Teague K E, Brown J A, Meyer J M, Kahn M J, Smith T J, Kreutzer K O, Bodurtha J N
Department of Human Genetics, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0033, USA.
J Cancer Educ. 1996 Winter;11(4):196-202. doi: 10.1080/08858199609528428.
With the identification of the breast cancer susceptibility genes BRCA1 and BRCA2, clinical testing for detection of the mutated genes may be available in the near future. Primary care physicians increasingly serve as full-service providers and gatekeepers and must be aware of presymptomatic testing in order to counsel their patients appropriately. To address this educational need, a new module was incorporated into the genetics course taken by first-year medical students at the Medical College of Virginia.
The module used small groups, led by genetics faculty and members of the Virginia Breast Cancer Foundation, for discussion of case examples. The medical students' knowledge of and attitudes toward cancer and predictive genetic testing were assessed by a pretest and a posttest.
After the module, knowledge scores increased by 27%, and significant changes were seen in the students' attitudes toward issues such as the regulation of testing availability and the psychological effect of testing. Most students consistently felt that predictive genetic testing is beneficial, that they would have the testing themselves, that genetic counseling should be required for testing, and that insurers' access to genetic testing results should be limited. Overall, the module was received favorably by all participants.
Small-group discussion of relevant case examples increases knowledge and awareness of issues regarding presymptomatic genetic testing for breast cancer.
随着乳腺癌易感基因BRCA1和BRCA2的发现,检测这些突变基因的临床检测在不久的将来可能会出现。初级保健医生越来越多地充当全方位服务提供者和把关人,必须了解症状前检测,以便为患者提供适当的咨询。为满足这一教育需求,弗吉尼亚医学院为一年级医学生开设的遗传学课程中纳入了一个新模块。
该模块采用小组讨论的形式,由遗传学教师和弗吉尼亚乳腺癌基金会成员带领,讨论案例。通过课前测试和课后测试评估医学生对癌症和预测性基因检测的知识及态度。
该模块结束后,知识得分提高了27%,学生对检测可用性的监管和检测的心理影响等问题的态度也有显著变化。大多数学生一直认为预测性基因检测是有益的,自己会进行检测,检测应要求进行遗传咨询,保险公司获取基因检测结果的途径应受到限制。总体而言,所有参与者对该模块评价良好。
对相关案例进行小组讨论可增加对乳腺癌症状前基因检测相关问题的知识和认识。