The impact of a genetics education program on physicians’ knowledge and genetic counseling referral patterns

Figures & data

Table

Practice points
•This study suggest that a flexible, targeted training program in genetics when adapted to the interests and needs of GPs in an institutional setting can effectively enhance the knowledge of physicians.
•The reasons that educating GPs in genetics is not linked to an increase in genetic counseling may be due to a better selection of patient referrals by the GP, patient demographics, insurance coverage, and a lack of patient knowledge of genetics.
•The utilization of genetic counseling services may be independent of GPs’ genetic knowledge and depend upon patient-driven inquiries.

Table 1.  Quarterly topics for faculty physicians and family practice residents

Lecture	Title	Subjects
1	Basic Genetic Principles in Primary Care	Inheritance, pedigree drawing, cytogenetics, gene expression, PCR, diagnostic genetic testing
2	Recognizing Genetic Syndromes	Craniofacial measurements, common dysmorphic syndromes.
3	Common Genetic Disorders I	Neurogenetics, metabolic disorders
4	Common Genetic Disorders II	Cancer genetics, deafness, hemochromatosis

Table 2.  Monthly didactic seminars for family practice residents

Seminar	Title	Subjects
1	Prenatal Genetics and	Ethnicity-based genetic carrier screening
	Maternal Serum Screening	Prenatal maternal serum screening: Principles of first and second trimester screening
2, 3	Principles of Medical Genetics I and II	Medical genetics: Past, present, future; Basic molecular genetics and mechanisms of genetic disease. Principles of Mendelian and non-Mendelian inheritance
4, 5	Cytogenetics I and II	Chromosome structure and function; Indications for chromosome testing; Chromosome abnormalities in clinical practice. Natural history of the common sex chromosome anomalies
6	Pedigree Clinic	Pedigree construction and the family medical history in primary care
7	Dysmorphology in Primary Care	Evaluation of developmental delay, principles of dysmorphology and syndrome recognition
8	Genetics of Common Inherited Disorders	Counseling issues involved in disorders such as diabetes, dyslipidemias, psychiatry, and neurology
9	Inherited Cancer Syndromes in Primary Care	Risk assessment and genetic counseling for inherited cancer syndromes (e.g. breast and colon cancer)
10	Biochemical Genetics	Principle and categories of inborn errors of metabolism
11	Genetic Testing	Indications and types of genetic laboratory studies including newborn screening, legal issues, and process of consent
12	Prenatal Ultrasound Anomalies	Identification, natural history, and genetic counseling for common prenatal ultrasound findings

Figure 1. Normal distribution of genetic knowledge test scores. (A) Pretests show lower mean scores as compared to (B) post-test scores (n = 143) after an educational program in genetics for primary care physicians. The rectangles represent the count of individuals who received a particular test score (%). The curves represent the normal distribution of the scores. The bars at the top of the rectangles show the standard error of the mean.

Figure 2. Overlay plot of quarterly referrals for genetic counseling. The graph shows the total number of genetic counseling referrals (•) during the two quarters (6 months) before the genetic educational program and over the 2-year period of the program. The number of genetic counseling referrals from primary care physicians who participated in the program (*) remained the same during the 2-year period. The number of referrals from specialists in perinatology (▪) and genetics (Δ) who did not participate in the educational program accounted for most of the genetic counseling referrals. It is important to note that all of the referrals from the perinatologist were from prenatal visits and were referred directly from the perinatologist to the genetic counselor. The number of referrals to the genetic counselor from the perinatologist seemed to increase despite their non-participation in the genetic educational program.