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staff (TC, FM, and EL) plus a subset of peer experts to represent adult, pediatric and/or somatic (cancer)
specialties. These peer experts were an integral part of the co-design process as they were able to identify key
concepts to develop understanding and skills in genomic testing relevant to their specialty, with learning
objectives worded in a way that was accessible to their peers. To ensure authentic, clinically-relevant
learning through cases based on real-world experience, they helped develop clinical cases for the specialty
workshops so that learners could apply new knowledge in relevant clinical contexts; for the blended
learning course, the peer experts helped select cases to illustrate adult, pediatric or somatic application of
genomic testing. They then also facilitated the CBL components of the program (details provided in
Supplementary Table 1). As clinical members of the co-design team were not principally educators, the
[21]
development phase included building skills in facilitating small-group discussion , including how to
establish and build on learners’ prior knowledge through guided questioning and using step-wise
explanations.

Program evaluation
Each program was evaluated separately to assess effectiveness; we did not aim to compare the effectiveness
of the two programs against each other or a control group. Evaluation questions aimed to assess program
objectives as well as inform the design of future effective and scalable education:

1. Do the programs increase confidence, understanding and skills, and impact attitudes to
practicing genomic medicine?

2. What is the value of facilitated case-based workshops for participants who have completed self-
directed online modules, in addition to any gains in confidence or understanding?

We compared the results of the two program evaluations to inform broader, enduring genomics educational
efforts.

In a longitudinal evaluation study design [Figure 1], we deployed surveys at up to four time points, with at
least one reminder to complete each survey:

• Baseline: to all registrants, before pre-reading was provided (specialty workshop) or online
modules opened (blended learning course)

• Post-online: to blended learning course participants who completed the online modules

• Completion: to all workshop attendees, after the workshop

• Follow-up: to all workshop attendees, at least 15 months later

Survey domains and outcome measures included changes in confidence, understanding, skills and attitudes
relating to genomic medicine, common constructs when evaluating continuing genomics education [8]
[Supplementary Table 2]. Measures were designed to assess the application of new knowledge and skills
within the Australian health system context. Questions were categorical, open-text, or Likert-scale
responses. To assess the ability to apply new knowledge, respondents reviewed an excerpt of a genomic test
report that identified a variant of uncertain significance (VUS) and answered a question about whether
predictive testing could be offered to family members [Supplementary Figure 1]. All surveys are available on
request.