODS A 25-question electronic survey was emailed to program directors of the 273 accredited PA programs. Questions represented PA program demographics and 4 domains: curricular characteristics and perceived adequacy; content; curricular approaches and instructional methods; and intent, barriers, and perceived needs for an optimal curriculum. RESULTS A total of 115 PA program representatives (42%) returned the survey. More than two-thirds of responding programs do not require a prerequisite genetics course for matriculation. Most programs (48%) include 1 to 10 contact hours of genetics-genomics content and use various content delivery methods and approaches. Most programs (67%) use PA program faculty to teach genetics-genomics as part of one course or many courses throughout the curriculum (85%) using didactic lectures (97%). The most significant barrier to developing an optimal curriculum is an already overloaded curriculum (71%). Physician assistant educators welcome supportive resources, such as genetic case studies (96%). CONCLUSIONS The study findings elucidate the current state of genetics-genomics education in PA programs. Every responding program reports that genetics-genomics is integrated into their curriculum; however, no standardization exists between programs. Although medical genetics-genomics has changed and advanced rapidly since a similar survey was conducted 14 years ago, the number of contact hours is unchanged, and genetics-genomics content is less dispersed throughout PA curricula. To create genetic-competent and genomic-competent PAs, education must evolve to stay current with ongoing advancements in genomic science.
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Affiliation(s)
- Wesley G Patterson
- Wesley G. Patterson, PhD, MSPA, PA-C, CAQ-Peds, is a genetics physician assistant, Greenwood Genetic Center, Greenwood, South Carolina
- Leta M. Tribble, PhD, is a director, Division of Education, Greenwood Genetic Center, Greenwood, South Carolina
- Casey S. Hopkins, PhD, RN, WHNP-BC, is an assistant professor, Clemson University School of Nursing, Clemson, South Carolina
- Tracy K. Fasolino, PhD, FNP-BC, ACHPN, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
- Linda D. Ward, PhD, CNE, FNP-C, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
| | - Leta M Tribble
- Wesley G. Patterson, PhD, MSPA, PA-C, CAQ-Peds, is a genetics physician assistant, Greenwood Genetic Center, Greenwood, South Carolina
- Leta M. Tribble, PhD, is a director, Division of Education, Greenwood Genetic Center, Greenwood, South Carolina
- Casey S. Hopkins, PhD, RN, WHNP-BC, is an assistant professor, Clemson University School of Nursing, Clemson, South Carolina
- Tracy K. Fasolino, PhD, FNP-BC, ACHPN, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
- Linda D. Ward, PhD, CNE, FNP-C, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
| | - Casey S Hopkins
- Wesley G. Patterson, PhD, MSPA, PA-C, CAQ-Peds, is a genetics physician assistant, Greenwood Genetic Center, Greenwood, South Carolina
- Leta M. Tribble, PhD, is a director, Division of Education, Greenwood Genetic Center, Greenwood, South Carolina
- Casey S. Hopkins, PhD, RN, WHNP-BC, is an assistant professor, Clemson University School of Nursing, Clemson, South Carolina
- Tracy K. Fasolino, PhD, FNP-BC, ACHPN, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
- Linda D. Ward, PhD, CNE, FNP-C, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
| | - Tracy K Fasolino
- Wesley G. Patterson, PhD, MSPA, PA-C, CAQ-Peds, is a genetics physician assistant, Greenwood Genetic Center, Greenwood, South Carolina
- Leta M. Tribble, PhD, is a director, Division of Education, Greenwood Genetic Center, Greenwood, South Carolina
- Casey S. Hopkins, PhD, RN, WHNP-BC, is an assistant professor, Clemson University School of Nursing, Clemson, South Carolina
- Tracy K. Fasolino, PhD, FNP-BC, ACHPN, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
- Linda D. Ward, PhD, CNE, FNP-C, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
| | - Linda D Ward
- Wesley G. Patterson, PhD, MSPA, PA-C, CAQ-Peds, is a genetics physician assistant, Greenwood Genetic Center, Greenwood, South Carolina
- Leta M. Tribble, PhD, is a director, Division of Education, Greenwood Genetic Center, Greenwood, South Carolina
- Casey S. Hopkins, PhD, RN, WHNP-BC, is an assistant professor, Clemson University School of Nursing, Clemson, South Carolina
- Tracy K. Fasolino, PhD, FNP-BC, ACHPN, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
- Linda D. Ward, PhD, CNE, FNP-C, is an associate professor, Clemson University School of Nursing, Clemson, South Carolina
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2022 Association of Professors of Human and Medical Genetics (APHMG) consensus-based update of the core competencies for undergraduate medical education in genetics and genomics. Genet Med 2022; 24:2167-2179. [PMID: 36040446 DOI: 10.1016/j.gim.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The field of genetics and genomics continues to expand at an unprecedented pace. As scientific knowledge is translated to clinical practice, genomic information is routinely being used in preventive, diagnostic, and therapeutic decision-making across a variety of clinical practice areas. As adoption of genomic medicine further evolves, health professionals will be required to stay abreast of new genetic discoveries and technologies and implementation of these advances within their scope of practice will be indicated. METHODS The Association of Professors of Human and Medical Genetics previously developed medical school genetics core competencies, last updated in 2013. The competencies were reviewed and updated through a structured approach incorporating a modified Delphi method. RESULTS The updated Association of Professors of Human and Medical Genetics core competencies are presented. Current revisions include competencies that are concise, specific, and assessable. In addition, they incorporate recent advances in clinical practice and promote equity and inclusion in clinical care. CONCLUSION The 2022 competencies will serve as a guide for medical school leadership and educators involved in curriculum development, implementation, and assessment. Use of these competencies across the undergraduate medical curricula will foster knowledge, skills, and behaviors required in medical practice across a wide range of specialties.
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5
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Gates RW, Hudgins L, Huffman LC. Medical genetics education for pediatrics residents: A brief report. Genet Med 2022; 24:2408-2412. [PMID: 36029300 DOI: 10.1016/j.gim.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Genetic testing is ubiquitous in the field of medicine and is often ordered or requested by primary care providers, nongenetics subspecialists, and patients themselves. Other studies have shown that providers are often not comfortable ordering genetic testing. There have been initiatives to teach these concepts via continuing medical education; however, there is not a standardized training program for teaching resident physicians about genetic testing. METHODS During September to October 2020, we recruited all the pediatrics residents at our institution via email (N = 102). Residents were invited to complete a Qualtrics electronic survey that addressed self-perceived level of knowledge about core concepts of genetic testing, as well as self-perceived confidence discussing these concepts with families. RESULTS Response rate was 46 to 102 (45%). Proportions of respondents reporting they felt insufficiently knowledgeable ranged from 28% (basic concepts of genetics) to 80% (Genetic Information Nondiscrimination Act). Most pediatrics residents agreed that a curriculum teaching basics of genetic testing would be helpful to them. Desired curricular topics included indications and limitations of genetic testing, testing procedures, and counseling families. CONCLUSION Despite its expanding importance across medicine, genetics education is lacking in pediatrics residency programs and residents would benefit from a curriculum teaching basic concepts of genetic testing.
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Affiliation(s)
- Ryan W Gates
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; Division of Medical Genetics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
| | - Louanne Hudgins
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; Division of Medical Genetics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Lynne C Huffman
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Stanford Medicine, Stanford, CA
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6
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Clinicians' Perceptions towards Precision Medicine Tools for Cardiovascular Disease Risk Stratification in South Africa. J Pers Med 2022; 12:jpm12091360. [PMID: 36143145 PMCID: PMC9505828 DOI: 10.3390/jpm12091360] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a leading cause of mortality and morbidity in South Africa. Risk stratification is the preferred approach to disease prevention, but identifying patients at high risk for CVD remains challenging. Assessing genetic risk could improve stratification and inform a clinically relevant precision medicine (PM) approach. Clinicians are critical to PM adoption, thus, this study explores practicing clinicians’ perceptions of PM-based CVD risk stratification in South Africa’s public health setting. Practicing clinicians (n = 109) at four teaching hospitals in Johannesburg, South Africa, completed an electronic self-administered survey. The effect of demographic and professional characteristics on PM-based CVD risk stratification perceptions was assessed. Fewer than 25% of respondents used clinical genetic testing, and 14% had formal genetics training. 78% had a low mean knowledge score, with higher scores associated with genetic training (p < 0.0005) and research involvement (p < 0.05). Despite limited knowledge and resources, 84% perceived PM approaches positively. 57% felt confident in applying the PM-based approach, with those already undertaking CVD risk stratification more confident (p < 0.001). High cost and limited access to genetics services are key barriers. Integrating genetic information into established clinical tools will likely increase confidence in using PM approaches. Addressing the genetics training gap and investment into the country’s genomics capacity is needed to advance PM in South Africa.
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7
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Niehaus AD, Rassbach CE, Stevenson DA. A survey of program directors for combined pediatrics and medical genetics and genomics residency programs: Perspectives when evaluating applicants. Am J Med Genet A 2022; 188:2315-2324. [PMID: 35633299 DOI: 10.1002/ajmg.a.62846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 11/06/2022]
Abstract
While combined pediatrics and medical genetics and genomics residency programs are growing in number and applicants, there are still workforce shortages within the medical genetics field. Medical students would benefit from additional information on the training pathways and insight into the application process itself. Program Directors of combined pediatrics and medical genetics and genomics residency programs were surveyed to characterize factors that influence interview selection and rank list decisions, application logistics, recruitment, and training pathways. When evaluating applicants, representatives from both pediatrics and medical genetics are involved in the screening process. Additionally, both groups value prior research experience, but do not have a clear preference for a particular subcategory or domain of research. Most program directors think that all currently-available training pathways can provide optimal training. Further action is needed to provide medical students with the knowledge to make more informed decisions about their career and medical school advisors with objective data to counsel students. There was support among program directors to initiate consideration of creating a pathway for medical students to match directly into a medical genetics and genomics residency.
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Affiliation(s)
- Annie D Niehaus
- Division of Medical Genetics, Department of Pediatrics, Stanford School of Medicine, Stanford, California, USA
| | - Caroline E Rassbach
- Department of Pediatrics, Stanford School of Medicine, Stanford, California, USA
| | - David A Stevenson
- Division of Medical Genetics, Department of Pediatrics, Stanford School of Medicine, Stanford, California, USA
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8
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Doll B, De Castro MJ, Fries MH, Pock AR, Seibert D, Yang W. Precision Medicine-A Demand Signal for Genomics Education. Mil Med 2021; 187:40-46. [PMID: 34967402 DOI: 10.1093/milmed/usab406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/04/2021] [Accepted: 10/13/2021] [Indexed: 11/12/2022] Open
Abstract
Pressed by the accumulating knowledge in genomics and the proven success of the translation of cancer genomics to clinical practice in oncology, the Obama administration unveiled a $215 million commitment for the Precision Medicine Initiative (PMI) in 2016, a pioneering research effort to improve health and treat disease using a new model of patient-powered research. The objectives of the initiative include more effective treatments for cancer and other diseases, creation of a voluntary national research cohort, adherence to privacy protections for maintaining data sharing and use, modernization of the regulatory framework, and forging public-private partnerships to facilitate these objectives. Specifically, the DoD Military Health System joined other agencies to execute a comprehensive effort for PMI. Of the many challenges to consider that may contribute to the implementation of genomics-lack of familiarity and understanding, poor access to genomic medicine expertise, needs for extensive informatics and infrastructure to integrate genomic results, privacy and security, and policy development to address the unique requirements of military medical practice-we will focus on the need to establish education in genomics appropriate to the provider's responsibilities. Our hypothesis is that there is a growing urgency for the development of educational experiences, formal and informal, to enable clinicians to acquire competency in genomics commensurate with their level of practice. Several educational approaches, both in practice and in development, are presented to inform decision-makers and empower military providers to pursue courses of action that respond to this need.
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Affiliation(s)
- Bruce Doll
- Office of the Vice President for Research, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | | | - Melissa H Fries
- Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC 20010, USA
| | - Arnyce R Pock
- E. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Diane Seibert
- Daniel K Inouye Graduate School of Nursing, Uniformed Services University, Bethesda, MD 20814, USA
| | - Wendy Yang
- E. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
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9
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Bauss J, Morris M, Shankar R, Olivero R, Buck LN, Stenger CL, Hinds D, Mills J, Eby A, Zagorski JW, Smith C, Cline S, Hartog NL, Chen B, Huss J, Carcillo JA, Rajasekaran S, Bupp CP, Prokop JW. CCR5 and Biological Complexity: The Need for Data Integration and Educational Materials to Address Genetic/Biological Reductionism at the Interface of Ethical, Legal, and Social Implications. Front Immunol 2021; 12:790041. [PMID: 34925370 PMCID: PMC8674737 DOI: 10.3389/fimmu.2021.790041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023] Open
Abstract
In the age of genomics, public understanding of complex scientific knowledge is critical. To combat reductionistic views, it is necessary to generate and organize educational material and data that keep pace with advances in genomics. The view that CCR5 is solely the receptor for HIV gave rise to demand to remove the gene in patients to create host HIV resistance, underestimating the broader roles and complex genetic inheritance of CCR5. A program aimed at providing research projects to undergraduates, known as CODE, has been expanded to build educational material for genes such as CCR5 in a rapid approach, exposing students and trainees to large bioinformatics databases and previous experiments for broader data to challenge commitment to biological reductionism. Our students organize expression databases, query environmental responses, assess genetic factors, generate protein models/dynamics, and profile evolutionary insights into a protein such as CCR5. The knowledgebase generated in the initiative opens the door for public educational information and tools (molecular videos, 3D printed models, and handouts), classroom materials, and strategy for future genetic ideas that can be distributed in formal, semiformal, and informal educational environments. This work highlights that many factors are missing from the reductionist view of CCR5, including the role of missense variants or expression of CCR5 with neurological phenotypes and the role of CCR5 and the delta32 variant in complex critical care patients with sepsis. When connected to genomic stories in the news, these tools offer critically needed Ethical, Legal, and Social Implication (ELSI) education to combat biological reductionism.
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Affiliation(s)
- Jacob Bauss
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Michele Morris
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Rama Shankar
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Rosemary Olivero
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Infectious Disease, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - Leah N Buck
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Mathematics, University of North Alabama, Florence, AL, United States
| | - Cynthia L Stenger
- Department of Mathematics, University of North Alabama, Florence, AL, United States
| | - David Hinds
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Joshua Mills
- Department of Biology, Grand Valley State University, Allendale, MI, United States
| | - Alexandra Eby
- Department of Science, Davenport University, Grand Rapids, MI, United States
| | - Joseph W Zagorski
- Office of Research, Spectrum Health, Grand Rapids, MI, United States
| | - Caitlin Smith
- Department of Biology, Athens State University, Athens, AL, United States
| | - Sara Cline
- Department of Biology, Athens State University, Athens, AL, United States
| | - Nicholas L Hartog
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Allergy & Immunology, Spectrum Health, Grand Rapids, MI, United States
| | - Bin Chen
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
| | - John Huss
- Department of Philosophy, The University of Akron, Akron, OH, United States
| | - Joseph A Carcillo
- Department of Critical Care Medicine and Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Surender Rajasekaran
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Office of Research, Spectrum Health, Grand Rapids, MI, United States.,Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - Caleb P Bupp
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Medical Genetics, Spectrum Health, Grand Rapids, MI, United States
| | - Jeremy W Prokop
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
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10
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Zimani AN, Peterlin B, Kovanda A. Increasing Genomic Literacy Through National Genomic Projects. Front Genet 2021; 12:693253. [PMID: 34456970 PMCID: PMC8387713 DOI: 10.3389/fgene.2021.693253] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Genomics is an advancing field of medicine, science, ethics, and legislation. Keeping up to date with this challenging discipline requires continuous education and exchange of knowledge between many target groups. Specific challenges in genomic education include tailoring complex topics to diverse audiences ranging from the general public and patients to highly educated professionals. National genomic projects face many of the same challenges and thus offer many opportunities to highlight common educational strategies for improving genomic literacy. We have reviewed 41 current national genomic projects and have identified 16 projects specifically describing their approach to genomic education. The following target groups were included in the educational efforts: the general public (nine projects), patients (six projects), and genomic professionals (16 projects), reflecting the general overall aims of the projects such as determining normal and pathological genomic variation, improving infrastructure, and facilitating personalized medicine. The national genomic projects aim to increase genomic literacy through supplementing existing national education in genomics as well as independent measures specifically tailored to each target group, such as training events, research collaboration, and online resources for healthcare professionals, patients, and patient organizations. This review provides the current state of educational activities within national genomic projects for different target groups and identifies good practices that could contribute to patient empowerment, public engagement, proficient healthcare professionals, and lend support to personalized medicine.
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Affiliation(s)
- Ana Nyasha Zimani
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Anja Kovanda
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
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11
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Zivanov C, Li X, Shah KP, Estrada L, Cutrer WB, Hooks M, Keedy V, Dahlman KB. Precision Cancer Medicine: Dynamic Learning of Cancer Biology in a Clinically Meaningful Context. MEDICAL SCIENCE EDUCATOR 2021; 31:1029-1042. [PMID: 34457947 PMCID: PMC8368858 DOI: 10.1007/s40670-021-01267-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Precision medicine is revolutionizing healthcare practices, most notably in oncology. With cancer being the second leading cause of death in the USA, it is important to integrate precision oncology content in undergraduate medical education. METHODS In 2015, we launched a Clinical Cancer Medicine Integrated Science Course (ISC) for post-clerkship medical students at Vanderbilt University School of Medicine (VUSM). In this ISC, students learned cancer biology and clinical oncology concepts through a combination of classroom and patient care activities. Student feedback from mid- and end-of-course surveys and student match data were analyzed and used to develop ongoing course improvements. RESULTS To date, 72 medical students have taken the Clinical Cancer Medicine ISC. Over 90% of students who completed end-of-course surveys agreed or strongly agreed that this course advanced their foundational science knowledge in clinical cancer medicine, that clinical relevance was provided during non-clinical foundational science learning activities, and that foundational science learning was embedded in course clinical experiences. Students who took this course most commonly matched in Internal Medicine, Pathology, Pediatrics, and Radiation Oncology. VUSM students who matched into Pathology and Radiation Oncology were more likely to take this ISC than students who matched in other specialties. CONCLUSION The Clinical Cancer Medicine ISC serves as a model for incorporating precision oncology, cancer biology foundational science, and oncology patient care activities in undergraduate medical education. The course prepares students to care for oncology patients in their fields of interests during their future career in medicine.
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Affiliation(s)
- Catherine Zivanov
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
| | - Xuanyi Li
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
| | - Kaustav P. Shah
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
| | - Lourdes Estrada
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Biochemistry, Vanderbilt University, Nashville, TN USA
| | - William B. Cutrer
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
- Departments of Pediatrics, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Mary Hooks
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Surgery, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Vicki Keedy
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Kimberly Brown Dahlman
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN USA
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Sanchez-Lara PA, Grand K, Haanpää MK, Curry CJ, Wang R, Ezgü F, Rose CM, D'Cunha Burkardt D, Conway RL, Relan A, Carey JC. Thinking outside "The Box": Case-based didactics for medical education and the instructional legacy of Dr John M. Graham, Jr. Am J Med Genet A 2021; 185:2636-2645. [PMID: 33913595 DOI: 10.1002/ajmg.a.62202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 12/23/2022]
Abstract
The increasing demand for advanced genomic services has finally come to the attention of healthcare systems and stakeholders who are now eager to find creative solutions to increase the pool of genomic literate providers. Training in genetics and dysmorphology has historically been conducted as a self-driven practice in pattern recognition, ideally within a formal or informal apprenticeship supervised by a master diagnostician. In recent times, case-based learning, framed by flipped classroom pedagogy have become the preferred teaching methods for complex medical topics such as genetics and genomics. To illuminate this perspective, our article was written in honor of the teaching style and pedagogy of Dr John M. Graham Jr and his lifelong commitment to medical education and mentoring.
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Affiliation(s)
- Pedro A Sanchez-Lara
- Division of Medical Genetics, Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Katheryn Grand
- Division of Medical Genetics, Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Maria K Haanpää
- Department of Genomics and Clinical Genetics, Turku University Hospital, Turku, Finland.,Department of Medicine, Stanford University, School of Medicine, Stanford, California, USA
| | - Cynthia J Curry
- Genetic Medicine, Department of Pediatrics, University of California San Francisco, Fresno, California, USA
| | - Raymond Wang
- Division of Metabolic Disorders, CHOC, Children's Hospital Orange County, Orange, California, USA.,Department of Pediatrics, University of California-Irvine School of Medicine, Orange, California, USA
| | - Fatih Ezgü
- Faculty of Medicine, Department and Laboratory of Pediatric Metabolic Disorders, Gazi University, Ankara, Turkey
| | - Catherine M Rose
- Victorian Clinical Genetic Service, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Deepika D'Cunha Burkardt
- Medical Genomics and Metabolic Genetics Branch, National Human genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Robert L Conway
- Department of Pediatric Neurosciences, Spectrum Health/Helen DeVos Children's Hospital Medical Genetics, Grand Rapids, Michigan, USA
| | - Anju Relan
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - John C Carey
- Department of Pediatrics, Division of Medical genetics, The University of Utah, Salt Lake City, Utah, USA
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13
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Haspel RL. Commentary on Sequence Now, Later, or Never? Clin Chem 2021; 66:886-887. [PMID: 32628760 DOI: 10.1093/clinchem/hvaa056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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14
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Haspel RL, Genzen JR, Wagner J, Fong K, Wilcox RL. Call for improvement in medical school training in genetics: results of a national survey. Genet Med 2021; 23:1151-1157. [PMID: 33580224 DOI: 10.1038/s41436-021-01100-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess, from the student perspective, medical school training in genetics and genomics. METHODS In 2019, the Undergraduate Training in Genomics (UTRIG) Working Group developed genetics-related survey and knowledge questions for the RISE-FIRST, an exam administered to postgraduate year 1 (PGY1) pathology residents in the United States during their first months of training. Survey questions focused on perceived knowledge in genetics and the structure and quality of training with responses compared with those in control areas. RESULTS There were 401 PGY1 pathology residents who took the 2019 RISE-FIRST (65% of those in the United States). There was significantly lower perceived understanding of genetics compared with nongenetics topics. Respondents also reported less time spent learning genetics and lower quality training compared with control areas. Only 53% indicated an interaction during medical school with a medical geneticist. Residents also did not perform as well on the UTRIG-developed knowledge questions than those in other areas of pathology. CONCLUSION The RISE-FIRST is a useful tool in assessing the current state of medical school training in genetics. This needs assessment may serve as a call to action to improve medical school genetics education and promote greater understanding of the role of genetics professionals in patient care.
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Affiliation(s)
- Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Jonathan R Genzen
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Jay Wagner
- American Society for Clinical Pathology (ASCP), Chicago, IL, USA
| | - Karen Fong
- American Society for Clinical Pathology (ASCP), Chicago, IL, USA
| | | | - Rebecca L Wilcox
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center and Larner College of Medicine, Burlington, VT, USA.
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15
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Afolaranmi O, Salako O, Okunade K, James A, Fagbenro G. Integrating genomics education into Nigerian undergraduate medical training - A narrative review. JOURNAL OF CLINICAL SCIENCES 2021. [DOI: 10.4103/jcls.jcls_6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Freeley M. Current postgraduate training programs and online courses in precision medicine. Expert Rev Mol Diagn 2020; 20:569-574. [PMID: 31875486 DOI: 10.1080/14737159.2020.1709826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Michael Freeley
- School of Biotechnology (Office X225), Dublin City University , Glasnevin, Ireland
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17
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Abstract
Medical teaching must include new knowledge and technologies and how these affect patient care. The Medical Humanities can contribute to a more holistic and caring view of health and disease.
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Affiliation(s)
- Maurizio Bifulco
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Simona Pisanti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Abstract
With rapid advances in genetics and genomics, the commercialization and access to new applications has become more widespread and omnipresent throughout biomedical research. Thus, increasingly, more patients will have personal genomic information they may share with primary care providers (PCPs) to better understand the clinical significance of the data. To be able to respond to patient inquiries about genomic data, variant interpretation, disease risk, and other issues, PCPs will need to be able to increase or refresh their awareness about genetics and genomics, and identify reliable resources to use or refer patients. While provider educational efforts have increased, with the rapid advances in the field, ongoing efforts will be needed to prepare PCPs to manage patient needs, integrate results into care, and refer as indicated.
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Affiliation(s)
- Susanne B Haga
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, 27708, USA.
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19
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Hyland K, Garber K, Dasgupta S. From helices to health: undergraduate medical education in genetics and genomics. Per Med 2019; 16:211-220. [DOI: 10.2217/pme-2018-0081] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Rapid advances in genomic technologies combined with drastic reductions in cost and a growing number of clinical genomic tests are transforming medical practice. While enthusiasm about applications of precision medicine is high, the existing clinical genetics workforce is insufficient to meet present demands and will fall increasingly short as the use of genetic and genomic testing becomes more routine. To address this shortage, physicians in all areas of medicine will require genomic literacy. Undergraduate medical students, therefore, need a solid foundation in genetics and genomics so they can apply genomic medicine across a range of specialties. Here, we review the current trends and challenges in undergraduate medical genetics education in North America, highlight innovations and offer recommendations.
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Affiliation(s)
- Katherine Hyland
- Department of Biochemistry & Biophysics, School of Medicine, Institute for Human Genetics, University of California, San Francisco, CA 94143, USA
| | - Kathryn Garber
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Shoumita Dasgupta
- Department of Medicine, Biomedical Genetics, Boston University School of Medicine, Boston, MA 02118, USA
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