Retention of medical genetics knowledge and skills by medical students

PurposeTo determine whether specific knowledge and skills medical students acquire after completing a Year 1 genetics course are retained at the end of Year 3.MethodsA genetics case was developed for an observed structured clinical exam at the end of Year 3. The case involved a pregnant patient who underwent population screening for cystic fibrosis and is identified as a carrier of a common mutation. Student's performance in completing eight essential genetic tasks taught in Year 1 was assessed by their ability to apply these concepts in the Year 3 observed structured clinical exam.ResultsA total of 212 students were included in the study. Performance on the essential tasks revealed that students were better able to discuss inheritance pattern (73.1%). Students were less likely to calculate and discuss fetal risk (25%), discuss the option of prenatal diagnosis if the father is a carrier (25%), and ask about a family history of cystic fibrosis (36.8%). Only half (50%) explained the test result and implications to the patient. There was no correlation between individual student exam scores in Year 1 and the eight essential genetics tasks scores assessed in the observed structured clinical exam (r = 0.003, P ≤ 0.67).ConclusionThird year medical students do not retain medical genetics knowledge and skills learned in the first year of medical school. Medical schools need to integrate genetics curriculum through the continuum of the 4 years of medical school.     

Bioinformatics for medical students: a 5-year experience using OMIM® in medical student education

PurposeGiven advances in genomic medicine, medical students need increased confidence in clinical genetics skills to address multiple genetic conditions. After success of first-year medical school instruction in the Online Mendelian Inheritance in Man (OMIM®) database, we report the impact on gaining confidence in broad clinical genetics skills in 5 subsequent years.MethodsWe collected 5 years of successive pre- and postintervention survey based self-assessments on medical student use of genetic medicine information resources and confidence in genetic medicine skills. To assess retention of confidence in these skills, we administered a follow-up survey to students after 1–2 years of clinical rotations.ResultsWe found a consistent, statistically significant increase in students’ confidence in clinical genetics skills after the first-year OMIM educational session, with confidence retention above baseline up to 2 years after the educational exposure. Skills include ability to generate a differential diagnosis for genetic conditions, share information with patients and families, and find accurate information on genetic conditions. The majority agreed that increased use of OMIM will better prepare students to achieve these skills.ConclusionIntegration of the OMIM database in first-year education is an effective instructional tool that may provide a lasting increase in confidence in clinical genetics skills.     

Trainee perspectives of COVID-19 impact on medical genetics education

PurposeThe SARS-CoV-2 pandemic abruptly altered medical education and clinical care. This work evaluates trainee perspectives of the impact of the pandemic on medical genetics education.MethodsA Qualtrics survey was sent to physician trainees who rotated in genetics before or midpandemic. Questions assessed patient care, didactic education, and competency in multiple domains. Number of clinic visits completed by trainees were collated through review of documentation.ResultsTwenty-three rotating residents completed the surveys. Five of the pediatric residents completed the elective during the pandemic. All residents participated in virtual care during the pandemic, and rotating residents reported an improvement in self-assessed competency in multiple domains. Potential weak areas of education midpandemic included dysmorphology and genetic counseling.ConclusionResidents on a genetics elective can gain crucial skills and knowledge even when the rotation is in a primarily virtual format. Supplemental dysmorphology and genetic counseling education may improve remote educational experiences. Further research across institutions may deepen understanding of the impact of the pandemic on education in genetics.     

Opportunities to improve recruitment into medical genetics residency programs: survey results of program directors and medical genetics residents

PurposeApproximately 50% of medical genetics residency positions remain unfilled each year. This study was designed to assess current recruitment strategies used by program directors, to identify factors that influenced trainees to choose medical genetics as a career, and to use these results as a foundation to develop a strategic plan to address the challenges of recruitment.MethodsTwo surveys were created, one for program directors and one for current medical genetics residents, to evaluate current recruiting efforts and institutional support for programs and to identify factors that helped trainees choose genetics as a career.ResultsProgram directors identified the most successful recruiting methods as “direct contact with residents or medical students” and “word of mouth” (80%). Residents listed having a mentor (50%), previous research in genetics (35%), and genetics coursework (33%) as the top reasons that influenced them to enter the field.ConclusionGeneticists should become more proactive in providing resources to students to help them understand a career as a medical geneticist and mentor those students/residents who show true interest in the field. Results of these surveys spurred the development of the Task Force on Medical Genetics Education and Training of the American College of Medical Genetics and Genomics.     

Lost in translation: Cultural divides in communication skills teaching identified in the ICCH 2016 student symposium

ObjectiveTo provide a platform for learners’ voices at an international conference on communication in healthcare.MethodsA group of medical students were invited to explore their experiences with communication skills learning at a symposium at the 2016 International Conference on Communication in Healthcare in Heidelberg, DE.ResultsStudents from the US, Denmark, Germany, and Russia discussed their experiences with communication skills curriculum at their institutions. We identified divides that have challenged our ability to develop and maintain strong communication skills: 1) valuation of communication skills vs. other topics, 2) curricular theory vs. practice, 3) evaluation vs. feedback, 4) preclinical vs. clinical learning, and 5) the medical student vs. practicing clinician role.ConclusionThe points of transition we identified on the road of communication skills teaching highlight opportunities to strengthen the educational experience for students. Without an effort to address these divides, however, our communication skills may be lost in translation.Practice implicationsStudents value communication skills teaching during their medical education and there are opportunities to translate this to countries that currently lack robust curricula and to the real-life post-graduate setting. Support is necessary from students, teachers, and administrators, and focus on translation of skills during role transitions is needed.     

Horizontal integration of OMIM across the medical school preclinical curriculum for early reinforcement of clinical genetics principles

PurposeWith the relentless expansion of genetics into every field of medicine, stronger preclinical and clinical medical student education in genetics is needed. The explosion of genetic information cannot be addressed by simply adding content hours. We proposed that students be provided a tool to access accurate clinical information on genetic conditions and, through this tool, build life-long learning habits to carry them through their medical careers.MethodsSurveys conducted at the Johns Hopkins University School of Medicine revealed that medical students in all years lacked confidence when approaching genetic conditions and lacked a reliable resource for accurate genetic information. In response, the school created a horizontal thread that stretches across the first-year curriculum and is devoted to teaching students how to use Online Mendelian Inheritance in Man (OMIM) (http://omim.org) and the databases to which it links as a starting point for approaching genetic conditions.ResultsThe thread improved the first-year students’ confidence in clinical genetics concepts and encouraged use of OMIM as a primary source for genetic information. Most students showed confidence in OMIM as a learning tool and wanted to see the thread repeated in subsequent years.ConclusionIncorporating OMIM into the preclinical curriculum improved students’ confidence in clinical genetics concepts.     

Valoración por los estudiantes de la formación práctica de grado de Medicina. El caso de la Neumología

IntroductionPractical training for medical students is provided during the final years of study and is determined by several conditioning factors, including the MIR training that students receive simultaneously. In general, practical training evaluation receives much less attention than the theoretical one; its quality is not evaluated, and the professors do not receive feedback. The objective of our study was to determine how students value practical training in pulmonology rated the experience after completing a three-week rotation, in order to apply the information gained toward a process of continual improvement.MethodsThe study included 2 anonymous surveys taken by medical students during the same academic year-one internal, prepared by the Department of Pneumology, itself, and another external one, prepared by the Evaluation Unit for Teaching Excellence at the University of Salamanca.ResultsOn the internal evaluation, student opinions of their practical training ran high (8.26) and the perceived usefulness was also high (8.23), on a scale of 0 to 10 and no differences were noted according to whether the survey was taken during their fourth, fifth, or sixth year of study. These results agree with those obtained in the external evaluation with a mean value of 4.56 on a scale of 0 to 5. Student preferences during their rotation in the department were for hospitalization and consultation units, with the technical areas being lesser valued.ConclusionsAchieving and maintaining a high quality of practical training is a goal that should be consistently evaluated so that professors may receive feedback (internal and external). Rotations in the Department of Pneumology provide an opportunity to improve the perception that medical students have regarding this specialty. It is imperative to reflect upon the contents of these rotations, seeking a balance between clinical areas and technical areas.     

The training of future clinical geneticists: Evaluation and reflection on the ACMG Foundation for Genetic and Genomic Medicine Summer Genetics Scholars Program

PurposeThe purpose of the Summer Genetics Scholars Program of the ACMG Foundation for Genetic and Genomic Medicine is to expose medical students to medical genetics and genomics early during school with the aim of increasing the number of physicians pursuing a career in this field. This survey study evaluated the Summer Genetics Scholars Program on the achievement of its goals.MethodsFormer Summer Genetics Scholars who had completed medical school were sent a 13-question survey aimed at evaluating the program and obtaining feedback about their experiences.ResultsOf 125 former scholars, 55 completed the survey with 2 additional participants partially completing the survey. The vast majority of former participants report either being very satisfied or satisfied with their experience (96%).ConclusionWhereas most participants found their experience to be beneficial, evaluation of the initial 6 years of the program did not show an increase in the number of students entering residencies in medical genetics and genomics. It likely is too early to assess the program’s true influence on entry into the field because data were only available for the first 6 years of the Summer Genetics Scholars Program, and many residents typically choose to complete another primary specialty before medical genetics and genomics.     

The virtual diagnostic laboratory: A new way of teaching undergraduate medical students about genetic testing

PurposeMedical students often perceive genetics as a discipline focused on rare diseases with relevance only to genetics specialists. Because genetic testing has now infiltrated most if not all medical disciplines, we need new teaching approaches to help trainees incorporate emerging genetic testing strategies appropriately into medical practice. With the ever-increasing number of known disease-associated genes, it is also important to shift from a paradigm of memorization to one of critical evaluation and an awareness of available resources.MethodsWe designed case-based virtual laboratory sessions for first-year medical students at Emory University. These sessions emphasize both rare and common health issues and allow the students to practice applying their fundamental genetics knowledge in the diagnostic setting.ResultsThese sessions proved a valuable approach to presenting the intricacies of diagnostic genetic testing. Students rate the sessions very highly, with 92% of them agreeing or strongly agreeing that the sessions had educational value. The students commented that ours was an effective approach to teaching the material that illustrates well the impact of genetics on patient care.ConclusionsThe virtual diagnostic laboratory approach is an effective, nonlecture-based method of teaching medical students about genetic testing strategies and their application in the clinical setting.     

Promoting Physician Diversity through Medical Student Led Outreach and Pipeline Programs

IntroductionCurrent projections anticipate a dramatic shift from historical population demographics in the United States. Racial and ethnic minorities are expected to constitute the majority of the population by 2050. However, racial minorities continue to be underrepresented in medical school admissions and the physician workforce. Creating a medical student and physician workforce that reflects population demographics of their patients will be an important determinant in promoting public health and health equity.MethodsMedical student led educational outreach programming targeting middle and high school students is one way by which current medical students can actively work to systematically address barriers to aspiring URiM medical students.ResultsOpportunities for medical students to implement meaningful educational outreach programming are limited only by personal motivation and institutional support. Implementation of these programs would provide college and medical school candidacy support for aspiring medical students while providing personal development and education benefits to medical students implementing the program.ConclusionThe authors call on medical students across the country to join in pursuit of health equity and a diverse physician workforce that reflects the evolving demographics of the United States. Medical students can impact the health of local communities through implementation of educational outreach programming to facilitate access to medical education for middle and high school students.     

Tell Me More®: A medical student focused humanistic communication model to enhance student professional identity formation through meaningful patient encounters

IntroductionThe Tell Me More (TMM)® program provides a template for guided interviews to help providers procure an expansive social history from patients and connect with them as people beyond their illness. (TMM)® may provide a dual benefit: it improves the patient’s experience with their healthcare team and the medical students' experience in developing their identity as a physician. Our aim was to characterize the impact of the patient-student conversations in TMM® on the participating medical students through analysis of their written reflections throughout the program.MethodsStudents conducted interviews with hospitalized patients using the TMM® template, Through narrative medicine and individualized posters, patients were able to highlight their unique qualities.ResultsQualitative analyses of 63 journal reflections from 14 students, across 7 hospital settings, identified 6 themes. These included connection, humanism, discovery, impact, privilege, and perspective.ConclusionReflective practice as a learning pedagogy created an opportunity to enhance the medical students’ awareness of empathy and compassion during the TMM® program. Documentation of reflections assured students would process the encounter as a profound learning experience and develop their professional identity formation as a student preparing to become a physician.Practical implicationsTMM® provides an opportunity for medical students to practice and apply their interpersonal and communication skills through authentic patient encounters.     

The use of role-play to enhance medical student understanding of genetic counseling

PurposeAdvances in genetics have meant that genetic testing will become increasingly relevant to all health care fields. It is therefore important that all physicians have increased genetic education in their training, including in the medical school curriculum.MethodsTo address this need, we used role-playing in an effort to enhance understanding of genetic counseling. Students were given the option of participating in a mock genetic counseling session whereby they would play the role of a patient receiving genetic test results. All students received questionnaires on their attitudes and knowledge about genetic counseling. Those who participated answered additional questions regarding effectiveness of the project.ResultsOf 88 students who returned presimulation questionnaires, 19 opted to participate in the mock session, and 15 participants returned postsimulation questionnaires. There was no significant difference between participant and nonparticipant questionnaire responses. However, all participants agreed that role-play was effective in helping them understand genetic counseling and testing. Most participants also commented that the session helped them understand the importance of referral for genetic counseling and the impact of test results.ConclusionsThe project proved overall valuable in improving medical student understanding of genetic counseling and may be applied to a variety of medical education settings to improve patient care.     

Online interactive genetics education during internal medicine clinical clerkship

PurposeAdvances in genetics have revolutionized disease surveillance and management. Understanding and integrating genetic principles clinically is becoming increasingly important for physician trainees. We developed an online, interactive, self-learning module/assessment to strengthen student proficiency in genetics.MethodsMedical student knowledge of genetics during Internal Medicine Clerkship was assessed by an online, asynchronous quiz using simulated vignettes that included questions on (1) genetic red flags, (2) differential diagnoses, (3) pedigree drawing, (4) interpretation of inheritance patterns, (5) selection of diagnostic testing modalities, and (6) genetic counseling. Student self-assessment of genetics competencies was elicited with survey questions.ResultsA total of 592 medical students from classes of 2016 to 2020 successfully completed the “Genetics in Internal Medicine” module/assessment. In total, 91% of students correctly recognized genetic red flags in patient histories, 84% could accurately draw pedigrees, and 93% could accurately interpret inheritance patterns. In total, 92% of students felt that genetic proficiency would improve patient rapport and 91% felt that they could apply what they had learned clinically. Student narrative comments about the activity were positive.ConclusionThis online module was easily integrated into the IM Clerkship. Medical students were able to solidify scientific principles and interpret historical details, predict genetic patterns, and provide counseling. They had successful performances, and the module/assessment was well-received.     

A structured genetics rotation for pediatric residents: an important educational opportunity

PurposeAs the integral role of genetics in health and disease becomes increasingly understood, pediatricians must incorporate genetic principles into their care of patients. Structured exposure to genetics during residency may better equip future pediatricians to meet this goal.MethodsPediatric interns in the Johns Hopkins pediatric residency program have the option to spend one week immersed in clinical genetics by attending outpatient clinics and seeing inpatient consults. A pretest assessing clinical genetics knowledge is given before the rotation and compared with an identical post-test. Interns have a “scavenger hunt” to introduce genetic resources useful to pediatricians and complete a logbook of patient experiences. An evaluation is completed at the end of the rotation.ResultsSince the selective started in July 2016, 50 interns have participated. Average pretest score was 2.5/5 compared with a post-test score of 4.3/5, p < 0.0001. Interns saw on average ten patients and four different diagnoses. Overall evaluation was 4.4 on a 5-point scale, 5 being “excellent.”ConclusionThis experience suggests that a structured rotation in genetics provides pediatric interns with an opportunity to learn basic clinical genetics knowledge and skills and see patients whom they may otherwise not encounter during residency.     

Enhancing exposure to genetics and genomics through an innovative medical school curriculum

PurposePhysicians entering medical practice in the 21st century will require more than a basic understanding of human genetics because of rapid progress in the field of genetics and genomics. The current undergraduate medical curriculum at most institutions is not adequate to prepare medical students for these challenges. Enhancing exposure to genetics throughout the medical school curriculum should help prepare the next generation of physicians to use genetic and genomic information for optimal patient care.MethodsWe have introduced a Genetics Track Curriculum to the undergraduate medical curriculum at Baylor College of Medicine.ResultsThis track runs in parallel to the existing 4-year curriculum and includes didactic sessions, small group discussions, longitudinal clinical experiences, clinical and laboratory rotations, community outreach, and scholarly projects related to genetics. It also provides the students a means to network and discuss topics and career paths in medical genetics.ConclusionWe have developed a novel curriculum that enhances genomic education for medical students with the ultimate goal of enabling our graduates to deliver more effective and personalized medical care. We believe that the Genetics Track Curriculum at Baylor College of Medicine can serve as a prototype for other medical schools across the country and abroad.Genet Med 2012:14(1):163–167.     

Medical and graduate students' attitudes toward personal genomics

PurposeMedical schools are being approached by direct-to-consumer genotyping companies about genotyping faculty or trainees as a method to “teach” them about the potential implications of genotyping. In thinking about the future incorporation of genotyping into a graduate level genetics course, the purpose of this study was 2-fold: first, to assess knowledge, attitudes, and beliefs of students toward personal genomics as it related to themselves as both as customers and future physicians and as it related to consumers at large, and second, to determine the impact of the course (as taught without genotyping) on knowledge, attitudes, and beliefs.MethodsWe surveyed first-year medical students and graduate students before and after a core genetics course.ResultsAfter the course, students were less likely to believe that genotyping information would be useful to physicians, patients, or consumers; genotyping would provide information to improve their own personal health; or personal genomic testing services are diagnostic of medical conditions. They were more likely to answer knowledge questions accurately after the course but still had difficulty with clinical interpretation. Despite these changes, a slight majority of students were, and remained, interested in undergoing genotyping themselves. Of note, the number who believed genotyping “would help them understand genetic concepts better than someone else's data” decreased. General curiosity was the most commonly chosen reason for interest in undergoing genotyping, and approximately 50% of respondents expressed concern about confidentiality of results.ConclusionsIn conclusion, even without the genotyping process, an educational program about genotyping increased knowledge, particularly about the clinical limitations of genotyping, but student interest in genotyping did not significantly change. Institutions thinking about offering genotyping to their students as part of a learning experience should consider the pros and cons of doing so.     

Juego de roles como método de enseñanza de Farmacología para estudiantes de la carrera de enfermería

IntroductionNursing professionals offer expert advice to patients. The latter requires relational skills. Literature indicates that these skills are not developed only from theoretical knowledge. Therefore, it is essential to equip nursing students with tools that assist them to develop these skills. Accordingly, role-play is considered an educational technique of active learning that facilitates the development of relational skills.AimThis paper aims to compare statically the students’ academic performance among groups of students exposed and not exposed to the role-play technique and characterise the students’ perception of satisfaction of whom participated in the role-play technique.Material and methodUsing a randomised controlled experimental design, nursing students were assigned to control groups (expose to the role-play technique) and one experimental group. Quantitative (i.e., student? academic performance) and qualitative data (i.e., students’ satisfaction survey) was collected to study the possible influence of the role-play technique in nursing students.ResultsThe student? academic performance was higher in the experimental groups than in the control group. Qualitative analyses show that students are satisfied with the use of this. They also consider that this technique allows them to solve simulated problems similar to those they will face in their workplace.ConclusionsThe results obtained in this study shows that it is possible to innovate with a positive impact of student satisfaction in medical education. The implications of this study are related to the use of an alternative teaching technique that promotes peer feedback, teamwork, and the analyses of student? reaction and responses of real-life situations.