Page 89 - Read Online

Page 83 Maher et al. J Transl Genet Genom 2023;7:94-109 https://dx.doi.org/10.20517/jtgg.2023.04

additional gains in confidence after attending a workshop following online learning. Workshop discussions with
experts were valued, particularly regarding interpreting and applying results. At follow-up, gains in confidence and
understanding were maintained for both programs and 81% of respondents had performed a new genomics activity
in clinical practice.

Conclusion: Scalable education is needed. Our results suggest that specialty-specific genomics education may not
be required to meet the needs of multiple specialties across a health system. Online learning can meet foundational
learning needs but may not be sufficient to apply learning to practice. Blended learning offers flexible, continuing
education pathways for dispersed national audiences as genomics becomes increasingly used across varied
specialties.
Keywords: Workforce, genomic medicine, physician, continuing education, professional development, evaluation,
case-based learning, blended learning

INTRODUCTION
Incorporating genomics into healthcare requires a health professional workforce that can apply genomic
[1,2]
technologies translated from research settings to medicine . Medical specialists without genetics training
(“non-genetics” specialists) and other health professionals (such as nurses) need genomic literacy, skills and
competencies appropriate for their professional role as genomics becomes relevant to the care of their
patients . Efforts to ensure graduating medical professionals have fundamental skills in genomic
[3]
medicine do not address the immediate need of practicing medical specialists to develop appropriate
[4,5]
genomic skills. Medical professionals report a need for specialty-specific continuing medical education
[6]
(CME) in genomics . This approach has been adopted by genomics educators globally, with efforts focused
[7,8]
on a single clinical area or specialty, such as oncology or primary care . However, a specialty-specific
approach to address the continuing professional development needs of “non-genetics” specialists may not
be feasible across an entire health system.

In Australia, doctors complete a medical degree and then undertake specialty training through a medical
college to become a Fellow (Consultant) of that college, e.g., the Royal Australasian College of Physicians.
To maintain their medical registration with the national Australian Health Practitioner Regulation Agency,
medical practitioners with specialist registration must self-report CME activities. Educational activities can
count for up to 60% of the minimum CME requirements established by their college, with activities offered
by a range of education providers. The funding and management of public health care delivery is the
[9]
responsibility of each state or territory . The State Government of Victoria funded the Melbourne
Genomics Health Alliance (“Melbourne Genomics”) to address barriers to the use of genomics in the
Victorian health system. This included identifying and testing approaches to foster the understanding and
skills in genomic medicine of practicing non-genetic specialists. At the time of our education programs,
access to genomic testing in a clinical setting by non-genetic specialists was largely through clinical
implementation research [10,11] , with some having access to hospital-funded panel tests, and the role of genetic
counselors varied .
[12]
Melbourne Genomics developed and implemented a multifaceted education strategy. The first phase of the
strategy (reported elsewhere [10,13] ) was to foster specialty-specific “peer” experts, potential opinion leaders
[14]
who could lead change within their discipline through experiences in genomics-rich workplaces .
[3]
Typically, these funded positions included rotation through a clinical genetics service or laboratory, or
projects at the point of clinical implementation (clinical service design “flagship” projects). This resource-
intensive approach is arguably best used at an early stage of translation when a cadre of early adopters needs