A Delphi consensus exercise to determine a genetics and genomics curriculum for primary medical degree in Aotearoa New Zealand
DOI:
https://doi.org/10.11157/fohpe.v24i4.653Keywords:
genetics, genomics, education, medical curriculum, indigenous peoplesAbstract
Introduction: Genetics and genomics are of increasing importance in diagnosis and treatment of patients. We aimed to determine relevant genetics and genomics curricular content and learning objectives for contemporary New Zealand medical graduates.
Methods: International and national undergraduate medical genetics curricula were identified and learning outcomes collated. Invited New Zealand subject experts (n = 58) contributed further learning objectives, with final pool of 73 learning objectives. A survey-based, two-round Delphi process was used to gain consensus on the level of learning for each learning objective. Learning outcomes with consensus for learning greater than “in some depth” or “in detail” were included in the proposed curriculum.
Results: The response rate for the Delphi rounds were 41% (n = 24/58) and 29% (n = 17/58) for Rounds 1 and 2, respectively. Experts reached consensus on retaining 58/60 (97%) of proposed learning objectives that were to be learned to at least “some depth”. Learning objectives in interprofessional skills, pharmacogenetics, clinical reasoning and information management were retained but refined. Learning outcomes : taking an appropriate genetic history, understanding cultural tenets connected to whakapapa (genealogy), an understanding of DNA samples and genomic data being taonga (sacred), the application of genetic data to Māori and other Indigenous populations and the role of genetics in colonisation and racism and their impact on healthcare.
Conclusions: Learning objectives for contemporary medical genetics curricula should consider including those focusing on Indigenous health. Findings highlight the necessity of timely re-evaluation of medical curricula.
References
Al-Kuwaiti, A. A. (2011). A proposal for improving genetics teaching for medical professionals in Saudi’s medical education. International Medical Publishing Group, 13, 494–501. http://www.drahmedalkuwaiti.com/research.php?id=18
Bankier, A., Bittles, A., Gaff, C., Ravine, D., Turner, D., Mowat, D., Sillence, D., Haan, E., Suthers, D., Christodoulou, J., Emery, J., MacMillan, J., McGaughran, J., Barlow-Stuart, K., Robertson, S., & Metcalfe, S. (2008). Core capabilities in genetics for medical graduates. Human Genetics Society of Australasia. https://www.hgsa.org.au/common/Uploaded%20files/pdfs/policies,%20position%20statements%20and%20guidelines/eesic/Core%20Capabilities%20in%20Genetics%20and%20Genomics%20for%20Medical%20Graduates.pdf
Bennett, R. L., Waggoner, D., & Blitzer, M. G. (2017). Medical genetics and genomics education: How do we define success? Where do we focus our resources? Genetics in Medicine, 19(7), 751–753. https://doi.org/10.1038/gim.2017.77
Burke, S., Martyn, M., Stone, A., Bennett, C., Thomas, H., & Farndon, P. (2009). Developing a curriculum statement based on clinical practice: Genetics in primary care. British Journal of General Practice, 59(559), 99–103. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629823/
Came, H., McCreanor, T., Haenga-Collins, M., & Cornes, R. (2019). Māori and Pasifika leaders’ experiences of government health advisory groups in New Zealand, Kōtuitui: New Zealand. Journal of Social Sciences Online, 14(1) 126–135. https://doi.org/10.1080/1177083X.2018.1561477
de Villiers, M. R., de Villiers, P. J. T., & Kent, A. P. (2005). The Delphi technique in health sciences education research. Medical Teacher, 27(7), 639–643. https://doi.org/10.1080/13611260500069947
Dhar, S. U., Alford, R. L., Nelson, E. A., & Potocki, L. (2011). Enhancing exposure to genetics and genomics through an innovative medical school curriculum. Genetics in Medicine, 14, 163–167. https://doi.org/10.1038/gim.0b013e31822dd7d4
Garrard, J. (2020). Health sciences literature review made easy (6th ed.). Jones and Bartlett Learning.
Hasson, F., Keeney, S., & McKenna, H. (2008). Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32(4), 1008–1015. https://doi.org/10.1046/j.1365-2648.2000.t01-1-01567.x
Houwink, E. J., Henneman, L., Westerneng, M., van Luijk, S. J., Cornel, M. C., Dinant, J. G., & van der Vleuten, C. (2012). Prioritization of future genetics education for general practitioners: A Delphi study. Genetics in Medicine, 14(3), 323–329. https://doi.org/10.1038/gim.2011.15
Hyland, K. M., Dasgupta, S., Garber, K., Gold, J-A., Toriello, H., Weissbecker K., Waggoner, D.,(2013). APHMG medical school genetics competencies: Medical school core curriculum in genetics 2013. Association of Professors of Human and Medical Genetics.
Jenkins, J., Blitzer, M., Boehm, K., Feetham, S., Gettig, E., Johnson, A., Lapham, E., Patenaude, A. F., Reynolds, P. P., & Guttmacher, A. E. (2001). Recommendations of core competencies in genetics essential for all health professionals. Genetics in Medicine, 3(2), 155–159. https://doi.org/10.1097/00125817-200103000-00011
Korf, B. R., Kaplan, F., Blitzer, M. G., Maeshiro, R., Boulware, D. W., McGovern, M. M., Elas, L. J., Schmidt, H. J., Gruppen L. D., Seashore M., Guttmacher, A. E., & Veach, T. L. (2004). Contemporary issues in medicine: Genetics education (Report VI) Medical School Objectives Project (MSOP). Association of American Medical Colleges. https://web.archive.org/web/20100603104700/https://www.ttuhsc.edu/som/curriculum/documents/msop_genetics.pdf
Magee, J., Gordon, J. I., & Whelan, A. (2001). Bringing the human genome and the revolution in bioinformatics to the medical school classroom: A case report from Washington University School of Medicine. Academic Medicine, 76(8), 852–855. https://doi.org/10.1097/00001888-200108000-00022
National Health Service, National Genetics and Genomics Education Centre. (2015). Learning outcomes in genetics and genomics for specialty trainees in non-genetic specialties. https://web.archive.org/web/20160115062845/http://geneticseducation.nhs.uk/for-healthcare-educators/learning-outcomes2
Phillips, B., Daniels, J., Woodward, A., Blakely, T., Taylor, R., & Morrell, S. (2017). Mortality trends in Australian Aboriginal peoples and New Zealand Māori. Population Health Metrics, 15, Article 25. https://doi.org/10.1186/s12963-017-0140-6
Plunkett-Rondeau, J., Hyland, K., & Dasgupta, S. (2015) Training future physicians in the era of genomic medicine: Trends in undergraduate medical genetics education. Genetics Medicine, 17(11), 927–934. https://doi.org/10.1038/gim.2014.208
Riegert-Johnson, D.L., Korf, B.R., Alford, R.L., Broder, M.I., Keats, B.J., Ormond, K.E., Pyeritz, R.E. and Watson, M.S. (2004). Outline of a medical genetics curriculum for internal medicine residency training programs. Genetics in Medicine, 6(6), 543–7. https://doi.org/10.1097/01.gim.0000144561.77590.85
Rubanovich, C. K., Cheung, C., Mandel, J., & Bloss, C. S. (2018). Physician preparedness for big genomic data: A review of genomic medicine education initiatives in the United States. Human Molecular Genetics, 27(R2), R250–R258. https://doi.org/10.1093/hmg/ddy170
Russell, L., Smiler, K., & Stace, H. (2013). Improving Māori health and reducing inequalities between Māori and non-Māori: Has the primary health care strategy worked for Māori. Health Research Council of New Zealand. https://www.researchgate.net/publication/322929224_Improving_Maori_health_and_reducing_inequalities_between_Maori_and_non-Maori_Has_the_Primary_Health_Care_Strategy_worked_for_Maori/link/5d1d90af92851cf440631484/download
Salari, K., Karczewski, K. J., Hudgins, L., & Ormond, K. E. (2013). Evidence that personal genome testing enhances student learning in a course on genomics and personalized medicine. PLOS ONE, 8(7), Article e68853. https://doi.org/10.1371/journal.pone.0068853
Skirton, H., Lewis, C., Kent, A., & Coviello, D. (2010). Genetic education and the challenge of genomic medicine: Development of core competences to support preparation of health professionals in Europe. European Journal of Human Genetics, 18(9), 972–977. https://doi.org/10.1038/ejhg.2010.64
Talwar, D., Chen, W. J., Yeh, Y. L., Foster, M., Al-Shagrawi, S., & Chen, L. S. (2019). Characteristics and evaluation outcomes of genomics curricula for health professional students: A systematic literature review. Genetics in Medicine, 21(8), 1675–1682. https://doi.org/10.1038/s41436-018-0386-9
Talwar, D., Tseng, T. S., Foster, M., Xu, L., & Chen, L. S. (2017). Genetics/genomics education for nongenetic health professionals: A systematic literature review. Genetics in Medicine, 19(7), 725–732. https://doi.org/10.1038/gim.2016.156
Telner, D. E., Carroll, J. C., & Talbot, Y. (2008). Genetics education in medical school: A qualitative study exploring educational experiences and needs. Medical Teacher, 30(2), 192–198. https://doi.org/10.1080/01421590701827353
Thangaratinam, S., & Redman, C. W. E. (2005). The Delphi technique. The Obstetrician & Gynaecologist, 7(2), 120–125. https://doi.org/10.1576/toag.7.2.120.27071
Thurston, V. C., Wales, P. S, Bell, M. A., Torbeck, L., & Brokaw, J. J. (2007). The current status of medical genetics instruction in U.S. and Canadian medical schools. Academic Medicine, 282(5), 441–445. https://doi.org/10.1097/ACM.0b013e31803e86c5
Tognetto, A., Michelazzo, M. B., Ricciardi, W., Federici, A., & Boccia, S. (2019). Core competencies in genetics for healthcare professionals: Results from a literature review and a Delphi method. BMC Medical Education, 19(1), Article 19. https://doi.org/10.1186/s12909-019-1456-7
Walt, D.R., Kuhlik, A., Epstein, S.K., Demmer, L.A., Knight, M., Chelmow, D., Rosenblatt, M. and Bianchi, D.W. (2011). Lessons learned from the introduction of personalized genotyping into a medical school curriculum. Genetics in Medicine, 13(1), 63–66. https://doi.org/10.1097/GIM.0b013e3181f872ac
Wolyniak, M. J., Bemis, L. T., & Prunuske, A. J. (2015). Improving medical students’ knowledge of genetic disease: A review of current and emerging pedagogical practices. Advances in Medical Education and Practice, 6, 597–607. https://doi.org/10.2147/AMEP.S73644
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Focus on Health Professional Education: A Multi-Professional Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
