Improving Genetics Education in Graduate and Continuing Health Professional Education Workshop Summary (2015) / Chapter Skim
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3 Educational Approaches
3 Educational Approaches
Pages 13-32
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From page 13... ...
New research findings and evidence-based approaches to education have transformed many learning environments and have improved learning outcomes. Workshop speakers discussed several of these new approaches, including just-in-time approaches to education, the use of social media and other technology platforms in health professional education, IPE, and the use of evidence and theory in designing educational 13
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From page 14... ...
"We need to get that information and figure out how to integrate it in a rapid way," he said, so that patients are receiving the best care possible. However, in his role as the director of a pulmonology genetics center who often sees patients with extremely rare disorders, Raby has witnessed firsthand what he called the "dilemma" of providing genetics education.
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From page 15... ...
The UpToDate resource tries to make information as accessible as possible by having the information directly linkable from electronic medical records, Raby said. UpToDate is also currently working on integrating calculators of risk prediction and decision-management solutions into electronic medical records, which could be pre-populated with patientspecific information.
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From page 16... ...
"These are the types of tools that we need to get into place for people to have the knowledge they need to move forward." TECHNOLOGY IN MEDICAL EDUCATION Emerging technologies and media platforms offer other new and intriguing ways to educate students and health care providers in genetics. But technology needs to serve patients as well as learners, said Alexander Djuricich, associate professor of clinical pediatrics and clinical medicine at the Indiana University School of Medicine.
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From page 17... ...
At the same time as the journal Pediatrics opted to move more toward a digital identity by developing a full-text mobile app and becoming active in social media tools, such as Facebook and Twitter, in response to reader preferences for accessing journal content (First et al., 2014) , an article was published in Academic Pediatrics warning against the overuse of technology and the effects of such overuse on interactions with patients and learners (Crain, 2014)
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This can be done, for instance, in a faculty-led or small-group environment where medical and nursing students are trained together, Seibert said. The goal of IPE is to improve collaborations between health care professionals in order to improve patient outcomes.
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recently published Core Competencies for Interprofessional Collaborative Practice, which has been "getting some forward traction," according to Seibert. For example, in October 2012 the Liaison Committee on Medical Education approved a new accreditation standard,2 which went into effect in July 2013, that requires that "the core curriculum of a medical education program must prepare medical students to function collaboratively on health care teams that include health professionals from other disciplines as they provide coordinated services to patients.
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From page 20... ...
"The topic will attract the audience." For example, nurse practitioners are very interested in family health histories and risk assessment. Many individuals are also interested in genetic testing, especially testing for common complex diseases that affect large numbers of patients.
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IDENTIFYING AND AVOIDING CONFLICTS OF INTEREST IN EDUCATIONAL MATERIALS3 Many physicians have a misplaced confidence that marketing bias is easy to recognize and straightforward to avoid, said Jean Silver-Isenstadt, executive director of the National Physicians Alliance. That belief makes it easier for marketers to embed themselves in medical education, research, and practice at many levels.
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It was designed to champion evidencebased care, and it sparked the Choosing Wisely campaign,5 which promotes the ability of patients to choose care that not only is supported by evidence but is not duplicative with other tests that have been performed previously, that is free from harm, and that is necessary for their care. One aspect of the Promoting Good Stewardship project was the creation of "top five" lists of common practices within internal medicine, pediatrics, and family practice that are not supported by clinical evidence and guidelines, such as prescribing antibiotics for a viral infection, rushing to order a computed tomography (CT)
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As a result, time is spent trying to tweak disclosure forms, causing frustrations for those who have to fill out the forms, Silver-Isenstadt said, rather than spending time on "the real problem, which is what is behind what is being disclosed." When making consumer decisions, people routinely consult independent evaluations of products' safety, cost-effectiveness, and price. Yet physicians routinely allow those with a personal stake in drugs, tests, and devices to fund and conduct continuing medical education, to ghostwrite journal articles, to make sales visits, to set up paid consulting agreements, and to distribute free products, Silver-Isenstadt said.
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"And to fix it is going to require a lot of courage." PRINCIPLES OF EVIDENCE IN DESIGNING EDUCATIONAL PROGRAMS Educational programs fall under the rubric of implementation research, which has been defined by the Fogarty International Center as "the study of methods to promote the integration of research findings and evidence into health care policy and practice,"10 as Maren Scheuner of the Department of Veterans Affairs explained. Similarly, Rubenstein and Pugh (2006)
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Scheuner has used these methodologies -- formative and summative evaluation as well as theory -- to examine genetic testing applications that have evidence of clinical utility, particularly with regard to family history. The project, known as Family History Education to Improve Risk Assessment for Hereditary Cancer, sought to improve the recognition and referral of patients at risk for hereditary cancer syndromes by primary care clinicians at women's health clinics.
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From page 26... ...
because they knew they needed help to better document family history." In response, Scheuner and her colleagues created a draft reminder tool designed to identify family history red flags for hereditary cancer, eventually expanding the reminder template to gather even more comprehensive family history information. Ultimately, a multifaceted strategy that included clinical interventions, information interventions, and behavior interventions was developed as part of a family history toolkit.
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In projects at the Department of Veterans Affairs, ongoing interviews are conducted with stakeholders, including front office staff. In particular, she emphasized the importance of quality improvement and the use of best practices, which requires quality indicators.
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This is a barrier." Putting resources into the further evaluation of continuing medical education initiatives would not be well spent. Instead, he suggested doing research on the problems that exist, such as the professional practice gap, and how those problems can best be addressed.
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From page 29... ...
, which enables the capture of performance information in order to improve patient care and outcomes. A recent study on the efficacy of METRIC found that in nearly 12,000 patient encounters with family physicians who had undergone the intervention, 75 percent of the quality markers in diabetes care showed improvement (Bird et al., 2013)
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From page 30... ...
For example, she talked with the leader of the Veterans Affairs Greater Los Angeles Healthcare System clinical service about BRCA1 and BRCA2 genetic testing, to which the leader was "very receptive." Clinicians also were interested in educational activities because they helped provide the context for the new tool they were using to obtain family histories. Raby said that clinicians could also be motivated by the coming "tsunami" of readily available genetic information.
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From page 31... ...
The accreditation of quality improvement projects for physicians and for multidisciplinary allied health staff teams has worked well for some institutions, according to one workshop participant. "For example," the participant said, "I work with pathologists, and they are constantly doing quality improvement with regard to turnaround time or improving laboratory reports." Physicians are extremely busy, but if they can receive continuing medical education in something that they are already doing, they can use that information to improve the quality of care for their patients.
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