Deanna Telner

Genetics education in medical school: a qualitative study exploring educational experiences and needs

Background: Genetic discoveries increasingly have an impact on clinical medicine. Primary care providers (PCPs) need to be prepared to address patients’ concerns about their genetic risks. Aims: To explore family medicine residents’ experiences with genetics in medical school and residency training and to understand their educational needs in genetics. Methods: Four focus groups were held with 33 family medicine residents at the University of Toronto, which represented graduates of 9 different Canadian medical schools. Groups were audio-taped, transcribed and analysed independently by 4 reviewers using content analysis. Recurrent themes were identified. Results: Participants described their experiences with genetics in medical school as almost entirely related to rare disorders, so genetics was not perceived to be clinically relevant. There was little awareness of the complex ethical and psychosocial issues that accompany genetics. However, participants felt that genetics would become significant in medical care in the future and PCPs would play an important role. They expressed a need for more knowledge of genetics to fulfill this role and practical teaching in genetics by clinicians. Conclusions: Medical school educational experiences may not be preparing future PCPs to address genetic issues with patients. A change and a broadening of the teaching of genetics are required to fulfill this need.

Flying blind: The experience of online interprofessional facilitation

The role of the facilitator is known to be important in fostering productive interprofessional education (IPE) in the face-to-face (F2F) environment. Online learning can help surmount some of the logistical challenges in IPE by bringing together diverse professionals in multiple geographical locations. Best practices in F2F IPE facilitation are beginning to emerge, but there is scant literature examining IPE facilitation online. What little research exists has focused on the asynchronous environment and suggests that the skill sets of online and F2F facilitators have considerable overlap, but there are further demands in the online setting. This qualitative study sought to examine online synchronous IPE facilitation through the self-reported experiences of seven trained facilitators during a 12-week online course. Data collected through focus groups and targeted interviews were analyzed by the research team using constant comparison techniques. Four major themes were revealed: technology as a dynamic force, reduction in non-verbal cues, evolution of the online IPE group process over time and the importance of co-facilitation. The foundations of IPE facilitation were seen to carry over to the online setting. This study has implications for the training of IPE facilitators and for the design of online IPE learning experiences.

Interactive Genetic Counseling Role-Play: A Novel Educational Strategy for Family Physicians

BackgroundFamily physicians (FPs) are increasingly involved in delivering genetic services. Familiarization with aspects of genetic counseling may enable FPs to help patients make informed choices.PurposeExploration of interactive role-play as a means to raise FPs’ awareness of the process and content of genetic counseling.MethodsFPs attending two large Canadian family medicine conferences in 2005 were eligible—93 participated. FPs discussed a case during a one-on-one session with a genetic counselor. Evaluation involved pre and post intervention questionnairesResultsFPs’ baseline genetic knowledge was self-rated as uniformly poor. Baseline confidence was highest in eliciting family history and providing psychosocial support and lowest in discussing risks/benefits of genetic testing and counseling process. Post-intervention, 80% of FPs had better appreciation of family history and 97% indicated this was an effective learning experience.ConclusionsRole-play with FPs is effective in raising awareness of the process and content of genetic counseling and may be applied to other health disciplines.

A scoping review of medical education research in family medicine

BackgroundLittle is known about the state of education research within family medicine. As family medicine education models develop, it is important to develop an understanding of the current state of this research and develop ways to advance the field.MethodsWe conducted a scoping review of family medicine education research to describe 1) research topic areas and 2) the methodologies and methods used to study these topics. MEDLINE, Social Sciences Abstracts and ERIC electronic databases were searched. 817 full text articles from 2002 to 2012 were screened; 624 articles were included in the review.ResultsThe following research topic areas were identified: continuing education, curriculum development, undergraduate education, teaching methods, assessment techniques, selection of entrants, non-clinical skills, professional and faculty development, clinical decision-making and resident well-being. Quantitative studies comprised the large majority of research approaches; overall minimal methodological details were provided.ConclusionsOur review highlights an overall need for increased sophisticated in methodological approaches to education research in family medicine, a problem that could be ameliorated by multiple strategies including better engagement of methodologists throughout the research process. The results provide guidance for future family medicine education research programs.

All for One and One for All: Understanding Health Professionals’ Experience in Individual Versus Collaborative Online Learning

Introduction: Computer‐supported collaborative learning (CSCL) may facilitate continuing interprofessional education while overcoming barriers of time and place for busy health care professionals. The purpose of this study was to understand the experiences, advantages, and challenges of group versus individual online learning. Methods: Fifteen multidisciplinary health professionals participated in a 12‐week online course on either diabetes or traumatic brain injury. This consisted of background e‐modules and a longitudinal build‐a‐case exercise, done either individually or as a group. Focus group sessions exploring participants’ experiences after course completion and at 4 months were conducted, transcribed, and analyzed for recurring themes. Participant reflection homework and video‐recorded group sessions were used for triangulation of results. Results: Individual learners appreciated the flexibility and control, but experienced decreased motivation. Group learners appreciated the immediate feedback from their co‐learners and felt social pressure to come to the weekly sessions prepared but expressed challenges in determining group goal‐setting for the session. Both groups felt they learned about interprofessional roles; however, group learners described a richer learning experience and understanding of interprofessional roles through the online collaboration exercise. The intense resources necessary for interprofessional CSCL, including time, faculty development, and technological issues, are described. Discussion: CSCL is a valuable educational strategy in online learning. While individual online learning may be better suited for short and simple educational interventions such as knowledge acquisition, CSCL seems to allow for richer and deeper learning in complex and interprofessional educational experiences. However, strategies, resources, and faculty development required to enhance CSCL need to be addressed carefully.

Examining the teaching roles and experiences of non-physician health care providers in family medicine education: a qualitative study

BackgroundPrimary Care reform in Canada and globally has encouraged the development of interprofessional primary care initiatives. This has led to significant involvement of non-physician Health Care Providers (NPHCPs) in the teaching of medical trainees. The objective of this study was to understand the experiences, supports and challenges facing non-physician health care providers in Family Medicine education.MethodsFour focus groups were conducted using a semi-structured interview guide with twenty one NPHCPs involved in teaching at the University of Toronto, Department of Family & Community Medicine. The focus groups were transcribed and analyzed for recurrent themes. The multi-disciplinary research team held several meetings to discuss themes.ResultsNPHCPs were highly involved in Family Medicine education, formally and informally. NPHCPs felt valued as teachers, but this often did not occur until after learners understood their educator role through increased time and exposure. NPHCPs expressed a lack of advance information of learner knowledge level and expectations, and missed opportunities to give feedback or receive teaching evaluations. Adequate preparation time, teaching space and financial compensation were important to NPHCPs, yet were often lacking. There was low awareness but high interest in faculty status and professional development opportunities.ConclusionsSharing learner goals and objectives and offering NPHCPs feedback and evaluation would help to formalize NPHCP roles and optimize their capacity for cross-professional teaching. Preparation time and dedicated space for teaching are also necessary. NPHCPs should be encouraged to pursue faculty appointments and to access ongoing Professional Development opportunities.