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Velu PD, Cushman-Vokoun A, Ewalt MD, Feilotter H, Gastier-Foster JM, Goswami RS, Laudadio J, Olsen RJ, Johnson R, Schlinsog A, Douglas A, Sandersfeld T, Kaul KL. Alignment of Fellowship Training with Practice Patterns for Molecular Pathologists: A Report of the Association for Molecular Pathology Training and Education Committee. J Mol Diagn 2022; 24:825-840. [PMID: 35690309 DOI: 10.1016/j.jmoldx.2022.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/12/2022] [Accepted: 04/26/2022] [Indexed: 12/19/2022] Open
Abstract
In the two decades since Accreditation Council for Graduate Medical Education-accredited Molecular Genetic Pathology fellowships began, the field of clinical molecular pathology has evolved considerably. The American Board of Pathology gathered data from board-certified molecular genetic pathologists assessing the alignment of skills and knowledge gained during fellowship with current needs on the job. The Association of Molecular Pathology conducted a parallel survey of program directors, and included questions on how various topics were taught during fellowship, as well as ranking their importance. Both surveys showed that most training aligned well with the practice needs of former trainees. Genomic profiling of tumors by next-generation sequencing, bioinformatics, laboratory management, and regulatory issues were topics thought to require increased emphasis in training. Topics related to clinical genetics and microbiology were deemed less important by those in practice, perhaps reflecting the increasing subspecialization of molecular pathologists. Program directors still viewed these topics as important to provide foundational knowledge. Parentage, identity, and human leukocyte antigen testing were less important to both survey audiences. These data may be helpful in guiding future adjustments to the Molecular Genetic Pathology curriculum and Accreditation Council for Graduate Medical Education program requirements.
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Affiliation(s)
- Priya D Velu
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Allison Cushman-Vokoun
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Mark D Ewalt
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Harriet Feilotter
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Julie M Gastier-Foster
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Departments of Pediatrics and Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Department of Pathology, Ohio State University College of Medicine, Columbus, Ohio
| | - Rashmi S Goswami
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Laboratory Medicine and Molecular Diagnostics/Department of Laboratory Medicine and Pathobiology, Sunnybrook Health Sciences Centre/University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Laudadio
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Randall J Olsen
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | | | | | | | | | - Karen L Kaul
- Molecular Genetic Pathology Curriculum Update Working Group of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois.
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Arcila ME, Snow AN, Akkari YMN, Chabot-Richards D, Pancholi P, Tafe LJ. Molecular Pathology Education: A Suggested Framework for Primary Care Resident Training in Genomic Medicine: A Report of the Association for Molecular Pathology Training and Education Committee. J Mol Diagn 2022; 24:430-441. [PMID: 35304347 DOI: 10.1016/j.jmoldx.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 10/17/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022] Open
Abstract
Developments in genomics are profoundly influencing medical practice. With increasing use of genetic and genomic testing across every aspect of the health care continuum, patients and their families are increasingly turning to primary care physicians (PCPs) for discussion and advice regarding tests, implications, and results. Yet, with the rapid growth of information, technology, and applications, PCPs are finding it challenging to fill the gaps in knowledge and support the growing needs of their patients. A critical component in expanding PCP genomic literacy lies in the education of physicians in training and in practice. Although a framework for developing physician competencies in genomics has already been developed, the Association for Molecular Pathology is uniquely situated to actively utilize the skills of its members to engage and support PCPs in this effort. This report provides an overview and a suggested basic teaching framework, which can be used by molecular professionals in their individual institutions as a starting point for educational outreach.
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Affiliation(s)
- Maria E Arcila
- Molecular Genetic Pathology Primary Care Curriculum Task Force of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony N Snow
- Molecular Genetic Pathology Primary Care Curriculum Task Force of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Yassmine M N Akkari
- Molecular Genetic Pathology Primary Care Curriculum Task Force of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Cytogenetics and Molecular Pathology, Legacy Health, Portland, Oregon
| | - Devon Chabot-Richards
- Molecular Genetic Pathology Primary Care Curriculum Task Force of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology, University of New Mexico, Albuquerque, New Mexico
| | - Preeti Pancholi
- Molecular Genetic Pathology Primary Care Curriculum Task Force of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Laura J Tafe
- Molecular Genetic Pathology Primary Care Curriculum Task Force of the Training and Education Committee, Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
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Haspel RL, Genzen JR, Wagner J, Lockwood CM, Fong K, Adesina AM, Browning L, Chabot-Richards D, Cushman-Vokoun AM, D’Angelo AR, DeFrances MC, Devarakonda S, Fernandes H, Fernandez P, Gupta R, Hurwitz ME, Lindeman NI, Nobori A, Nohr E, Payton J, Saylor B, Sobel ME, Stringer KF, Vanderbilt CM, Young M, Adesina AM, Browning L, Chabot-Richards D, Cushman-Vokoun AM, D’Angelo AR, DeFrances MC, Devarakonda S, Fernandes H, Fernandez P, Gupta R, Hurwitz ME, Lindeman NI, Nobori A, Nohr E, Payton J, Saylor B, Sobel ME, Stringer KF, Vanderbilt CM, Young M. Integration of Genomic Medicine in Pathology Resident Training. Am J Clin Pathol 2020; 154:784-791. [PMID: 32696061 DOI: 10.1093/ajcp/aqaa094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To assess current pathology resident training in genomic and molecular pathology. METHODS The Training Residents in Genomics (TRIG) Working Group has developed survey questions for the pathology Resident In-Service Examination (RISE) since 2012. Responses to these questions, as well as knowledge questions, were analyzed. RESULTS A total of 2,529 residents took the 2019 RISE. Since 2013, there has been an increase in postgraduate year 4 (PGY4) respondents indicating training in genomic medicine (58% to approximately 80%) but still less than almost 100% each year for molecular pathology. In 2019, PGY4 residents indicated less perceived knowledge and ability related to both genomic and traditional molecular pathology topics compared with control areas. Knowledge question results supported this subjective self-appraisal. CONCLUSIONS The RISE is a powerful tool for assessing the current state and also trends related to resident training in genomic pathology. The results show progress but also the need for improvement in not only genomic pathology but traditional molecular pathology training as well.
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Affiliation(s)
- Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | | | - Jay Wagner
- American Society for Clinical Pathology (ASCP), Chicago, IL
| | - Christina M Lockwood
- Department of Laboratory Medicine, University of Washington School of Medicine, Seattle
| | - Karen Fong
- American Society for Clinical Pathology (ASCP), Chicago, IL
| | - Adekunle M Adesina
- Department of Pathology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | - Lisa Browning
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Devon Chabot-Richards
- Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque
| | | | - Alix R D’Angelo
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans
| | - Marie C DeFrances
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Helen Fernandes
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY
| | - Pedro Fernandez
- Department of Anatomical Pathology, Hospital Germans Trias I Pujol, Badalona, Spain
| | - Ruta Gupta
- NSW Health Pathology, Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Neal I Lindeman
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA
| | - Erik Nohr
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, Calgary, Canada
| | - Jaqueline Payton
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO
| | - Benjamin Saylor
- Department of Pathology, University of Alabama at Birmingham
| | - Mark E Sobel
- American Society for Investigative Pathology, Bethesda, MD
| | - Keith F Stringer
- Department of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Chad M Vanderbilt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Young
- Cytopathology Department, Royal Free Hospital, London, UK
| | - Adekunle M Adesina
- Department of Pathology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | - Lisa Browning
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Devon Chabot-Richards
- Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque
| | | | - Alix R D’Angelo
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans
| | - Marie C DeFrances
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Helen Fernandes
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY
| | - Pedro Fernandez
- Department of Anatomical Pathology, Hospital Germans Trias I Pujol, Badalona, Spain
| | - Ruta Gupta
- NSW Health Pathology, Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Neal I Lindeman
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA
| | - Erik Nohr
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, Calgary, Canada
| | - Jaqueline Payton
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO
| | - Benjamin Saylor
- Department of Pathology, University of Alabama at Birmingham
| | - Mark E Sobel
- American Society for Investigative Pathology, Bethesda, MD
| | - Keith F Stringer
- Department of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Chad M Vanderbilt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Young
- Cytopathology Department, Royal Free Hospital, London, UK
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4
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Haspel RL, Ali AM, Huang GC, Smith MH, Atkinson JB, Chabot-Richards DS, Elliott RM, Kaul KL, Powell SZ, Rao A, Rinder HM, Vanderbilt CM, Wilcox R. Teaching Genomic Pathology: Translating Team-Based Learning to a Virtual Environment Using Computer-Based Simulation. Arch Pathol Lab Med 2018; 143:513-517. [PMID: 30500295 DOI: 10.5858/arpa.2018-0153-oa] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Developing skills related to use of computer-based tools is critical for practicing genomic pathology. However, given the relative novelty of genomics education, residency programs may lack faculty members with adequate expertise and/or time to implement training. A virtual team-based learning (TBL) environment would make genomic pathology education available to more trainees. OBJECTIVE.— To translate an extensively implemented in-person TBL genomic pathology workshop into a virtual environment and to evaluate both knowledge and skill acquisition. DESIGN.— Using a novel interactive simulation approach, online modules were developed translating aspects of the TBL experience into the virtual environment with a goal of acquisition of necessary computer-related skills. The modules were evaluated at 10 postgraduate pathology training programs using a pre-post test design with participants deidentified. A postmodule anonymous survey obtained participant feedback on module quality and efficacy. RESULTS.— There were 147 trainees who received an email request to voluntarily participate in the study. Of these, 43 trainees completed the pretest and 15 (35%) subsequently completed the posttest. Mean overall scores were 45% on the pretest compared with 70% on the posttest ( P < .001; effect size = 1.4). Posttest improvement of results was similar for questions testing acquisition of knowledge versus skills. Regarding the 19 participants who took the survey, 18 (95%) would recommend the modules to others and believed they met the stated objectives. CONCLUSIONS.— A simulation-based approach allows motivated pathology trainees to acquire computer-related skills for practicing genomic pathology. Future work can explore efficacy in a nonvoluntary setting and adaptation to different specialties, learners, and computer tools.
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Affiliation(s)
- Richard L Haspel
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Asma M Ali
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Grace C Huang
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Matt H Smith
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - James B Atkinson
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Devon S Chabot-Richards
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Robin M Elliott
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Karen L Kaul
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Suzanne Z Powell
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Arundhati Rao
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Henry M Rinder
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Chad M Vanderbilt
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
| | - Rebecca Wilcox
- From the Departments of Pathology (Dr Haspel) and Medicine (Dr Huang), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; the American Society for Clinical Pathology, Chicago, Illinois (Dr Ali and Mr Smith); the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Atkinson); the Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque (Dr Chabot-Richards); the Department of Pathology, UH Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Elliott); the Department of Pathology, NorthShore University HealthSystem and the University of Chicago Pritzker School of Medicine, Evanston, Illinois (Dr Kaul); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas (Dr Powell); Baylor Scott and White Central Region Pathology and Texas A&M Medical School, Temple (Dr Rao); the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Rinder); the Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (Dr Vanderbilt); and the Department of Pathology and Laboratory Medicine, Larner College of Medicine and University of Vermont Medical Center, Burlington (Dr Wilcox). Dr Ali is now with AA Associates, Oak Park, Illinois. Mr Smith is now with Intracon Spain, Barcelona, Spain
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5
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Rubanovich CK, Cheung C, Mandel J, Bloss CS. Physician preparedness for big genomic data: a review of genomic medicine education initiatives in the United States. Hum Mol Genet 2018; 27:R250-R258. [PMID: 29750248 PMCID: PMC6061688 DOI: 10.1093/hmg/ddy170] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 12/11/2022] Open
Abstract
In the last decade, genomic medicine education initiatives have surfaced across the spectrum of physician training in order to help address a gap in genomic medicine preparedness among physicians. The approaches are diverse and stem from the belief that 21st century physicians must be proficient in genomic medicine applications as they will be leaders in the precision medicine movement. We conducted a review of literature in genomic medicine education and training for medical students, residents, fellows, and practicing physicians with articles published between June 2015 and January 2018 to gain a picture of the current state of genomic medicine education with a focus on the United States. We found evidence of progress in the development of new and innovative educational programs and other resources aimed at increasing physician knowledge and readiness. Three overarching educational approach themes emerged, including immersive and experiential learning; interdisciplinary and interprofessional education; and electronic- and web-based approaches. This review is not exhaustive, nevertheless, it may inform future directions and improvements for genomic medicine education. Important next-steps include: (i) identifying and studying ways to best implement low-cost dissemination of genomic information; (ii) emphasizing genomic medicine education program evaluation and (iii) incorporating interprofessional and interdisciplinary initiatives. Genomic medicine education and training will become more and more relevant in the years to come as physicians increasingly interact with genomic and other precision medicine technologies.
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Affiliation(s)
- Caryn Kseniya Rubanovich
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Cynthia Cheung
- The Qualcomm Institute of Calit2, University of California, San Diego, La Jolla, CA, USA
| | - Jess Mandel
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Cinnamon S Bloss
- The Qualcomm Institute of Calit2, University of California, San Diego, La Jolla, CA, USA
- Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
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6
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Wilcox RL, Adem PV, Afshinnekoo E, Atkinson JB, Burke LW, Cheung H, Dasgupta S, DeLaGarza J, Joseph L, LeGallo R, Lew M, Lockwood CM, Meiss A, Norman J, Markwood P, Rizvi H, Shane-Carson KP, Sobel ME, Suarez E, Tafe LJ, Wang J, Haspel RL. The Undergraduate Training in Genomics (UTRIG) Initiative: early & active training for physicians in the genomic medicine era. Per Med 2018; 15:199-208. [PMID: 29843583 DOI: 10.2217/pme-2017-0077] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Genomic medicine is transforming patient care. However, the speed of development has left a knowledge gap between discovery and effective implementation into clinical practice. Since 2010, the Training Residents in Genomics (TRIG) Working Group has found success in building a rigorous genomics curriculum with implementation tools aimed at pathology residents in postgraduate training years 1-4. Based on the TRIG model, the interprofessional Undergraduate Training in Genomics (UTRIG) Working Group was formed. Under the aegis of the Undergraduate Medical Educators Section of the Association of Pathology Chairs and representation from nine additional professional societies, UTRIG's collaborative goal is building medical student genomic literacy through development of a ready-to-use genomics curriculum. Key elements to the UTRIG curriculum are expert consensus-driven objectives, active learning methods, rigorous assessment and integration.
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Affiliation(s)
- Rebecca L Wilcox
- Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine, University of Vermont, Burlington, VT, 05401, USA
| | - Patricia V Adem
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - Ebrahim Afshinnekoo
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - James B Atkinson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Leah W Burke
- Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine, University of Vermont, Burlington, VT, 05401, USA
| | - Hoiwan Cheung
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH/Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA
| | - Shoumita Dasgupta
- Department of Medicine, Biomedical Genetics Section, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Julia DeLaGarza
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - Loren Joseph
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, 02115, USA
| | - Robin LeGallo
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Christina M Lockwood
- Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, 98195, USA
| | - Alice Meiss
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | | | | | - Hasan Rizvi
- Institue of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, E1 2AD, UK
| | - Kate P Shane-Carson
- Division of Human Genetics, Department of Internal Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Mark E Sobel
- American Society for Investigative Pathology, Rockville, MD, 20852, USA
| | - Eric Suarez
- Pathology Department, Uniformed Services University, Bethesda, MD, 20814, USA
| | - Laura J Tafe
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH/Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA
| | - Jason Wang
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, 02115, USA
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7
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Statz CM, Patterson SE, Mockus SM. Barriers preventing the adoption of comprehensive cancer genomic profiling in the clinic. Expert Rev Mol Diagn 2017; 17:549-555. [DOI: 10.1080/14737159.2017.1319280] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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8
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Clay MR, Fisher KE. Bioinformatics Education in Pathology Training: Current Scope and Future Direction. Cancer Inform 2017; 16:1176935117703389. [PMID: 28469393 PMCID: PMC5392012 DOI: 10.1177/1176935117703389] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/20/2017] [Indexed: 12/11/2022] Open
Abstract
Training anatomic and clinical pathology residents in the principles of bioinformatics is a challenging endeavor. Most residents receive little to no formal exposure to bioinformatics during medical education, and most of the pathology training is spent interpreting histopathology slides using light microscopy or focused on laboratory regulation, management, and interpretation of discrete laboratory data. At a minimum, residents should be familiar with data structure, data pipelines, data manipulation, and data regulations within clinical laboratories. Fellowship-level training should incorporate advanced principles unique to each subspecialty. Barriers to bioinformatics education include the clinical apprenticeship training model, ill-defined educational milestones, inadequate faculty expertise, and limited exposure during medical training. Online educational resources, case-based learning, and incorporation into molecular genomics education could serve as effective educational strategies. Overall, pathology bioinformatics training can be incorporated into pathology resident curricula, provided there is motivation to incorporate, institutional support, educational resources, and adequate faculty expertise.
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Affiliation(s)
- Michael R Clay
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kevin E Fisher
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.,Department of Pathology, Texas Children's Hospital, Houston, TX, USA
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9
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Utilization Management in a Large Community Hospital. UTILIZATION MANAGEMENT IN THE CLINICAL LABORATORY AND OTHER ANCILLARY SERVICES 2017. [PMCID: PMC7123185 DOI: 10.1007/978-3-319-34199-6_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The utilization management of laboratory tests in a large community hospital is similar to academic and smaller community hospitals. There are numerous factors that influence laboratory utilization. Outside influences like hospitals buying physician practices, increasing numbers of hospitalists, and hospital consolidation will influence the number and complexity of the test menu that will need to be monitored for over and/or under utilization in the central laboratory and reference laboratory. CLIA’88 outlines the four test categories including point-of-care testing (waived) and provider-performed microscopy that need laboratory test utilization management. Incremental cost analysis is the most efficient method for evaluating utilization reduction cost savings. Economies of scale define reduced unit cost per test as test volume increases. Outreach programs in large community hospitals provide additional laboratory tests from non-patients in physician offices, nursing homes, and other hospitals. Disruptive innovations are changing the present paradigms in clinical diagnostics, like wearable sensors, MALDI-TOF, multiplex infectious disease panels, cell-free DNA, and others. Obsolete tests need to be universally defined and accepted by manufacturers, physicians, laboratories, and hospitals, to eliminate access to their reagents and testing platforms.
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10
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Murphy MJ, Shahriari N, Payette M, Mnayer L, Elaba Z. Development of a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees. J Cutan Pathol 2016; 43:858-65. [PMID: 27328619 DOI: 10.1111/cup.12760] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/13/2016] [Accepted: 06/19/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Results of molecular studies are redefining the diagnosis and management of a wide range of skin disorders. Dermatology training programs maintain a relative gap in relevant teaching. OBJECTIVE To develop a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees at our institution. The aim is to provide trainees with a specialty-appropriate, working knowledge in clinical molecular dermatology. METHODS The Departments of Dermatology and Pathology and Laboratory Medicine collaborated on the design and implementation of educational objectives and teaching modalities for the new curriculum. RESULTS A multidisciplinary curriculum was developed. It comprises: (i) assigned reading from the medical literature and reference textbook; (ii) review of teaching sets; (iii) two 1 hour lectures; (iv) trainee presentations; (v) 1-week rotation in a clinical molecular pathology and cytogenetics laboratory; and (vi) assessments and feedback. Residents who participated in the curriculum to date have found the experience to be of value. CONCLUSIONS Our curriculum provides a framework for other dermatology residency programs to develop their own specific approach to molecular diagnostics education. Such training will provide a foundation for lifelong learning as molecular testing evolves and becomes integral to the practice of dermatology.
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Affiliation(s)
- Michael J Murphy
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Neda Shahriari
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Michael Payette
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Laila Mnayer
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT, USA
| | - Zendee Elaba
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT, USA
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