Advancing Pharmacogenomics Education in the Core PharmD Curriculum through Student Personal Genomic Testing

By Adams, Solomon M.; Anderson, Kacey B. et al. | American Journal of Pharmaceutical Education, February 2016 | Go to article overview

Advancing Pharmacogenomics Education in the Core PharmD Curriculum through Student Personal Genomic Testing


Adams, Solomon M., Anderson, Kacey B., Coons, James C., Smith, Randall B., Meyer, Susan M., Parker, Lisa S., Empey, Philip E., American Journal of Pharmaceutical Education


INTRODUCTION

Pharmacogenomics, the study of how genetic variation impacts drug response, has been implemented in clinical practice based on the premise that it improves medication outcomes. (1) As medication experts, pharmacists are well-positioned to ensure genetic data are used safely and effectively to tailor medication use to achieve "precision medicine," defined by the National Institutes of Health (NIH) as: "tailoring of medical treatment to the individual characteristics of each patient." (2, 3) Professional position statements advocate for pharmacists to play a leadership role in pharmacogenomics-based patient care. (2, 3) However, the majority of pharmacists are not confident with pharmacogenomics data. (2, 4-7)

Because the 2016 Accreditation Council for Pharmacy Education (ACPE) Standards include pharmacogenomics, it is the responsibility of pharmacy schools to prepare pharmacists entering clinical practice to effectively use genetic data in the delivery of precision medicine. (8) Furthermore, the American Association of Colleges of Pharmacy (AACP), (4) the NIH-funded Genetics/Genomics Competency Center (G2C2), (9) and the National Coalition for Health Professional Education in Genetics (NCHPEG) (10) have created genetics competencies applicable to pharmacists. However, the state of pharmacogenomics instruction at most pharmacy schools was reported as "poor" or "not at all adequate" in a 2010 survey. (11) New methods of instruction may be needed to drive better learning and retention.

A participatory education model in which students undergo personal genomic testing (PGT) enhanced classroom learning in limited trials but remains controversial. (12-15) To explore pharmacy student interest at our institution, we polled over 200 students at the University of Pittsburgh School of Pharmacy in 2013 and found the majority (77%) were interested in undergoing PGT to help learn pharmacogenomics. We therefore sought to scale this innovative educational approach to the core doctor of pharmacy (PharmD) curriculum to attain its educational benefits within an appropriate ethical framework. In this report, we describe our development of "Test2Learn" (www.test2learn.org, trademark pending), an educational program focused on using PGT as a pedagogical tool, its implementation in a required course in the second-year of the PharmD curriculum at the University of Pittsburgh, and outcomes derived from objective measures of learning and student surveys. We hypothesized that the integration of PGT would engage students and enable them to achieve high-level pharmacogenomics competencies through active-learning experiences.

DESIGN

At the University of Pittsburgh, PharmD students are introduced to pharmacogenomics in the second year of the curriculum in the course Drug Development II. This required course teaches pharmacokinetics and pharmacodynamics concepts, which are critical to student understanding of the scientific basis of variable patient drug response. It bridges the foundational content in Biochemistry, Principles of Drug Action (including pharmacology), and Drug Development I (clinical trials and the diversity of patient populations) courses taught in year one with therapeutics courses in the third year. Drug Development II is team-taught by 10 clinical and research faculty members and takes place in the school's new state-of-the-art classroom designed to facilitate group activities using computer/mobile technology.

In summer 2014, course faculty members were offered PGT through the direct-to-consumer genetic testing company, 23andMe (Mountain View, CA). The objective of this "teach the teacher" approach was to expose faculty members to PGT as a pedagogical tool and to demonstrate how to incorporate pharmacogenomics and genetic data into their lessons, if desired. Drug Development II course objectives (Table 1) were designed through a formal process of review and integration of pharmacogenomics competencies and learning outcomes from the following sources: AACP, (4) NCHPEG, (10) the G2C2 Pharmacist Competencies, (9) ACPE 2016 accreditation standards, (8) a recent American College of Clinical Pharmacy commentary, (16) and the existing University of Pittsburgh PharmD program curricular and course outcomes. …

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