title: Genetics in primary care: a USA faculty development initiative.
abstract: The Genetics in Primary Care (GPC) project is a USA national faculty development initiative with the goal of enhancing the training of medical students and primary care residents by developing primary care faculty expertise in genetics. Educational strategies were developed for the project by an executive committee with input from an advisory committee, comprising individuals with primary care, medical education and genetics expertise. These committees identified the key issues in genetics education for primary care as (1) considering inherited disease in the differential diagnosis of common disorders; (2) using appropriate counseling strategies for genetic testing and diagnosis, and (3) understanding the implications of a genetic diagnosis for family members. The group emphasized the importance of a primary care perspective, which suggests that the clinical utility of genetic information is greatest when it has the potential to improve health outcomes. The group also noted that clinical practice already incorporates the use of family history information, providing a basis for discussing the application of genetic concepts in primary care. Genetics and primary care experts agreed that educational efforts will be most successful if they are integrated into existing primary care teaching programs, and use a case-based teaching format that incorporates both clinical and social dimensions of genetic disorders. Three core clinical skills were identified: (1) interpreting family history; (2) recognizing the variable clinical utility of genetic information, and (3) acquiring cultural competency. Three areas of potential controversy were identified as well: (1) the role of nondirective counseling versus shared decision-making in discussions of genetic testing; (2) the intrinsic value of genetic information when it does not influence health outcomes, and (3) indications for a genetics referral. The project provides an opportunity for ongoing discussion about these important issues.
authors.affiliation: University of Washington, Seattle, Wash., USA. wburke@u.washington.edu
authors.forename: Wylie
authors.initials: W
authors.lastname: Burke
authors.forename: Louise
authors.initials: L
authors.lastname: Acheson
authors.forename: Jeffery
authors.initials: J
authors.lastname: Botkin
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bridges
authors.forename: Ardis
authors.initials: A
authors.lastname: Davis
authors.forename: James
authors.initials: J
authors.lastname: Evans
authors.forename: Jaime
authors.initials: J
authors.lastname: Frias
authors.forename: James
authors.initials: J
authors.lastname: Hanson
authors.forename: Norman
authors.initials: N
authors.lastname: Kahn
authors.forename: Ruth
authors.initials: R
authors.lastname: Kahn
authors.forename: David
authors.initials: D
authors.lastname: Lanier
authors.forename: Linda E
authors.initials: LE
authors.lastname: Pinsky
authors.forename: Nancy
authors.initials: N
authors.lastname: Press
authors.forename: Michele A
authors.initials: MA
authors.lastname: Lloyd-Puryear
authors.forename: Eugene
authors.initials: E
authors.lastname: Rich
authors.forename: Nancy
authors.initials: N
authors.lastname: Stevens
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Thomson
authors.forename: Steven
authors.initials: S
authors.lastname: Wartman
authors.forename: Modena
authors.initials: M
authors.lastname: Wilson