Increasing confidence and changing behaviors in primary care providers engaged in

描述(由申请人提供)：初级保健医生几乎没有接受过遗传学方面的培训，也没有接受过基因测试、诊断和治疗的伦理、法律和社会影响(ELSI)方面的培训。此外，仅仅提供课程内容并不能影响医生的行为。然而，以既定的教育和成人学习原则为基础的项目已被证明在影响行为变化方面是有效的。我们建议评估是否参与以网络为基础的课程，重点关注初级保健遗传学中的伦理、法律和社会问题，是否会改善初级保健医生对遗传问题的处理方法。具体地说，我们将评估参与是否会改善医生的知识、态度和执业行为。我们将在加州的五个医疗系统(加州大学戴维斯分校、农村健康网络、加州大学洛杉矶分校、Kaiser Permanente、萨特医疗集团萨克拉门托)招聘120名PCP。PCP将按练习地点随机分组，以控制(纸质课程)或积极干预以前由NHRGI资助开发的基于网络的互动课程。本课程使用可视化工具、视频片段和其他互动内容来说明有关风险评估、基因筛查和SDM的关键点。PCP遇到已公布的标准化患者学习目标将用于评估PCP的ELSI相关行为变化。评估还将包括遗传知识课程的有效性(知识测试)、技能(自我报告、学习计划的后续行动)和态度(调查和自我效能评估)。如果被证明有效，这些基于网络的工具可以很容易地在全国和国际上传播，以改善医生和患者对基因筛查的知识和态度。 公共卫生相关性：大多数初级保健医生几乎没有接受过遗传学方面的培训，也没有接受过基因测试、诊断和治疗的伦理、法律和社会影响(ELSI)方面的培训。该项目评估了一个新的基于网络的课程，重点是初级保健遗传学中的伦理、法律和社会问题，以提高初级保健医生对遗传疾病对患者生活的影响的理解。如果被证明是有效的，这些基于网络的工具可以很容易地传播，以提高医生对遗传学社会背景的了解，并提高他们参与与患者分享关于基因筛查的决策的能力。

DESCRIPTION (provided by applicant): Primary care physicians have almost no training in genetics, nor in the ethical, legal and social implications (ELSI) of genetic testing, diagnosis and therapy. Further, mere provision of curricular content fails to impact physician behavior. However, programs with elements that are based on established educational and adult learning principles have been shown to effective in affecting behavioral change. We propose to evaluate whether participation in a web-based curriculum focusing on the ethical legal and social issues in primary care genetics will improve primary care physicians' approach to genetic issues. Specifically, we will assess whether participation will improve physician knowledge, attitudes, and practice-behaviors. We will recruit 120 PCPs across five health systems in California (UC Davis, Rural Health Network, UC Los Angeles, Kaiser Permanente, Sutter Medical Group Sacramento). PCPs will be randomized by practice site to control (paper curriculum) or active intervention with an interactive web-based curriculum previously developed with funding from the NHRGI. This curriculum utilizes visual tools, video clip vignettes, and other interactive content to illustrate key points about risk assessment, genetic screening, and SDM. PCPs encounters with Announced Standardized Patients Learning objectives will be used to assess PCP's ELSI related behavioral change. Evaluation will also include the effectiveness of the curriculum for genetic knowledge (testing of knowledge), skills (self-report, follow-through with learning plan), and attitudes (survey and self-efficacy assessments). If proven effective, these web-based tools can be easily disseminated around the country, and internationally, to improve knowledge and attitudes about genetic screening among physicians and patients. PUBLIC HEALTH RELEVANCE: Most primary care physicians have almost no training in genetics, nor in the ethical, legal and social implications (ELSI) of genetic testing, diagnosis and therapy. This project evaluates a novel web-based curriculum focusing on the ethical legal and social issues in primary care genetics in order to improve primary care physicians' understanding of the implications of genetic disorders in patients' lives. If proven effective, these web-based tools can be easily disseminated to improve physician's knowledge of the social context of genetics and improve their ability to engage in shared decision-making with patients about genetic screening.