1] Department of Clinical Genetics, Section of Community Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands [2] Department of General Practice, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Genet Med. 2014 Jan;16(1):45-52. doi: 10.1038/gim.2013.69. Epub 2013 May 30.
General practitioners are increasingly called upon to deliver genetic services and could play a key role in translating potentially life-saving advancements in oncogenetic technologies to patient care. If general practitioners are to make an effective contribution in this area, their genetics competencies need to be upgraded. The aim of this study was to investigate whether oncogenetics training for general practitioners improves their genetic consultation skills.
In this pragmatic, blinded, randomized controlled trial, the intervention consisted of a 4-h training (December 2011 and April 2012), covering oncogenetic consultation skills (family history, familial risk assessment, and efficient referral), attitude (medical ethical issues), and clinical knowledge required in primary-care consultations. Outcomes were measured using observation checklists by unannounced standardized patients and self-reported questionnaires.
Of 88 randomized general practitioners who initially agreed to participate, 56 completed all measurements. Key consultation skills significantly and substantially improved; regression coefficients after intervention were equivalent to 0.34 and 0.28 at 3-month follow-up, indicating a moderate effect size. Satisfaction and perceived applicability of newly learned skills were highly scored.
The general practitioner-specific training proved to be a feasible, satisfactory, and clinically applicable method to improve oncogenetics consultation skills and could be used as an educational framework to inform future training activities with the ultimate aim of improving medical care.
全科医生越来越多地被要求提供遗传服务，并且可以在将肿瘤遗传学技术的潜在救生进展转化为患者护理方面发挥关键作用。如果全科医生要在这一领域做出有效的贡献，他们的遗传学能力需要得到提升。本研究旨在探讨对全科医生进行肿瘤遗传学培训是否能提高他们的遗传咨询技能。
在这项实用、盲法、随机对照试验中，干预措施包括 4 小时的培训（2011 年 12 月和 2012 年 4 月），涵盖肿瘤遗传咨询技能（家族史、家族风险评估和有效转诊）、态度（医学伦理问题）和初级保健咨询中所需的临床知识。通过未事先通知的标准化患者的观察检查表和自我报告问卷来衡量结果。
最初同意参与的 88 名随机分配的全科医生中，有 56 名完成了所有的测量。主要咨询技能显著且大幅度提高；干预后的回归系数在 3 个月随访时相当于 0.34 和 0.28，表明具有中等的效果大小。对新学到的技能的满意度和可应用性评价很高。
针对全科医生的特定培训被证明是一种可行、满意和临床适用的方法，可以提高肿瘤遗传学咨询技能，并可用作告知未来培训活动的教育框架，最终目的是改善医疗保健。
