Hofman K J, Tambor E S, Chase G A, Geller G, Faden R R, Holtzman N A
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Acad Med. 1993 Aug;68(8):625-32. doi: 10.1097/00001888-199308000-00013.
To assess primary care physicians' and psychiatrists' knowledge of genetics and genetic tests and the factors associated with differences in these physicians' knowledge.
Questionnaires were mailed in 1991 to 1,795 primary care physicians (family physicians, internists, pediatricians, obstetrician-gynecologists) and psychiatrists who had graduated from medical school between 1950 and 1985 (67.6% of the sample had graduated after 1970) and who were members of professional societies. The questions elicited demographic and practice characteristics as well as knowledge of genetics concepts and facts and awareness of the availability of genetic tests. To validate the questionnaire, 360 medical geneticists and genetic counselors received questionnaires. Statistical analysis involved arc-sine function transformation, t-tests, analyses of variance, F-tests, Tukey's HSD, and stepwise multiple regression.
A total of 1,140 (64.8%) of the non-geneticist physicians responded. They correctly answered an average of 73.9%, SD, 13.9%, of the knowledge items, compared with 94.6%, SD, 4.2%, for the genetics professionals (p < .001). The most significant predictors of knowledge were recency of graduation from medical school and practicing in primary care specialties in which exposure to genetics problems is likely. Other significant predictors (from most to least important) were graduation from a U.S. medical school, willingness to adopt a new predictive test before it becomes standard practice, not using pharmaceutical companies as a source of information about new medical practices, and taking a required genetics course in medical school.
The results suggest that knowledge of genetics and genetic tests is increasing among physicians, particularly among more recent graduates and physicians who are exposed to genetics problems in their practices, but deficiencies remain. Although a medical school course in genetics may improve knowledge, it is not sufficient. Greater emphasis is needed at all levels of medical education to reduce the chance of physician error as more genetic tests become available.
评估初级保健医生和精神科医生对遗传学及基因检测的了解程度，以及与这些医生知识差异相关的因素。
1991年，向1795名初级保健医生（家庭医生、内科医生、儿科医生、妇产科医生）和精神科医生邮寄了调查问卷，这些医生于1950年至1985年间毕业于医学院（样本中67.6%的人于1970年后毕业），且为专业协会成员。问题涉及人口统计学和执业特征，以及遗传学概念和事实的知识，还有对基因检测可用性的认知。为验证问卷，向360名医学遗传学家和遗传咨询师发放了问卷。统计分析包括反正弦函数变换、t检验、方差分析、F检验、图基 Honestly Significant Difference检验和逐步多元回归。
共有1140名（64.8%）非遗传学家医生回复了问卷。他们正确回答了平均73.9%（标准差13.9%）的知识问题，而遗传学专业人员的正确率为94.6%（标准差4.2%）（p <.001）。知识的最重要预测因素是医学院毕业的近期程度以及在可能接触遗传学问题的初级保健专科领域执业。其他重要预测因素（从最重要到最不重要）包括毕业于美国医学院、在新的预测性检测成为标准做法之前愿意采用、不将制药公司作为新医疗实践信息来源以及在医学院修过必修的遗传学课程。
结果表明，医生对遗传学和基因检测的了解正在增加，尤其是在近期毕业生和在实践中接触遗传学问题的医生中，但仍存在不足。虽然医学院的遗传学课程可能会提高知识水平，但还不够。随着更多基因检测出现，医学教育的各个层面都需要更加强调，以减少医生出错的可能性。
