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培训，也没有接受过基因检测、诊断和治疗的伦理、法律的和社会影响（ELSI）培训。此外，仅仅提供课程内容不能影响医生的行为。然而，具有基于既定教育和成人学习原则的要素的方案已被证明在影响行为改变方面是有效的。我们建议评估是否参与一个基于网络的课程，侧重于初级保健遗传学的伦理法律的和社会问题，将提高初级保健医生的遗传问题的方法。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。我们将在加州的五个卫生系统（加州大学戴维斯分校、农村卫生网络、加州大学洛杉矶分校、凯撒医疗机构、萨特医疗集团萨克拉门托）招募120名PCP。PCP将按实践地点随机分配，以控制（纸质课程）或使用先前由NHRGI资助开发的互动式网络课程进行积极干预。本课程利用视觉工具，视频剪辑小插曲，和其他互动内容来说明有关风险评估，遗传筛查和SDM的关键点。PCP与宣布的标准化患者学习目标的接触将用于评估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，贯彻学习计划）和态度（调查和自我效能评估）课程的有效性。如果证明有效，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遗传筛查的知识和态度。 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、法律的和社会影响方面的培训。该项目评估了一种新的基于网络的课程，重点是初级保健遗传学的伦理法律的和社会问题，以提高初级保健医生对遗传疾病在患者生活中的影响的理解。如果证明有效，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决策遗传筛查的能力。

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.