title: Cancer genetics education in a low- to middle-income country: evaluation of an interactive workshop for clinicians in Kenya.
abstract: BACKGROUND
  Clinical genetic testing is becoming an integral part of medical care for inherited disorders. While genetic testing and counseling are readily available in high-income countries, in low- and middle-income countries like Kenya genetic testing is limited and genetic counseling is virtually non-existent. Genetic testing is likely to become widespread in Kenya within the next decade, yet there has not been a concomitant increase in genetic counseling resources. To address this gap, we designed an interactive workshop for clinicians in Kenya focused on the genetics of the childhood eye cancer retinoblastoma. The objectives were to increase retinoblastoma genetics knowledge, build genetic counseling skills and increase confidence in those skills.
  
  
  METHODS
  The workshop was conducted at the 2013 Kenyan National Retinoblastoma Strategy meeting. It included a retinoblastoma genetics presentation, small group discussion of case studies and genetic counseling role-play. Knowledge was assessed by standardized test, and genetic counseling skills and confidence by questionnaire.
  
  
  RESULTS
  Knowledge increased significantly post-workshop, driven by increased knowledge of retinoblastoma causative genetics. One-year post-workshop, participant knowledge had returned to baseline, indicating that knowledge retention requires more frequent reinforcement. Participants reported feeling more confident discussing genetics with patients, and had integrated more genetic counseling into patient interactions.
  
  
  CONCLUSIONS
  A comprehensive retinoblastoma genetics workshop can increase the knowledge and skills necessary for effective retinoblastoma genetic counseling.
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Hill
authors.affiliation: Laboratory Medicine and Pathobiology Program, University of Toronto, Toronto, Canada.
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, University of Nairobi, Nairobi, Kenya.
authors.forename: Lucy
authors.initials: L
authors.lastname: Njambi
authors.affiliation: Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America; Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Corson
authors.affiliation: Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada; Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada; Department of Human Pathology, University of Nairobi, Nairobi, Kenya.
authors.forename: Helen
authors.initials: H
authors.lastname: Dimaras
mesh_terms: D002983:Clinical Competence; D003695:Delivery of Health Care; D004502:Education, Medical, Continuing / Q000379:methods*; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000235:genetics; D005817:Genetic Counseling; D033142:Genetic Services / Q000592:standards*; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D010820:Physicians; D012175:Retinoblastoma / Q000175:diagnosis* / Q000235:genetics