Top

Journal of Cancer Education

Published in:

01-06-2012

Impact of Web-Based Case Conferencing on Cancer Genetics Training Outcomes for Community-Based Clinicians

Authors: Kathleen R. Blazer, Christina Christie, Gwen Uman, Jeffrey N. Weitzel

Published in: Journal of Cancer Education | Issue 2/2012

Abstract

Introduction

Technology and market forces are driving the demand for cancer risk assessment services in the community setting, where few clinicians are trained to order and interpret predictive genetic tests. City of Hope conducts a three-phase course in genetic cancer risk assessment (GCRA) for community-based clinicians, comprised of distance didactics, face-to-face workshops, and 12 months of professional development. As designed, the course cannot meet increasing demands for GCRA training. Action research identified face-to-face workshops as a barrier to increasing course capacity. This study compared the learning effectiveness of Web-based case conferencing to face-to-face training.

Methods

A quasi-experimental design compared pre- to post-knowledge, skills, and professional self-efficacy outcomes from 2009 to 2010 course cohorts (n = 96). The intervention group (n = 52) engaged in Web-based case conferences during distance learning; the comparison group (n = 44) participated in the course as originally designed.

Results

Both groups and all practice disciplines demonstrated significant pre- to post-increases on all measures. Knowledge increases were higher for the intervention group (p < 0.015); skills and self-efficacy increases were comparable between groups (p < 0.33 and p < 0.30, respectively).

Discussion

Findings support the learning utility of Web-based case conferencing. Further studies may inform the development of tools to assess the impact of Web-based case conferencing on practice change and patient outcomes, in alignment with the highest standards of continuing professional development.

The option of recorded sessions was included in response to feedback from course alumni who reported that the fixed mid-week timeslot for working group posed a barrier to participation due to conflicting clinical schedules.

In compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements for patient privacy and confidentiality, all patient-related materials and discussion conducted during Working Group are completely anonymized, and recorded sessions are delivered as password-protected streaming media that cannot be downloaded, copied, or disseminated to nonparticipants.

Ng PC, Murray SS, Levy S et al (2009) An agenda for personalized medicine. Nature 461(7265):724–726. doi:10.1038/461724a PubMedCrossRef

Murphy SAR, Freed JS (2008) Healthcare’s ascension to patient-centered genomic care. Pers Med 5(5):505–509. doi:10.2217/17410541.5.5.505 CrossRef

Vadaparampil ST, Wideroff L, Olson L et al (2005) Physician exposure to and attitudes toward advertisements for genetic tests for inherited cancer susceptibility. Am J Med Genet 135A(1):41–46. doi:10.1002/ajmg.a.30681 CrossRef

Weitzel JN, Blazer KR, MacDonald DJ et al (2011) Genetics, genomics and cancer risk assessment: state of the art and future directions in the era of personalized medicine. CA Cancer J Clin 61(5):327–359. doi:10.3322/caac.20128

Caffarella RS, Merriam SB (1999) Learning in adulthood: a comprehensive guide, 2nd edn. Josey-Bass, San Francisco

Davis D, O’Brien MA, Freemantle N et al (1999) Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 282(9):867–874. doi:10.1001/jama.282.9.867 PubMedCrossRef

Davis DA, Thomson MA, Oxman AD et al (1995) Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA 274(9):700–705. doi:10.1001/jama.274.9.700 PubMedCrossRef

Mansouri M, Lockyer J (2007) A meta-analysis of continuing medical education effectiveness. J Contin Educ Health Prof 27(1):6–15. doi:10.1002/chp.088 PubMedCrossRef

Tian J, Atkinson NL, Portnoy B et al (2007) A systematic review of evaluation in formal continuing medical education. J Contin Educ Health Prof 27(1):16–27. doi:10.1002/chp.089 PubMedCrossRef

10.

Spivey BE (2005) Continuing medical education in the United States: why it needs reform and how we propose to accomplish it. J Contin Educ Health Prof 25(3):134–143. doi:10.1002/chp.20 PubMedCrossRef

11.

Bennett N, Davis D, Easterling W et al (2000) Continuing medical education: a new vision of the professional development of physicians. Acad Med 75(12):1167–1172PubMedCrossRef

12.

IOM (Institute of Medicine) (2010) Redesigning continuing education in the health professions. National Academies Press, Washington, DC. Available at: http://www.nap.edu/catalog/12704.html. Accessed June 1, 2010

13.

Miller SH (2005) American Board of Medical Specialties and repositioning for excellence in lifelong learning: maintenance of certification. J Contin Educ Health Prof 25(3):151–156. doi:10.1002/chp.22 PubMedCrossRef

14.

Blazer KR, MacDonald DJ, Ricker C et al (2005) Outcomes from intensive training in genetic cancer risk counseling for clinicians. Genet Med 7(1):40–47. doi:10.1097/01.GIM.0000151154.27612.49 PubMedCrossRef

15.

Blazer KR, MacDonald DJ, Culver JO et al (2011) Personalized cancer genetics training for personalized medicine: improving community-based healthcare through a genetically literate workforce. Genet Med 13(9):832–840. doi:10.1097/GIM.0b013e31821882b7 PubMedCrossRef

16.

Blazer KR, Sand S, Hilario J, et al. (2009) Using action research to evaluate and innovate a program of personalized cancer genetics training for personalized medicine. Paper presented at the AACE international cancer education conference: the art and science of cancer education and evaluation, Houston, TX

17.

Lave J, Wenger E (1991) Situated learning: legitimate peripheral participation. Cambridge University Press, Cambridge

18.

Wenger E, McDermott R, Snyder W (2002) Cultivating communities of practice: a guide to managing knowledge. Harvard Business School, Boston

19.

Shadish WR, Cook TD, Campbell DT (2002) Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin, Boston

20.

Secretary’s Advisory Committee on Genetics Health and Society (SACGHS) (2011) Genetics education and training: report of the secretary’s advisory committee on genetics, health, and society. Available at: http://oba.od.nih.gov/SACGHS/sacghs_home.html. Accessed January 3, 2011

21.

The American Society of Human Genetics (ASHG) Social Issues Committee, The American College of Medical Genetics (ACMG) Social–Ethical and Legal Issues Committee (2000) ASHG/ACMG statement. Genetic testing in adoption. Am J Hum Genet 66:761–767CrossRef

22.

Institute of Medicine (IOM) (2007) Cancer-related genetic testing and counseling: workshop proceedings. National Academies Press, Washington, DC. Available at: www.nap.edu/catalog/11971.html. Accessed July 1, 2007

23.

Daly MB, Axilbund JE, Buys S et al (2010) Genetic/familial high-risk assessment: breast and ovarian. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 8(5):562–594PubMed

24.

National Cancer Institute (NCI) (2010) Cancer genetics overview (PDQ): genetic resources. Available at: www.nci.nih.gov/cancertopics/pdq/genetics/overview/HealthProfessional/page5. Accessed Dec. 29, 2010

25.

Reynolds PP, Benkendorf JL (1999) Genes and generalists: why we need professionals with added competencies. West J Med 171:375–379PubMed

26.

Schwartz MD, Valdimarsdottir HB, DeMarco TA et al (2009) Randomized trial of a decision aid for BRCA1/BRCA2 mutation carriers: impact on measures of decision making and satisfaction. Health Psychol 28(1):11–19. doi:10.1037/a0013147 PubMedCrossRef

27.

Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215PubMedCrossRef

28.

Bandura A (1982) The assessment and predictive generality of self-percepts of efficacy. J Behav Ther Exp Psychiatr 13(3):195–199CrossRef

29.

Slotnick HB (1996) How doctors learn: the role of clinical problems across the medical school-to-practice continuum. Acad Med 71(1):28–34. doi:10.1097/00001888-199601000-00014 PubMedCrossRef

30.

ACCME (2008) Tools to support implementation of a monitoring system for regularly scheduled series (RRS). Available at: www.accme.org/dir_docs/doc_upload/62fa1df3-e304-408f-ade2-7919a27a4dc8_uploaddocument.pdf. Accessed November 22, 2009

31.

Onishi H (2008) Role of case presentation for teaching and learning activities. Kaohsiung J Med Sci 24(7):356–360PubMedCrossRef

32.

Petty JK, Vetto JT (2002) Beyond doughnuts: tumor board recommendations influence patient care. J Canc Educ 17(2):97–100

33.

Price DW, Felix KG (2008) Journal clubs and case conferences: from academic tradition to communities of practice. J Contin Educ Health Prof 28(3):123–130. doi:10.1002/chp.180 PubMedCrossRef

34.

Li LC, Grimshaw JM, Nielsen C, et al. (2009) Use of communities of practice in business and health care sectors: a systematic review. Implement Sci 4(27). doi:10.1186/1748-5908-4-27

35.

Jackson MJ, Gallis HA, Gilman SC et al (2007) The need for specialty curricula based on core competencies: a white paper of the conjoint committee on continuing medical education. J Contin Educ Health Prof 27(2):124–128. doi:10.1002/chp.111 PubMedCrossRef

36.

Kuehn BM (2010) IOM: improve clinician CME system. JAMA 303(8):716. doi:10.1001/jama.2010.160 PubMedCrossRef

37.

Leist JC, Green JS (2000) Congress 2000: a continuing medical education summit with implications for the future. J Contin Educ Health Prof 20(4):247–251. doi:10.1002/chp.1340200408 PubMedCrossRef

38.

Leist JC (2003) Accreditation: standards for quality continuing professional development. J Vet Med Educ 30(1):13–18. doi:10.3138/jvme.30.1.13 PubMedCrossRef

Title: Impact of Web-Based Case Conferencing on Cancer Genetics Training Outcomes for Community-Based Clinicians
Authors: Kathleen R. Blazer
Christina Christie
Gwen Uman
Jeffrey N. Weitzel
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Journal of Cancer Education / Issue 2/2012
Print ISSN: 0885-8195
Electronic ISSN: 1543-0154
DOI: https://doi.org/10.1007/s13187-012-0313-8

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

Please log in to get access to this content

Other articles of this Issue 2/2012

The Impact of Education on Caregiver Burden on Two Inpatient Oncology Units

Ethics Corner—Inequality and Injustice for Some

Assessment of Cancer Education Seminars for Appalachian Populations

Erratum to: Recognition and Management of HBV Infection in a Social Context

Readers’ Theatre: A Communication Tool for Colorectal Cancer Screening

Developing Partnerships and Recruiting Dyads for a Prostate Cancer Informed Decision Making Program: Lessons Learned From a Community-Academic-Clinical Team

Keynote webinar | Spotlight on antibody–drug conjugates in cancer