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Arshad M, Trepanier A, Hashmi SS, Naeem R, Mehmood S, Ashfaq M. Medical students' self-perceived knowledge and clinical comfort with genetics in Pakistan. J Genet Couns 2023. [PMID: 37960989 DOI: 10.1002/jgc4.1828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/07/2023] [Accepted: 10/14/2023] [Indexed: 11/15/2023]
Abstract
Pakistan has a high rate of genetic disorders and neonatal mortality concurrent with noted lack of genetic counselors and geneticists. To meet the needs of the patient population, the responsibility of providing clinical genetic services falls on general and specialty physicians. However, their education regarding these essential services is not standardized in medical school curricula nor has it ever been evaluated. The purpose of this work is to describe the self-perceived knowledge, clinical comfort, and perspectives of Pakistani medical students toward their medical genetics' education. A web-based survey was distributed electronically to medical schools around the country. The survey comprised of four sections: (1) participant demographics, (2) self-perceived medical genetics knowledge, (3) level of comfort in applying genetic knowledge and skills, and (4) attitudes toward medical genetics education. Descriptive statistics and a one-way analysis of variance were used for data analysis. Medical students in years 3, 4, and 5 (n = 473) from 25 medical schools participated in this research representing medical education in four Pakistani provinces. Most medical students reported "minimal" to "basic" knowledge of genetic testing methodology (64.7%), cancer genetics (64.9%), prenatal genetic testing (63.02%), and treatment strategies for genetic disease (72.9%). A plurality of students (37%) reported they were uncomfortable with interpreting and communicating genetic test results to patients. Medical students also expressed dissatisfaction with their medical genetics (40%) and genetic counselors training (42%). The self-perceived knowledge and clinical comfort with genetics among Pakistani medical students was limited, especially regarding genetic testing. A significant portion (74.5%) expressed desire for additional genetics education during medical school to aid in their role as future physicians. It is important for physicians-in-training to have a solid understanding of genetic concepts, technologies, and genetic counseling to best support their patients. As endorsed by the participating medical students, this study supports inclusion of more robust genetics' education into Pakistan's medical school curricula.
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Affiliation(s)
- Maheen Arshad
- Wayne State University School of Medicine, Center for Molecular Medicine and Genetics, Detroit, Michigan, USA
- Henry Ford Health System, Detroit, Michigan, USA
| | - Angela Trepanier
- Wayne State University School of Medicine, Center for Molecular Medicine and Genetics, Detroit, Michigan, USA
| | - S Shahrukh Hashmi
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, Texas, USA
| | - Rizwan Naeem
- Albert Einstein College of Medicine, New York City, New York, USA
| | - Saqib Mehmood
- University of Health Sciences, Lahore, Punjab, Pakistan
| | - Myla Ashfaq
- Department of Pediatrics, Division of Medical Genetics, McGovern Medical School at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, Texas, USA
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Alotaibi AA, Cordero MAW. Assessing Medical Students' Knowledge of Genetics: Basis for Improving Genetics Curriculum for Future Clinical Practice. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1521-1530. [PMID: 35002351 PMCID: PMC8722570 DOI: 10.2147/amep.s337756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE The knowledge of genetics among medical students was assessed to identify and analyze gaps that serve as bases for the revision of the current genetics curriculum of the (Bachelor of Medicine, Bachelor of Surgery) MBBS Program of the College of Medicine at Princess Nourah bint Abdulrahman University (PNU). METHODS A 65-item multiple-choice (MCQs) test in Genetics was administered to 71 second and fourth-year medical students to assess their knowledge in Genetics. MCQs were validated and tested for their reliability. Self-assessment of students' genetics knowledge was also determined by asking them whether their knowledge in genetics is sufficient or not sufficient for their future clinical practice. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20. RESULTS Forty-one second-year and thirty fourth-year medical students took the Genetic test. Exam results showed insufficient knowledge of Genetics, with 43.85% among the students answering the exam correctly. In self-assessment, the majority (83.3% to 87.8%) of the respondents considered their knowledge of genetics insufficient for future clinical practice. A higher knowledge level of basic genetics compared with clinically related genetics concepts was observed. Generally, second-year students significantly scored higher in molecular and cytogenetics (P=0.012), principles of genetic transmission (P=0.022), and inheritance of genetic diseases (P=0.024), compared with the fourth-year medical students who only scored higher in items related to cancer genetics (P=0.022). CONCLUSION Medical students' genetics knowledge is insufficient, especially on clinically oriented concepts like genetic testing and genetic counseling and should be strengthened for future clinical practice. The fourth-year medical students do not retain the knowledge of genetics; thus, integrating medical genetics in clinical years is imperative.
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Affiliation(s)
- Amal A Alotaibi
- Basic Science Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Kingdom of Saudi Arabia
| | - Mary Anne W Cordero
- Basic Science Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Kingdom of Saudi Arabia
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A systematic review of communication interventions to help healthcare professionals discuss genetic testing for breast cancer. Breast Cancer Res Treat 2020; 183:9-21. [PMID: 32577939 PMCID: PMC7376076 DOI: 10.1007/s10549-020-05741-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/09/2020] [Indexed: 12/19/2022]
Abstract
Purpose This systematic review examined educational training interventions for healthcare professionals (HCPs) discussing genetic testing and risk for hereditary breast cancer. There was a particular focus on the presence, and content, of communication elements within these packages. Methods Searches were run via CINAHL, EMBASE, PUBMED, and PsychInfo in February 2019 to identify training interventions available to HCPs with reference to communication skills. Studies were assessed for quality, with relevant intervention and outcome data extracted and synthesized. This review followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement and was registered on the PROSPERO database (CRD42019124010). Results Of 3,988 items, seven papers, two of which were linked, were eligible for inclusion. There was a mix of randomized and single arm studies with web-based and face-to-face interventions. Content included an overview of genetics, hereditary and familial background, and recommended practice techniques. Outcomes focused on communication, self-efficacy, knowledge, and satisfaction. Interventions were designed for genetic counselors, physicians, primary care physicians (PCPs), medical students, and nurses. None of the papers featured oncologists or surgeons. Conclusions This review revealed an overall lack of publications which evaluated interventions to assist HCPs discussing hereditary breast cancer risk and testing. Studies failed to operationalize which ‘communication skills’ they included, nor did they consistently report randomization, outcome measures, or analysis. Discussing the need for, and management of, genetic testing for inherited cancer risk with individuals and their families can be challenging. As genetic testing in breast cancer becomes more common, the provision of specific communication-based training programs, with reference to genetic testing, risk assessments, and counseling skills is warranted. Electronic supplementary material The online version of this article (10.1007/s10549-020-05741-z) contains supplementary material, which is available to authorized users.
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Characteristics and evaluation outcomes of genomics curricula for health professional students: a systematic literature review. Genet Med 2018; 21:1675-1682. [DOI: 10.1038/s41436-018-0386-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/16/2018] [Indexed: 11/09/2022] Open
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Negri EC, Mazzo A, Martins JCA, Pereira GA, Almeida RGDS, Pedersoli CE. Clinical simulation with dramatization: gains perceived by students and health professionals. Rev Lat Am Enfermagem 2017; 25:e2916. [PMID: 28793125 PMCID: PMC5626175 DOI: 10.1590/1518-8345.1807.2916] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 05/02/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: to identify in the literature the gains health students and professionals perceive
when using clinical simulation with dramatization resources. Method: integrative literature review, using the method proposed by the Joanna Briggs
Institute (JBI). A search was undertaken in the following databases: Latin
American and Caribbean Health Sciences Literature, Web of Science, National
Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The
Cochrane Library, Scopus, Scientific Electronic Library Online. Results: 53 studies were analyzed, which complied with the established inclusion criteria.
Among the different gains obtained, satisfaction, self-confidence, knowledge,
empathy, realism, reduced level of anxiety, comfort, communication, motivation,
capacity for reflection and critical thinking and teamwork stand out. Conclusion: the evidence demonstrates the great possibilities to use dramatization in the
context of clinical simulation, with gains in the different health areas, as well
as interprofessional gains.
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Affiliation(s)
- Elaine Cristina Negri
- Doctoral student, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Alessandra Mazzo
- PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | - Gerson Alves Pereira
- PhD, Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rodrigo Guimarães Dos Santos Almeida
- Doctoral student, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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A review of consanguinity in Ireland—estimation of frequency and approaches to mitigate risks. Ir J Med Sci 2015; 185:17-28. [DOI: 10.1007/s11845-015-1370-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/07/2015] [Indexed: 11/26/2022]
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Defenbaugh N, Chikotas NE. The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students. Nurse Educ Pract 2015; 16:176-81. [PMID: 26122938 DOI: 10.1016/j.nepr.2015.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 02/15/2015] [Accepted: 06/10/2015] [Indexed: 10/23/2022]
Abstract
The purpose of this qualitative study was to examine the impact of standardized patient experiences (SPE) in the education of the Advanced Practice Nurse (APN). The education of the APN requires educators to make every attempt to promote competency in the areas of communication and clinical-decision making. SPE programs have been found to improve the interpersonal, problem solving, and critical thinking skills of nursing students. For this research twenty-nine APN students participated in SPEs over the course of two semesters. Fifteen student volunteers of those 29 participants were then interviewed three months after the experience. Results revealed that having an expert in the field of communication studies increased awareness of communication skills and how to improve nurse-patient encounters in the clinical setting. The interprofessional collaboration during the SPEs assisted in facilitating the application of learned communication skills into patient-centered care of the APN student.
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Affiliation(s)
- Nicole Defenbaugh
- Department of Family Medicine, Lehigh Valley Health Network, USF Morsani College of Medicine - SELECT Program, Allentown, 18105, PA, USA.
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Plunkett-Rondeau J, Hyland K, Dasgupta S. Training future physicians in the era of genomic medicine: trends in undergraduate medical genetics education. Genet Med 2015; 17:927-34. [PMID: 25674779 DOI: 10.1038/gim.2014.208] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/22/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Advances in genomic technologies are transforming medical practice, necessitating the expertise of genomically-literate physicians. This study examined 2013-2014 trends in genetics curricula in US and Canadian medical schools to ascertain whether and how curricula are keeping pace with this rapid evolution. METHODS Medical genetics course directors received a 60-item electronic questionnaire covering curriculum design, assessment, remediation of failing grades, and inclusion of specific topics. RESULTS The response rate was 74%. Most schools teach the majority of genetics during the first 2 years, with an increase in the number of integrated curricula. Only 26% reported formal genetics teaching during years 3 and 4, and most respondents felt the amount of time spent on genetics was insufficient preparation for clinical practice. Most participants are using the Association of Professors of Human and Medical Genetics Core Curriculum(1) as a guide. Topics recently added include personalized medicine (21%) and direct-to-consumer testing (18%), whereas eugenics (17%), linkage analysis (16%), and evolutionary genetics (15%) have been recently eliminated. Remediation strategies were heterogeneous across institutions. CONCLUSION These findings provide an important update on how genetics and genomics is taught at US and Canadian medical schools. Continuous improvement of educational initiatives will aid in producing genomically-literate physicians.
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Affiliation(s)
- Jevon Plunkett-Rondeau
- Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Katherine Hyland
- Department of Biochemistry and Biophysics, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Shoumita Dasgupta
- Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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Mills J, West C, Langtree T, Usher K, Henry R, Chamberlain-Salaun J, Mason M. ‘Putting it together’: Unfolding case studies and high-fidelity simulation in the first-year of an undergraduate nursing curriculum. Nurse Educ Pract 2014; 14:12-7. [DOI: 10.1016/j.nepr.2013.06.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 04/04/2013] [Accepted: 06/13/2013] [Indexed: 11/16/2022]
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Pearl PL, Pettiford JM, Combs SE, Heffron A, Healton S, Hovaguimian A, Macri CJ. Assessment of genetics knowledge and skills in medical students: insight for a clinical neurogenetics curriculum. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2011; 39:191-5. [PMID: 21618382 DOI: 10.1002/bmb.20489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The pace of discovery in biochemistry and genetics and its effect on clinical medicine places new curricular challenges in medical school education. We sought to evaluate students' understanding of neurogenetics and its clinical applications to design a pilot curriculum into the clinical neurology clerkship. We utilized a needs assessment and a written examination to evaluate the genetics knowledge of 81 third- and fourth-year medical students. The needs assessment surveyed students' self-perceptions of their own understanding of basic and clinically related genetic principles and clinical skills, as well as the most effective educational methods. Medical students reported more competence with basic science learned during the preclinical years than clinical concepts, and they demonstrated relatively low knowledge levels in clinical neurogenetics concepts on the examination, with an average of 29% correct on questions pertaining to genetic counseling compared with 82% correct with regard to inheritance patterns. Common, cross-specialty clinical skills were attained (e.g. internet search, family histories), while at least half of students reported minimal understanding or awareness of key genetics websites (e.g. OMIM) and indications for support group recommendations and genetics referrals. Teaching these more specific genetics skills and concepts needs to be emphasized in the clinical curriculum.
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Affiliation(s)
- Phillip L Pearl
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
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Simunovic VJ, Hozo I, Rakic M, Jukic M, Tomic S, Kokic S, Ljutic D, Druzijanic N, Grkovic I, Simunovic F, Marasovic D. New paradigm in training of undergraduate clinical skills: the NEPTUNE-CS project at the Split University School of Medicine. Croat Med J 2010; 51:373-80. [PMID: 20960586 DOI: 10.3325/cmj.2010.51.373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Clinical skills' training is arguably the weakest point in medical schools' curriculum. This study briefly describes how we at the Split University School of Medicine cope with this problem. We consider that, over the last decades, a considerable advancement in teaching methodologies, tools, and assessment of students has been made. However, there are many unresolved issues, most notably: (i) the institutional value system, impeding the motivation of the teaching staff; (ii) lack of a strong mentoring system; (iii) organization, timing, and placement of training in the curriculum; (iv) lack of publications pertinent to training; and (v) unwillingness of patients to participate in student training. To improve the existing training models we suggest increased institutional awareness of obstacles, as well as willingness to develop mechanisms for increasing the motivation of faculty. It is necessary to introduce changes in the structure and timing of training and to complement it with a catalog, practicum, and portfolio of clinical skills. At Split University School of Medicine, we developed a new paradigm aimed to improve the teaching of clinical skills called "Neptune-CSS," which stands for New Paradigm in Training of Undergraduate Clinical Skills in Split.
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Affiliation(s)
- Vladimir J Simunovic
- Unit for Science and Research, University Hospital Split, 21 000 Split, Croatia.
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Abe K, Suzuki T, Fujisaki K, Ban N. A national survey to explore the willingness of Japanese standardized patients to participate in teaching physical examination skills to undergraduate medical students. TEACHING AND LEARNING IN MEDICINE 2009; 21:240-7. [PMID: 20183345 DOI: 10.1080/10401330903018567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Standardized patients (SPs) are an increasingly prevalent resource in medical education and evaluation. There is a variety of clinical skills training programs including courses designed to teach and assess communication skills as well as physical examination (PE) skills. In Japan, SPs have contributed enormously to help medical students improve their communication skills. However, there are few SPs who participate in physical examination training and the use of SPs for physical examination is rarely considered as a useful educational resource. PURPOSE The purpose is to explore SPs' perceptions about participating in PE training. METHOD A 27-item questionnaire was used to survey 532 SPs in Japan. RESULT The response rate was 62% (n = 332). The ratio of females to males was 4:1. SPs perceived PE training using SPs was effective in teaching students physical examination. Eighty percent of SPs were willing to have PE of head, arms, and legs. Twenty-five percent were willing to have PE on their chest, back, and abdomen. Willingness varied by gender and age. CONCLUSION SPs perceived that including SPs in physical examination was valuable. Males or people over 50 years old are more willing to participate than females or people under 50. Reluctance to participate in PE may decrease through experience or improved knowledge of PE training and by beginning with examination of head, neck, and legs, then gradually moving to chest, back, and abdomen.
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Affiliation(s)
- Keiko Abe
- Department of Medical Education Development Center, Gifu University School of Medicine, Gifu, Japan.
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Altshuler L, Kachur E, Krinshpun S, Sullivan D. Genetics objective structured clinical exams at the Maimonides Infants & Children's Hospital of Brooklyn, New York. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2008; 83:1088-1093. [PMID: 18971664 DOI: 10.1097/acm.0b013e31818902e5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In 2003, the Maimonides Infants & Children's Hospital received a Title VII Residency Training in Primary Care grant to integrate genetic-specific competencies into postgraduate pediatrics education. As part of that endeavor, mandatory yearly genetics objective structured clinical exams (OSCEs) were instituted for third-year residents. This article reports on the first three years of experience with this innovative educational tool.After an overview of genetic concepts, dysmorphology, and communication styles, residents complete a five-station OSCE and receive feedback from standardized patients and from the faculty who observe them. After this clinical exercise, the residents participate in a small-group debriefing session to share strategies for effective communication and clinical case management and to discuss the ethical issues that arise with these genetic cases.In three years, 60 residents have completed the genetics OSCE program. Evaluation data demonstrate that the program has been effective in both introducing genetic-specific challenges and assessing residents' clinical skills. It has helped trainees self-identify both strengths and further training needs. Pre- and postsurveys among the trainees show increased comfort levels in performing 5 of 12 genetic-related clinical tasks.We conclude that genetics OSCEs are an enriching educational tool. Merely providing trainees and practicing physicians with the latest scientific information is unlikely to prepare them for counseling patients about complex genetic issues. Developing proficiency requires focused practice and effective feedback.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
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Affiliation(s)
- Lisa Altshuler
- Developmental & Behavioral Pediatrics, Maimonides Infants & Children's Hospital of Brooklyn, Brooklyn, New York 11219, USA.
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