Department of Medicine, University of California Davis, School of Medicine, Sacramento, California 95833, USA.
Genet Med. 2011 Jun;13(6):553-62. doi: 10.1097/GIM.0b013e31820e279a.
Medical genetics lends itself to disseminated teaching methods because of mismatches between numbers of physicians having patients with genetic disorders and availability of genetic specialists.
During 3 years, we implemented an interactive, web-based curriculum on ethical, legal, and social implications in medical genetics for primary care residents in three specialties at three institutions. Residents took five (of 10) cases and three (of five) tutorials that varied by specialty. We assessed changes in self-efficacy (primary outcome), knowledge, application, and viewpoints.
Overall enrollment was 69% (279/403). One institution did not complete implementation and was dropped from pre-post comparisons. We developed a six-factor ethical, legal, and social implications self-efficacy scale (Cronbach α = 0.95). Baseline self-efficacy was moderate (71/115; range: 23-115) and increased 15% after participation. Pre-post knowledge scores were high and unchanged. Residents reported that this curriculum covered ethical, legal, and social implications/genetics better than their usual curricula. Most (68-91%) identified advantages, especially in providing flexibility and stimulating self-directed learning. After participation, residents reported creating learning goals (66%) and acting on those goals (62%).
Ethical, legal, and social implications genetics curricular participation led to modest self-efficacy gains. Residents reported that the curriculum covered unique content areas, had advantages over traditional curriculum, and that they applied ethical, legal, and social implications content clinically. We share lessons from developing and implementing this complex web-based curriculum across multiple institutions.
由于患有遗传疾病的医生人数与遗传专家的数量不匹配，医学遗传学适合采用分散式教学方法。
在 3 年内，我们为三个机构的三个专业的初级保健住院医师实施了一个关于医学遗传学中的伦理、法律和社会影响的互动式网络课程。住院医师接受了五个（十个中的五个）病例和三个（五个中的三个）不同专业的辅导。我们评估了自我效能感（主要结果）、知识、应用和观点的变化。
总的入学率为 69%（279/403）。有一个机构没有完成实施，因此从前后比较中删除。我们开发了一个六因素的伦理、法律和社会影响自我效能感量表（Cronbach α=0.95）。基线自我效能感中等（71/115；范围：23-115），参与后增加了 15%。前后知识得分均较高且不变。住院医师报告说，该课程比他们通常的课程更好地涵盖了伦理、法律和社会影响/遗传学方面的内容。大多数（68-91%）认为有优势，特别是在提供灵活性和激发自我导向学习方面。参与后，住院医师报告说制定了学习目标（66%）并按照这些目标行动（62%）。
参与伦理、法律和社会影响遗传学课程导致自我效能感适度提高。住院医师报告说，该课程涵盖了独特的内容领域，与传统课程相比具有优势，并且他们将伦理、法律和社会影响内容应用于临床。我们分享在多个机构开发和实施这种复杂的网络课程的经验教训。
