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Development of an Evidence-Based, Theory-Informed National Survey of Physician Preparedness for Genomic Medicine and Preferences for Genomics Continuing Education.

ABSTRACT: Despite some early implementation of genomic medicine globally, there is a lack of rigorous, large-scale assessments of medical specialists' current practice and continuing education needs. As a first step to addressing this gap, we describe the development of a robust, expert-reviewed, survey using a mixed-methods sequential study design. We conducted semi-structured qualitative interviews with 32 education providers and 86 non-genetic medical specialists about current genomic medicine practice and need for continuing education. Key concepts were identified and used as an initial framework for the survey. These were: personal characteristics (medical specialty, years of practice); current practice of genomics in clinical and research settings; perception of how proximal genomic medicine is to practice; perception of preparedness (competence and confidence); and, preferences for future roles and models of care in genomic medicine and for continuing education. Potential survey questions that related to at least one of these concepts were identified from the literature or were created if no suitable question existed. Using a modified, reactive Delphi approach, questions were reviewed by a panel of 22 experts. Experts were selected purposefully representing four areas of expertise: non-genetic medical specialties; clinical genetics; genetic/genomic education and evaluation; and implementation science. Three Delphi rounds assessed relevance, clarity and importance of each question. The questions were also mapped to the behaviour change wheel theoretical framework which encompasses capability, opportunity and motivation (COM-B). The survey (included as supplementary material) was then tested with a small group of non-genetic medical specialists and feedback was written or verbal in 'talk-aloud', cognitive interviews. The final survey was then piloted with a further 29 specialists. We describe the methodology to create a robust, data- and theory-informed survey. The final survey captures not only levels of experience, practice of genomics and preferences for education but also the challenges around engaging with education. Survey data will provide evidence for education providers to inform development of education which meets learner needs and contributes to a medical workforce that is literate in genomics and more confident to competently practice genomic medicine.

SUBMITTER: McClaren BJ

PROVIDER: S-EPMC7063665 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Development of an Evidence-Based, Theory-Informed National Survey of Physician Preparedness for Genomic Medicine and Preferences for Genomics Continuing Education.

McClaren Belinda J BJ King Emily A EA Crellin Erin E Gaff Clara C Metcalfe Sylvia A SA Nisselle Amy A

Frontiers in genetics 20200303

Despite some early implementation of genomic medicine globally, there is a lack of rigorous, large-scale assessments of medical specialists' current practice and continuing education needs. As a first step to addressing this gap, we describe the development of a robust, expert-reviewed, survey using a mixed-methods sequential study design. We conducted semi-structured qualitative interviews with 32 education providers and 86 non-genetic medical specialists about current genomic medicine practice ...[more]

PMID: 32194615

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Project description:ObjectiveEven as genomic medicine is implemented globally, there remains a lack of rigorous, national assessments of physicians' current genomic practice and continuing genomics education needs. The aim of this study was to address this gap.DesignA cross-sectional survey, informed by qualitative data and behaviour change theory, to assess the current landscape of Australian physicians' genomic medicine practice, perceptions of proximity and individual preparedness, and preferred models of practice and continuing education. The survey was advertised nationally through 10 medical colleges, 24 societies, 62 hospitals, social media, professional networks and snowballing.Results409 medical specialists across Australia responded, representing 30 specialties (majority paediatricians, 20%), from mainly public hospitals (70%) in metropolitan areas (75%). Half (53%) had contacted their local genetics services and half (54%) had ordered or referred for a gene panel or exome/genome sequencing test in the last year. Two-thirds (67%) think genomics will soon impact their practice, with a significant preference for models that involved genetics services (p<0.0001). Currently, respondents mainly perform tasks associated with pretest family history taking and counselling, but more respondents expect to perform tasks at all stages of testing in the future, including tasks related to the test itself, and reporting results. While one-third (34%) recently completed education in genomics, only a quarter (25%) felt prepared to practise. Specialists would like (more) education, particularly on genomic technologies and clinical utility, and prefer this to be through varied educational strategies.ConclusionsThis survey provides data from a breadth of physician specialties that can inform models of genetic service delivery and genomics education. The findings support education providers designing and delivering education that best meet learner needs to build a competent, genomic-literate workforce. Further analyses are underway to characterise early adopters of genomic medicine to inform strategies to increase engagement.

Project description:BackgroundContinuing Medical Education (CME) is an important part of the training process for health workers worldwide. In China, training in Traditional Chinese Medicine (TCM) not only improves the expertise of medical workers, but also supports the Chinese Government's policy of promoting TCM as an equal treatment to western medicine. CME, including learning Traditional Chinese Medicine Technologies (TCMTs), perform poorly and research into the motivation of health workers to engage in CME is urgently required. Using a discrete choice experiment, this study assessed the CME learning preferences of primary health workers, using TCMT as a case study of CME programs.MethodsWe conducted a discrete choice experiment among health workers in Shandong Province, Guizhou Province, and Henan provinces from July 1, 2021 to October 1, 2022 on the TCMT learning preferences of primary health workers. The mixed logit model and latent class analysis model were used to analyze primary health workers' TCMT learning preferences.ResultsA total of 1,063 respondents participated in this study, of which 1,001 (94.2%) passed the consistency test and formed the final sample. Our key finding was that there were three distinct classes of TCMT learners. Overall, the relative importance of the seven attributes impacting the learning of TCMTs were: learning expenses, expected TCMT efficacy, TCMT learning difficulty, TCMT mode of learning, TCMT type, time required to learn, and expected frequency of TCMT use. However, these attributes differed significantly across the three distinct classes of TCMT learners. Infrequent users (class 1) were concerned with learning expenses and learning difficulty; workaholics (class 2) focused on the mode of learning; and pragmatists (class 3) paid more attention to the expected TCMT efficacy and the expected frequency of TCMT use. We recommend targeted strategies to motivate TCMT learning suited to the requirements of each class of TCMT learners.ConclusionRather than a single TCMT medical education program for primary health workers, CME programs should be targeted at different classes of TCMT learners.

Project description:BackgroundContinuing education (CE) is an international tool that requires lifelong active participation in learning activities allowing the pharmacist to stay a major player among others. In 2014 the CE program was introduced to the pharmacists licensed in Lebanon as a mandatory requirement for re-licensure. In the absence of guidelines regarding the quality and quantity of CE programs, behavioral resistance to precipitate in the CE programs might be encountered among the pharmacists.ObjectiveThe objective of this study is to assess the perceptions of pharmacists working in Lebanese hospitals on the continuing education preferences. The advantage of this program is to collect information that would help the Order of Pharmacy in Lebanon to upgrade the CE program in a way that is more acceptable and convenient for the pharmacists.MethodsA cross-sectional study was carried out in 2016, using a proportionate random sample of Lebanese hospital pharmacies from all governorates in Lebanon. A structured questionnaire was distributed to all hospital pharmacies in Lebanon. Descriptive statistics were calculated for all study variables. This includes the mean and standard deviation for continuous measures, counts and percentages for categorical variables.ResultsA total of 107 (53.5%) participants completed the questionnaires. The majority of participants were from Beirut and Mount Lebanon. The percentage of participants working at private hospitals was (68.2%).The majority of participants who completed the questionnaire (86.2%) agreed that continuing education programs affects their way of practice and increases their knowledge. Their preferred CE types to be used in the future were the computer based ones (60.6%), interactive workshops (45.5%) and printed materials (44.9%). Their considerations for selecting the CE type is based on their interest in the topic (80.6%), the ease of access to print or online material (77.2%), or the convenience of being offered during an event (67.1%). Participants noted that barriers to attend live CEs were mainly work responsibilities (76%), travel distance (65.6%), family commitments (48.4%) and scheduling (40.6%).ConclusionsLebanese hospital pharmacists are highly committed to CE. They consider it a practical tool for career development and advancement.

Project description:BACKGROUND:Feedback is essential for improving the skills of continuing medical education (CME) presenters. However, there has been little research on improving the quality of feedback to CME presenters. OBJECTIVES:To validate an instrument for generating balanced and behavior-specific feedback from a national cross-section of participants to presenters at a large internal medicine CME course. DESIGN, SETTING, AND PARTICIPANTS:A prospective, randomized validation study with qualitative data analysis that included all 317 participants at a Mayo Clinic internal medicine CME course in 2009. MEASUREMENTS:An 8-item (5-point Likert scales) CME faculty assessment enhanced study form (ESF) was designed based on literature and expert review. Course participants were randomized to a standard form, a generic study form (GSF), or the ESF. The dimensionality of instrument scores was determined using factor analysis to account for clustered data. Internal consistency and interrater reliabilities were calculated. Associations between overall feedback scores and presenter and presentation variables were identified using generalized estimating equations to account for multiple observations within talk and speaker combinations. Two raters reached consensus on qualitative themes and independently analyzed narrative entries for evidence of balanced and behavior-specific comments. RESULTS:Factor analysis of 5,241 evaluations revealed a uni-dimensional model for measuring CME presenter feedback. Overall internal consistency (Cronbach alpha?=?0.94) and internal consistency reliability (ICC range 0.88-0.95) were excellent. Feedback scores were associated with presenters' academic ranks (mean score): Instructor (4.12), Assistant Professor (4.38), Associate Professor (4.56), Professor (4.70) (p?=?0.046). Qualitative analysis revealed that the ESF generated the highest numbers of balanced comments (GSF?=?11, ESF?=?26; p?=?0.01) and behavior-specific comments (GSF?=?64, ESF?=?104; p?=?0.001). CONCLUSIONS:We describe a practical and validated method for generating balanced and behavior-specific feedback for CME presenters in internal medicine. Our simple method for prompting course participants to give balanced and behavior-specific comments may ultimately provide CME presenters with feedback for improving their presentations.

Dataset Information

Development of an Evidence-Based, Theory-Informed National Survey of Physician Preparedness for Genomic Medicine and Preferences for Genomics Continuing Education.

Publications

Development of an Evidence-Based, Theory-Informed National Survey of Physician Preparedness for Genomic Medicine and Preferences for Genomics Continuing Education.

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