Sarah Burke

A "neglected part of the curriculum" or "of limited use"? Views on genetics training by nongenetics medical trainees and implications for delivery.

Purpose: Although the importance of genetics education for health care professionals is increasingly recognized worldwide, little is known about the needs and views of nongenetics postgraduate medical trainees.Methods: Data on the views of 143 learners from four specialties (family practice, neurology, cardiology, and dermatology) in two regions in England (West Midlands and South Western) were collected using focus groups, questionnaires, and interviews.Results: Low levels of genetics training were reported by both trainee family practitioners and trainee hospital consultant specialists. Responses to attitude statements indicate that the majority of trainee family practitioners believed genetics was important but thought that they were underprepared in this area. Focus groups with specialty trainees revealed general consensus that there was not enough formal postgraduate genetics training, although some cardiologists disagreed and trainees in all three specialties thought that the existing curriculum was overcrowded. Trainees stressed the importance of tailoring genetics education to be directly relevant to their daily practice. Trainee family practitioners prioritized topics related to the identification and referral of patients, and the subsequent implication of results. In contrast, specialty trainees prioritized topics related to the genetics and management of particular diseases.Conclusion: There is still work to be done before trainees in nongenetics specialties recognize how genetics can be relevant to their practice. Involvement of specialty trainers in the development and delivery of genetics education may help to address this issue.

Developing a curriculum statement based on clinical practice: genetics in primary care.

BACKGROUND Advances in medical genetics are increasingly being incorporated into clinical management outside specialist genetic services. This study was therefore undertaken to develop learning outcomes in genetics for general practice specialty training, using methods to ensure the knowledge, skills, and attitudes relevant to genetics in primary care were identified. AIM To identify key knowledge, skills, and attitudes in genetics and to synthesise these into learning outcomes to assist training in genetics for primary care. DESIGN OF STUDY Delphi survey and review by expert group. SETTING Primary care practices and Regional Genetics Centre in the West Midlands region of the UK. METHOD A modified Delphi survey involved GP trainers, programme directors, and geneticists (n = 60). The results, along with results from a survey of GP registrars, were reviewed by an expert group, which included GPs, geneticists, and educationalists. RESULTS Core genetics topics for GPs were identified, prioritised, and developed into competency statements in the style of the curriculum structure of the Royal College of General Practitioners. CONCLUSION The development of the GP curriculum statement Genetics in Primary Care was based on a study of educational needs, incorporating the views of practitioners (GP trainers, programme directors, and registrars) and specialists (clinical geneticists). This inclusive approach has enabled the identification of learning outcomes which directly reflect clinical practice.

Engaging Nurses in Genetics: The Strategic Approach of the NHS National Genetics Education and Development Centre

The UK government announced the establishment of an NHS National Genetics Education and Development Centre in its Genetics White Paper. The Centre aims to lead and coordinate developments to enhance genetics literacy of health professionals. The nursing program takes a strategic approach based on Ajzen’s Theory of Planned Behavior, using the UK nursing genetics competences as the platform for development. The program team uses innovative approaches to raise awareness of the relevance of genetics, working collaboratively with policy stakeholders, as key agents of change in promoting competence. Providing practical help in preparing learning and teaching resources lends further encouragement. Evaluation of the program is dependent on gathering baseline data, and the program has been informed by an education needs analysis. The challenges faced are substantial and necessitate international collaboration where expertise and resources can be shared to produce a global system of influence to facilitate the engagement of non-genetic nurses.

Developing education tailored to clinical roles: Genetics education for haemophilia nurses

BACKGROUND Genetics is an important component of the clinical work of haemophilia nurses, but little was known about the genetic education needs of haemophilia nurses. AIM To develop, deliver and evaluate genetic education for haemophilia nurses, based on clinical roles. METHODS Perceived relevance of genetics to haemophilia nursing practice was explored using electronic voting (response rate 75%, 58/77). A follow-on questionnaire to a volunteer sample of participants explored educational preferences (response rate 41%, 17/41). Results informed development of a two-hour genetics workshop session, evaluated by questionnaire (response rate 67%, 47/70). RESULTS Genetic competences were considered relevant to the clinical practice of haemophilia nurses, and learning needs were identified. Preference was expressed for education focused on practical skills. During the subsequent workshop, participant confidence ratings significantly increased in the four areas addressed. Planned changes to clinical care and training were reported. CONCLUSION Within new areas of advanced nursing practice, learning needs can be addressed by: identifying relevant clinical activities and associated learning needs; creating a strategy and resources using preferred forms of delivery; implementing the strategy; and evaluating its effect. This will enable development of education that addresses the real needs of practising nurses, grounded in their daily clinical practice.

Evaluation of a pilot careers advice service for junior doctors.

This study evaluates a pilot careers service for junior doctors provided by a non-medical careers adviser. Evaluation forms and interviews indicate high satisfaction with this service. The junior doctors valued help with CVs and interviews, information regarding career routes and meetings with senior doctors arranged by the adviser. A longitudinal survey suggests that these doctors became clearer about their career pathways compared with controls, although they did not view the adviser as influencing their career choices. The employment of non-medical careers advisers is proposed.

Curriculum and assessment in higher specialist training

Higher Specialist Training (HST) has been radically reformed in the last decade, and specialties have been urged to conduct further reform. This paper reports on an explorative investigation into curriculum provision and assessment within four specialties in the West Midlands. Methods include analysis of curriculum documents; observation of the RITA process; and interviews with consultants (4), specialist registrars (5) and members of the regional higher specialist training management team (3). Three major themes identified within the interviews are discussed: the content and use of the curriculum; the impact of service-based learning; and issues around assessment.