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to be developed to support subsequent stages of implementation. To achieve the reach needed across a
[15]
health system, scalable CME is needed . Therefore, the second facet of our strategy was to co-design and
deliver structured continuing education programs for non-genetics medical specialists to increase their
[3]
understanding of genomic medicine and its application .

We developed and implemented two structured CME programs in genomics: face-to-face, stand-alone
workshops tailored to specialist groups and a blended learning course with specialty-agnostic online content
and adult, pediatric or cancer clinical cases.

Here we describe the development of these two CME programs and present the results of their evaluation.
The place of specialty-specific and generalized genomics education to upskilling medical professionals
across a health system is considered in light of these results.

METHODS
Program design and delivery
Audience
The target audience for both our genomics education programs were Victorian medical doctors training or
qualified in specialties other than medical genetics (“medical specialists”). There were no pre-requisite
genomics knowledge or skills. The specialty-specific workshops were designed to meet needs that emerged
as the use of genomic testing was being evaluated in clinical care through the Melbourne Genomics
program. The blended learning course was informed by the specialty workshops and designed to meet the
needs of a broader range of specialists. In each case, educational programs were promoted through member
hospitals and existing communication channels, including the Melbourne Genomics newsletter, website,
and/or social media accounts. Advertising for specialty workshops was targeted to the relevant medical
specialty. The periods of advertising for each program did not overlap; specialists could attend either
program.

Theoretical frameworks, design principles and processes
All learning activities were based on theories of adult learning, that is, learners have varied prior knowledge
[16]
and are self-motivated to learn when content is most relevant to their professional practice . The learning
design was case-based learning (CBL), with both programs including small-group discussion and learning
from peer experts. The CBL approach is commonly used in medical education to link theory with
practice . The blended learning course also incorporated self-directed use of interactive, online resources.
[17]
The programs focused on core background knowledge and clinically-relevant practical application. This
approach was based on adult learning theory and our experience that applied clinical learning, such as
identifying patients suitable for genomic tests and interpreting test results, is more immediately relevant to
most non-genetic specialists than technical aspects of genomics, such as test methodology and variant
interpretation processes [18,19] .

We used a co-design approach to develop both education programs, where the end-users of a “product”
collaborate with designers and relevant stakeholders to contribute to the design process . Learning
[20]
objectives for the specialty workshops were developed by a co-design team that included Melbourne
Genomics education staff (TC, FM, and EL), genetic specialists (clinical/medical geneticists, genetic
counselors) and non-genetic “peer expert” medical specialists from the relevant specialties, many of whom
had gained some expertise in genomics through Melbourne Genomics clinical flagship or immersion
activities. The co-design team for the blended learning course comprised the same Melbourne Genomics