Academic journal article American Journal of Pharmaceutical Education

Effects of Using Personal Genotype Data on Student Learning and Attitudes in a Pharmacogenomics Course

Academic journal article American Journal of Pharmaceutical Education

Effects of Using Personal Genotype Data on Student Learning and Attitudes in a Pharmacogenomics Course

Article excerpt

INTRODUCTION

Tremendous scientific advances have occurred in genomic variability and its association with drug response, toxicity, disease risk, and disease prognosis. Although clinical use of pharmacogenomic and genomic data to inform patient care decisions is increasing, it is not yet routine. Coverage of these concepts in health professions education, including pharmacy education, is lacking, and most practitioners feel inadequately prepared to apply these data in clinical practice. (1-3) This knowledge gap is a significant barrier to widespread implementation of genomic medicine. (4) While core competencies in genomic medicine and pharmacogenomics are available for pharmacists and other health professionals, they largely emphasize scientific knowledge of genetics rather than skills needed to apply these data. Additionally, didactic lectures remain the primary teaching method for this content in health professions education, despite data showing limited benefit of this strategy in improving practitioner understanding and retention of genomic medicine concepts. (5-10)

Educational approaches are needed that blend knowledge-based and skills-based learning activities, incorporate real-world applications, utilize collaborative teaching methods, and are accessible by a broad audience to support use of genomic and pharmacogenomics data. (11-13) Although the optimal strategy to meet this need is debated, incorporation of student personal genetic testing is proposed as one option to improve learning outcomes. (11,12,14-16) Medical and graduate students enrolled in a genetics course at Stanford School of Medicine were offered personal genome-wide testing through a direct-to-consumer company. (11,16) Researchers reported improved engagement, motivation, and learning outcomes in students who underwent personal genetic testing. Of the students who underwent genetic testing, 70% self-reported a better understanding of human genetics based on their participation. In addition, genotyped students demonstrated a significantly higher increase from pretest to posttest knowledge scores compared with students who did not undergo genotyping. Results of a pilot study in two interdisciplinary electives at Duke University were similar. (12) Other proposed or explored approaches include development of experiential, team-based learning programs for residents; (17) student performance of limited self-genotyping in laboratory exercises; (18,19) and development of educational tracks or shared curricular materials for schools of pharmacy and medicine. (20-22)

There remains a need for development of educational models in this area. Although student genetic testing through an external laboratory provider has been employed in some models, (11,12) this approach may not be scalable and has raised ethical concerns. (15) Additionally, teaching strategies employed in these courses to date lack an emphasis on patient care applications of these data. They also employ traditional, residential-based teaching methods and thus do not present a solution to broad-based education in this area. Based on this need, the University of Florida (UF) College of Pharmacy, in conjunction with UF Health Personalized Medicine Program clinicians and faculty members, offered two 8-week, 1-credit hour elective courses on the clinical applications of pharmacogenomics and genomic medicine in fall 2014 for third-year doctor of pharmacy (PharmD) students. The courses were delivered in an online format. The goal of these courses was to provide students with the knowledge and skills to use pharmacogenomic and genomic medicine data in future clinical practice. The online courses incorporated a flipped-classroom model with interprofessional lectures, patient-case discussions, and role-playing exercises that required use of clinical practice guidelines, databases, and primary literature. In the pharmacogenomics course, students could have their DNA genotyped on a custom pharmacogenomics chip (23) and apply their genetic information (or use de-identified genotype data) to solve patient cases. …

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