Community Cancer Genetics and Research Training (Revision)

描述（由申请人提供）：迫切需要熟练的癌症风险咨询师和癌症预防和控制研究，以提高经鉴定具有遗传癌症易感性的个体的有效性和管理选择范围。癌症风险评估比大多数其他临床服务涉及更多的步骤和提供者的时间，并已成为一个高度专业化的学科。癌症风险评估的从业人员水平能力以高级技能为标志，包括以下能力：生成扩展的鉴别诊断;确定个体化癌症风险（遗传和/或经验）;提供量身定制的风险管理建议;以及确定潜在的研究资格。大多数社区癌症遗传学从业者没有足够的技能或机会参与研究。医学院的课程、遗传咨询或护理培训方案还没有完全涉及这些技能的综合。曾经是学术健康中心的专属领域，临床癌症遗传学服务越来越多地在社区环境中提供。因此，可能无法实现大量潜在的临床研究受试者。2005年NCI旁路预算强调了癌症交流和战略的重要性，以解决与癌症易感性相关的临床、行为和社会问题（NIH出版物编号03-5446）。该文件指出了促进网络、伙伴关系和联盟的重要性，以将研究成果转化为临床实践和公共卫生效益。然而，到目前为止，还没有针对社区临床医生的临床癌症遗传学和研究合作方面的强化培训计划。 最近公布的一个试点课程的结果表明，参与者的癌症遗传学知识有了显著提高（p>0.001），一项需求评估调查表明，目标人群仍然需要教育，试点课程校友对研究合作的兴趣和努力表明，利用课程促进参与研究活动是可行的。因此，我们建议开发一个多模式的，跨学科的课程，赋予在癌症风险评估，并在社区环境中促进研究参与的技能，医务人员水平的能力。该计划将提供约60小时的规定教学和互动教学，通过网络会议和长期访问异步学习的网络板的持续实践发展的12个月。该计划设计新颖，使用多种同步和异步教学模式，以最大限度地提高学习效果，并灵活地适应不同培训背景和实践环境的参与者的需求。课程对参与者的知识，技能，实践中的变化和研究参与的影响将被衡量。该项目的长期目标是增加社区获得合格的癌症遗传学服务的机会，并增加高风险患者参与研究方案的机会。课程和交付设计可以作为传播到其他癌症中心的模型，以帮助解决NCI的优先事项，如家庭登记的增加（例如合作家庭研究）

DESCRIPTION (provided by applicant): Skilled cancer risk counselors and cancer prevention and control studies are critically needed to improve the efficacy and range of management options available to individuals identified to have a genetic cancer predisposition. Cancer risk assessment involves more steps and provider time than most other clinical services, and has emerged as a highly specialized discipline. Practitioner- level competence in cancer risk assessment is marked by advanced skills, including the ability to: generate expanded differential diagnoses; determine individualized cancer risk (genetic and/or empiric); provide tailored risk management recommendations; and identify potential research study eligibility. Most community-based cancer genetics practitioners do not have adequate skills or opportunity to participate in research. The composite of these skills is not yet fully addressed in the curricula of medical school, genetic counseling or nursing training programs. Once the exclusive domain of academic health centers, clinical cancer genetics services are increasingly being delivered in community settings. Consequently, a substantial number of potential clinical research subjects may not be realized. The NCI bypass budget for 2005 highlights the importance of cancer communications and strategies to address the clinical, behavioral and societal issues associated with cancer susceptibility (NIH Publication No. 03-5446). The document notes the importance of promoting networks, partnerships and coalitions to translate the results of research into clinical practice and public health benefit. However, to date there are no intensive training programs in clinical cancer genetics and research collaboration for community-based clinicians. Recently published outcomes from a pilot course demonstrated significant improvement in cancer genetics knowledge for participants (p>0.001), and a needs assessment survey demonstrated continued need for education in the target populations, and research collaboration interest and efforts by pilot course alumni suggested the feasibility of using a course to promote participation in research activities. Therefore, we propose to develop a multi-modal, interdisciplinary course to confer practitioner-level competence in cancer risk assessment, and skills to promote research participation in a community setting. The program will provide approximately 60 hours of prescribed didactic and interactive instruction, twelve months of continued practice development via web-conferencing and long-term access to a web board for asynchronous learning. The program design is novel, uses multiple synchronous and asynchronous teaching modalities to maximize learning, and is flexible to accommodate the needs of participants with varied training backgrounds and practice settings. The impact of the course on participant knowledge, skills, changes in practice, and research participation will be measured. Long-term objectives of the project are to increase community access to competent cancer genetics services, and to increase accrual of high-risk patients into research protocols. The curriculum and delivery design may serve as a model for dissemination to other cancer centers to help address NCI priorities such as augmentation of familial registries (e.g. Cooperative Family Studies)