Genetics in primary care: a USA faculty development initiative.
Genetics in primary care: a USA faculty development initiative.
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DOI：
10.1159/000065165
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发表时间：
2002-01-01
期刊：
影响因子：
--
通讯作者：
Wilson, Modena
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文献类型：
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作者：
Burke, Wylie;Acheson, Louise;Wilson, Modena
遗传学在初级保健（GPC）项目是美国国家教师发展计划，其目标是通过发展初级保健教师在遗传学方面的专业知识，加强对医学生和初级保健居民的培训。一个执行委员会在咨询委员会的投入下为该项目制定了教育战略，咨询委员会由具有初级保健、医学教育和遗传学专门知识的个人组成。这些委员会确定了初级保健遗传学教育的关键问题：（1）在常见疾病的鉴别诊断中考虑遗传性疾病;（2）使用适当的遗传检测和诊断咨询策略;（3）理解遗传诊断对家庭成员的影响。该小组强调了初级保健观点的重要性，这表明遗传信息的临床效用在它有可能改善健康结果时最大。该小组还指出，临床实践已经纳入了家族史信息的使用，为讨论遗传概念在初级保健中的应用提供了基础。遗传学和初级保健专家一致认为，教育工作将是最成功的，如果他们被整合到现有的初级保健教学计划，并使用基于案例的教学格式，结合遗传疾病的临床和社会层面。确定了三个核心临床技能：（1）解释家族史;（2）识别遗传信息的可变临床效用;（3）获得文化能力。还确定了三个潜在的争议领域：（1）在讨论基因检测时，非指导性咨询与共同决策的作用;（2）当遗传信息不影响健康结果时，遗传信息的内在价值;（3）遗传学转诊的指征。该项目为持续讨论这些重要问题提供了机会。
The Genetics in Primary Care (GPC) project is a USA national faculty development initiative with the goal of enhancing the training of medical students and primary care residents by developing primary care faculty expertise in genetics. Educational strategies were developed for the project by an executive committee with input from an advisory committee, comprising individuals with primary care, medical education and genetics expertise. These committees identified the key issues in genetics education for primary care as (1) considering inherited disease in the differential diagnosis of common disorders; (2) using appropriate counseling strategies for genetic testing and diagnosis, and (3) understanding the implications of a genetic diagnosis for family members. The group emphasized the importance of a primary care perspective, which suggests that the clinical utility of genetic information is greatest when it has the potential to improve health outcomes. The group also noted that clinical practice already incorporates the use of family history information, providing a basis for discussing the application of genetic concepts in primary care. Genetics and primary care experts agreed that educational efforts will be most successful if they are integrated into existing primary care teaching programs, and use a case-based teaching format that incorporates both clinical and social dimensions of genetic disorders. Three core clinical skills were identified: (1) interpreting family history; (2) recognizing the variable clinical utility of genetic information, and (3) acquiring cultural competency. Three areas of potential controversy were identified as well: (1) the role of nondirective counseling versus shared decision-making in discussions of genetic testing; (2) the intrinsic value of genetic information when it does not influence health outcomes, and (3) indications for a genetics referral. The project provides an opportunity for ongoing discussion about these important issues.