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，也没有接受过基因检测、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，基于既定教育和成人学习原则的项目已被证明可以有效影响行为改变。我们建议评估参与专注于初级保健遗传学中的道德法律和社会问题的网络课程是否会改善初级保健医生处理遗传问题的方法。具体来说，我们将评估参与是否会提高医生的知识、态度和实践行为。我们将在加州五个卫生系统（加州大学戴维斯分校、农村健康网络、加州大学洛杉矶分校、凯撒医疗机构、萨克拉门托萨特医疗集团）招募 120 名 PCP。 PCP 将按实践地点随机分配，以进行控制（纸质课程）或使用先前由 NHRGI 资助开发的交互式网络课程进行积极干预。本课程利用视觉工具、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 的要点。 PCP 与已公布的标准化患者的接触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（知识测试）、技能（自我报告、学习计划的跟进）和态度（调查和自我效能评估）课程的有效性。如果被证明有效，这些基于网络的工具可以轻松地在全国和国际范围内传播，以提高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，也没有接受过基因检测、诊断和治疗的伦理、法律和社会影响 (ELSI) 方面的培训。该项目评估了一种新颖的网络课程，重点关注初级保健遗传学中的道德法律和社会问题，以提高初级保健医生对遗传性疾病对患者生活影响的理解。如果被证明有效，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，并提高他们与患者共同制定基因筛查决策的能力。

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.