title: Personalized cancer genetics training for personalized medicine: improving community-based healthcare through a genetically literate workforce.
abstract: OBJECTIVE
  To assess the impact of a multimodal interdisciplinary course on genetic cancer risk assessment and research collaboration for community-based clinicians. Clinicians are increasingly requested to conduct genetic cancer risk assessment, but many are inadequately prepared to provide these services.
  
  
  METHODS
  A prospective analysis of 131 participants (48 physicians, 41 advanced-practice nurses, and 42 genetic counselors) from community settings across the United States. The course was delivered in three phases: distance didactic learning, face-to-face training, and 12 months of web-based professional development activities to support integration of skills into practice. Cancer genetics knowledge, skills, professional self-efficacy, and practice changes were measured at baseline, immediate, and 14 months postcourse.
  
  
  RESULTS
  Knowledge, skills, and self-efficacy scores were significantly different between practice disciplines; however, postscores increased significantly overall and for each discipline (P < 0.001). Fourteen-month practice outcomes reflect significant increases in provision of genetic cancer risk assessment services (P = 0.018), dissemination of cancer prevention information (P = 0.005) and high-risk screening recommendations (P = 0.004) to patients, patient enrollment in research (P = 0.013), and educational outreach about genetic cancer risk assessment (P = 0.003).
  
  
  CONCLUSIONS
  Results support the efficacy of the multimodal course as a tool to develop a genetically literate workforce. Sustained alumni participation in web-based professional development activities has evolved into a distance-mediated community of practice in clinical cancer genetics, modeling the lifelong learning goals envisioned by leading continuing medical education stakeholders.
authors.affiliation: Division of Clinical Cancer Genetics, City of Hope Comprehensive Cancer Center, Duarte, California 91010, USA.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Blazer
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Macdonald
authors.forename: Julie O
authors.initials: JO
authors.lastname: Culver
authors.forename: Carin R
authors.initials: CR
authors.lastname: Huizenga
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Morgan
authors.forename: Gwen C
authors.initials: GC
authors.lastname: Uman
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Weitzel
mesh_terms: D004502:Education, Medical, Continuing; D005817:Genetic Counseling / Q000379:methods* / Q000639:trends; D005820:Genetic Testing / Q000379:methods; D019538:Health Care Surveys; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000235:genetics; D057285:Precision Medicine / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors