Cancer Genetics Professional Education in a Global Community of Practice

描述（申请人提供）：快速发展的遗传/基因组技术彻底改变了我们的遗传癌症风险评估（GCRA）、筛查、预防和靶向癌症治疗方法，预示着个性化医疗时代的到来。许多遗传性癌症基因的临床检测是可用的，技术正在使整个外显子组触手可及。GCRA是一个跨学科的实践，使用遗传/基因组工具和经验风险模型来识别高风险个体。直接面向消费者的营销加速了社区临床医生对GCRA服务的需求，这些临床医生往往没有充分准备好选择、应用和解释基因检测。举办了一个强化的GCRA培训课程，以提高教师一级的能力。多模式课程包括远程教学法和面对面的讲习班，并允许试点开展课后专业发展活动。有显着的GCRA知识，技能和专业自我效能感（p<.001）的参与者之间的前到后的增加。有趣的是，一些校友在完成课程要求后继续参与专业发展。[美国和国际]对该课程的需求超过了能力的几倍。这些经验和正在进行的调查表明，有必要使GCRA培训在全球范围内更容易获得，课程需要解决新基因组学的临床翻译问题。行动研究发现，面对面的组成部分是一个能力障碍，并赞同创建所有距离和专业的GCRA培训轨道。比较分析表明，CME认证的GCRA网络会议系列可以提供有效的基于案例的GCRA培训。该项目提出了一个创新的全球临床癌症遗传学实践社区（CCGCoP）的发展，以帮助解决癌症遗传学/基因组学培训和循证患者护理的需求。该项目从情境学习的理论框架出发，利用希望之城、芝加哥大学和美国肿瘤学网络的资源和专业知识，实现以下目标：开发基于网络的工具、活动和合作，以支持CCGCoP的学习环境;招募国际思想领袖创建一个新的课程，其中包括快速发展的癌症遗传学/基因组学内容[并解决国内和全球的准入问题];开发全方位和所有距离的专科轨道作为培训选项，并支持 通过持续的专业发展活动，促进GCRA技能发展和循证实践，将新培训的参与者纳入CCGCoP。创新的设计和评估计划包括技能，实践变化和患者结果的纵向评估，与CME问责制的卓越改革标准保持一致。CCGCoP的最终目标是增加能够将遗传学/基因组学的进步转化为全球个性化医疗的临床医生数量。

DESCRIPTION (provided by applicant): Rapidly evolving genetic/genomic technologies have revolutionized our approach to genetic cancer risk assessment (GCRA), screening, prevention and targeted cancer therapies, heralding the era of personalized medicine. Clinical testing is available for many hereditary cancer genes, and technologies are bringing whole exomes within reach. GCRA, an interdisciplinary practice, uses genetic/genomic tools and empiric risk models to identify high-risk individuals. Direct-to-consumer marketing has accelerated the demand for GCRA services from community-based clinicians, who are often inadequately prepared to select, apply and interpret genetic tests. An intensive GCRA training course was conducted to promote practitioner-level competence. The multimodal course included distance mediated didactics and face-to-face workshops, and enabled piloting of post-course professional development activities. There were significant pre-to-post increases among participants in GCRA knowledge, skills and professional self-efficacy (p<.001). Interestingly, some alumni continued to participate in professional development after fulfilling course requirements. Demand for the course [across the U.S. and internationally] exceeded capacity several-fold. These experiences and ongoing inquiries indicate a need to make GCRA training more accessible globally, and the curriculum needs to address clinical translation of new genomics. Action research identified the face-to-face component as a capacity barrier, and endorsed creation of all-distance and specialty GCRA training tracks. Comparative analysis indicated that a CME-accredited GCRA web conference series might provide effective case-based GCRA training. This project proposes the development of an innovative global Clinical Cancer Genetics Community of Practice (CCGCoP) to help address the demand for cancer genetics/genomics training and evidence-based patient care. Working from the theoretical framework of situated learning, the proposed project leverages the resources and expertise of the City of Hope, University of Chicago and U.S. Oncology Network to accomplish the following aims: Develop web-based tools, activities and collaborations to support the CCGCoP learning environment; enlist international thought leaders to create a new curriculum that includes rapidly-evolving cancer genetics/genomics content [and addresses domestic and global access issues]; develop full spectrum and all- distance subspecialty tracks as training options, and support integration of newly-trained participants into the CCGCoP through continuing professional development activities that promote GCRA skills development and evidence-based practice. The innovative design and evaluation plan encompasses longitudinal assessments of skills, practice change and patient outcomes, aligned with reformed standards of excellence in CME accountability. The ultimate goal of the CCGCoP is to increase the number of clinicians who are able to translate advances in genetics/genomics into personalized medicine globally.