Effect of live education targeted to genetic counselors on knowledge and competence.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11035-11035
Author(s):  
Vanessa Carranza ◽  
Susan H. Gitzinger ◽  
Bryan Carson Taylor ◽  
Joan B. Fowler
Keyword(s):  
Genetic Testing ◽  
Parp Inhibitor ◽  
A Priori ◽  
Genetic Counselors ◽  
Statistical Testing ◽  
Healthcare Team ◽  
Post Test ◽  
Chi Square Analysis ◽  
Germline Testing

11035 Background: Rapid advancements in genomics and sequencing technologies have presented a growing need for experts in the field of genetics to translate results and optimize patient care. As knowledge regarding DNA mutations and the technology to properly detect them continuously advances, it will be vital that genetic counselors play a larger role in the oncology healthcare team. Methods: These activities were designed to target genetic counselors involved in the diagnosis, management and genetic counseling of patients who have or are at risk for DDR-mutated cancers, attending live symposia at the 2018 & 2019 American College of Medical Genetics & Genomics Annual Meeting. Learning and knowledge was objectively assessed by analyzing pre- and post-test results before and after the educational activities. To determine retention of knowledge over time, follow-up assessments were sent to participants after each live activity. Assessment questions in the form of case studies were utilized to gauge whether participants translated knowledge into practice at follow-up. Statistical testing between pre- and post-tests and from pre-test to follow-up were conducted via chi square analysis with a priori significance set at 0.05. Results: Evaluations were collected from N = 275 (onsite) participants. Improved learners, as determined by significant ( P < 0.05) increases in correct responses, were observed in several specific topic areas: When to consider germline testing (2018 participants: 53.33% pre-test vs. 87.5% post-test; 2019 participants: 42.55% pre-test vs. 84.72% post-test). Patients most likely to benefit from a PARP inhibitor based on genetic testing results (2018 participants: 50% pre-test vs. 93.75% post-test; 2019 participants: 75.49% pre-test vs. 94.37% post-test). However not all improvement was sustained at follow-up: When it is appropriate to consider germline testing (2018 participants: 64.44% at follow-up – not significant ( P= 0.138); 2019 participants: 85% at follow-up ( P< 0.001). Patients most likely to benefit from a PARP inhibitor based on genetic testing results (2018 participants: 68.89% at follow-up – not significant ( P= 0.140); 2019 participants: 65% at follow-up – not significant ( P= 0.329). Conclusions: This analysis shows that live accredited education can significantly improve the knowledge and competence of genetic counselors in multiple areas surrounding the use of germline testing to guide treatment recommendations. Results also suggest that ongoing education in clinically appropriate scenarios is warranted.

The impact of live education on the competence and performance of oncology practitioners who care for patients with ovarian cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23010-e23010
Author(s):  
Vanessa Carranza ◽  
Bryan Carson Taylor ◽  
Susan H. Gitzinger ◽  
Joan B. Fowler ◽  
Jessica Hall
Keyword(s):  
Ovarian Cancer ◽  
Genetic Testing ◽  
Cancer Patients ◽  
Parp Inhibitor ◽  
Inhibitor Therapy ◽  
Community Based ◽  
Educational Initiatives ◽  
Post Test ◽  
Chi Square Analysis

e23010 Background: About a third of ovarian cancer patients in the US have limited access to a gynecologic oncologist (GO) due to geographic disparities. A survey by The Society of Gynecologic Oncology (SGO) found that the majority of GOs found it was vital to coordinate local access to care, from diagnosis to survivorship, for patients living in areas of disparity. This allows rural/underserved patients broader access to novel therapies, as they increasingly become standard of care. It is critical for not only GOs to be current on the latest ovarian cancer data, but all clinicians who care for these patients. Methods: CEC Oncology developed two educational initiatives focused on PARP inhibitor therapy in ovarian cancer, which was targeted to all US healthcare professionals caring for ovarian cancer patients. Evaluations were collected from attendees attending an SGO Symposium and Ground Round (GR) series to assess impact on practice, increased competency, and intent to make a change in practice. Learning, knowledge, and competence was objectively assessed by analyzing pre-test, post-test, and follow-up survey data (sent 4-6 weeks post-activity). Chi-square analysis was conducted with a priori significance set at 0.05. Results: A total of 830 clinicians were educated, with SGO attendees primarily practicing in academic settings and GR attendees mostly from community practices. SGO attendees were asked case questions at baseline, immediately after the activity, and 4-6 weeks after the activity. Knowledge increased from pre- to post-test regarding current genetic testing recommendations (23% increase; P= .004) and appropriate selection of PARP inhibitor therapy (25% increase; P= .017). Knowledge was sustained at follow-up analysis. At follow-up, 90% of SGO and 84% of GR attendees made a change as a result of attending the activities. More attendees were able to incorporate germline multigene testing into practice, than originally intended; increase of 29% for SGO and 7% for GR audiences. All attendees experienced the barrier lack of patient education about the importance of genetic testing/counseling more than anticipated; increase of 7% for SGO and 13% for GR audiences. At follow-up, there was a 9% increase in GR attendees listing staying current with trial data and practice guidelines as a barrier. Conclusions: There were some notable differences seen in competence/performance among attendees of the two ovarian cancer educational initiatives. Differences may be attributed to practice setting (SGO primarily academic; GR primarily community.) Overall, GR attendees were more likely to face barriers, suggesting that community-based clinicians have fewer resources and experience more barriers to implementing best practices. Thus, it is vital to offer education for clinicians in community-based practices, particularly in areas that are considered ‘geographically disparate’.

The impact of an expert exchange-based educational initiative on urologist confidence and knowledge in implementing immunotherapy for bladder cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23001-e23001
Author(s):  
Susan H. Gitzinger ◽  
Bryan Carson Taylor ◽  
Joan B. Fowler ◽  
Vanessa Carranza ◽  
Rebecca Weaver
Keyword(s):  
Bladder Cancer ◽  
Statistical Testing ◽  
Academic Medical Centers ◽  
Educational Activities ◽  
Medical Centers ◽  
Activity Assessment ◽  
Academic Medical ◽  
Post Test ◽  
Chi Square Analysis

e23001 Background: The rapid and robust emergence of the immunotherapy era in bladder cancer has prompted a paradigmatic shift in both early and late-stage bladder cancer management. Given this change, it is imperative that members of the bladder cancer care team, most notably urologists, medical oncologists, and urologic oncologists, be well-equipped to safely and effectively integrate immune checkpoint inhibitors into the treatment armamentarium. Methods: CEC Oncology delivered education at select meetings throughout 2019-2021 including ASCO GU, AUA, and SUO Annual Meetings; in addition to live presentations, the content was streamed live and on-demand on www.ceconceptslive.com and endured on myCME.com. Learning and knowledge was objectively assessed by analyzing pre- and post-test results before and after the educational activities. To determine retention of knowledge over time, follow-up assessments were sent to participants after each live activity. Assessment questions in the form of case studies were utilized to gauge whether participants translated knowledge into practice at follow-up. Statistical testing between pre- and post-tests and from pre-test to follow-up were conducted via chi square analysis with a priori significance set at 0.05. Results: Executed five live educational activities and a spin-off enduring component hosted on myCME.com. 765 total clinicians educated across the live elements of the curriculum. Across the curriculum, over 70% of attendees indicated at post-activity assessment that they would use systemic immunotherapy either primarily or exclusively in their practice compared to just 25% at pre-activity. Among urologists practicing at academic medical centers, confidence in appropriate implementation of immunotherapy increased for all participants, and more specifically, for clinicians practicing at academic medical centers (on a 4-point scale, All Participants demonstrated a confidence increase from 2.70 to 2.91; Academic Medical Center clinicians demonstrated an increase of 2.75 to 3.00); 97% said that the initiative increased their knowledge of ongoing ICI clinical trials in bladder cancer; Attendee ability to appropriately manage an irAE increased substantially from pre-test to post-test assessment (37% vs. 63%; P=.057). Clinicians practicing in community settings are the only attendees who did not exhibit an increase in mean confidence in appropriately implementing immunotherapy at post-activity assessment. Conclusions: Our Expert Exchange Bladder Cancer Curriculum precipitated substantive practice advances related to appropriate implementation of ICI therapy. Many of these advances, however, were specific to academic urologists and urologic oncologists; outcomes analyses have revealed tangible educational gaps among community-based urologists.

Genetic counseling and the role of genetic counselors in the United States

2021 ◽  
Vol 33 (1) ◽  
pp. 29-34
Author(s):  
Christian P. Schaaf
Keyword(s):  
United States ◽  
Genetic Counseling ◽  
Genetic Testing ◽  
Genomic Medicine ◽  
The United States ◽  
Genetic Counselors ◽  
Healthcare Team ◽  
Primary Role ◽  
Medical Histories ◽  
The U.S

Abstract Genetic counselors represent an indispensable, well-established, and well-integrated group of healthcare providers in the field of genetic and genomic medicine in the United States. They work with other members of the healthcare team to provide information and support to individuals and families concerned with genetic disorders. With more than 5,000 certified genetic counselors in the U.S. and an expected growth of 100 % over the next decade, genetic counseling represents one of the fastest-growing professions in the U.S. Genetic counselors work in clinical environments (e. g., hospitals), in companies (e. g., genetic testing firms), and as consultants to medical practices and others. Twenty-six states license genetic counselors as practitioners who can bill independently, with licensure applications underway in the remaining 24 states. Physicians, genetic counselors, and diagnosticians represent the three pillars of comprehensive, integrated genomic medical care. Within this triad, genetic counselors see their primary role in procuring and interpreting family and medical histories, assessing inheritance, quantifying chances of recurrence, facilitating decision-making regarding genetic testing options, and explaining the results of such testing to the respective individuals within the greater context of their families.

Results from MAGENTA: A national randomized four-arm noninferiority trial evaluating pre- and post-test genetic counseling during online testing for breast and ovarian cancer genetic risk.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1506-1506 ◽  
Author(s):  
Elizabeth M. Swisher ◽  
Nadine Rayes ◽  
Deborah Bowen ◽  
Christine B Peterson ◽  
Tara Coffin ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Genetic Counseling ◽  
Genetic Testing ◽  
Genetic Education ◽  
Breast And Ovarian Cancer ◽  
Post Test ◽  
Anxiety Depression ◽  
Decisional Regret ◽  
Test Completion

1506 Background: Hereditary breast and ovarian cancer (HBOC) is preventable when genetic risk is identified. We aimed to test whether pre and/or post-test genetic counseling is needed to optimally deliver online accessible genetic testing. Methods: MAGENTA (Making GENetic Testing Accessible) is a four-arm non-inferiority trial evaluating electronic genetic education and results delivery alone or combined with pre-test only, or post-test only telephone genetic counseling compared to mandatory pre- and post-test counseling (control arm) in women at risk of HBOC (NCT02993068). Regardless of assigned arm, all subjects with a pathogenic mutation received post-test telephone counseling. All subjects were enrolled electronically as part of either a family history cohort (FHC) or a cascade cohort (CC, known familial mutation). The primary outcome was cancer risk distress at 3 months and the trial was powered for the FHC. Secondary outcomes included completion of testing (i.e., received results), anxiety, depression, quality of life, and decisional regret, all measured by standardized scales. Results: Enrollment is complete and a total of 3,822 participants were randomized, 3,111 in FHC and 711 in CC. Participants were enrolled from all 50 states, but most were white/non-Hispanic (88%). Among participants that completed genetic testing, 173 (7.2%) had a mutation in a breast or ovarian cancer gene, with 114 (5.7%) of FHC and 59 (14.2%) of CC. In the primary intention-to-treat analysis of FHC, each of the three experimental arms was non-inferior to the control arm for distress at 3 months (p < 0.025/3 = 0.0083). In the CC, no and pre-test only counseling were also non-inferior (p < 0.025/3 = 0.0083). Distress was lowest in the arm with neither pre nor post-test counseling. Overall, 318 (18%) participants had very high distress at three month follow-up, and this rate was not significantly different across arms. Anxiety, depression and decisional regret did not have statistically significant differences across arms at follow-up. Test completion was highest in the no counseling arm (86.4%) and lowest in the control arm (60.6%). Conclusions: Electronic genetic education and results release without genetic counseling was non-inferior with regard to patient distress and was associated with higher test completion and lower distress. These results support use of a genetic testing paradigm providing individualized genetic counseling only for patients with positive test results. Clinical trial information: NCT02993068.

Förderung der Lesekompetenz mittels reziproken Lehrens: Implementation und Wirksamkeit imRegelunterricht

2016 ◽  
Vol 30 (4) ◽  
pp. 213-225 ◽  
Author(s):  
Helvi Koch ◽  
Nadine Spörer
Keyword(s):  
Good Practice ◽  
Post Test

Zusammenfassung. Ziel war es, die Effektivität zweier Interventionen zur Förderung der Lesekompetenz von Fünftklässlern zu untersuchen. Beide Treatments wurden von Regellehrkräften implementiert. Die eine Intervention war das reziproke Lehren, welches um Selbstregulationsprozeduren angereichert wurde (RT+SRL). Die zweite war eine von Lehrkräften konzipierte lesestrategiebasierte Unterrichtseinheit (Good Practice, GP). Zusätzlich gab es eine No-Treatment-Kontrollgruppe (KG0). Insgesamt nahmen an der Studie N = 244 Schüler teil. Im Rahmen eines Pre-, Post-, Follow-Up-Test-Untersuchungsplans kamen standardisierte Leseverständnisaufgaben, selbstkonstruierte Lesestrategieaufgaben und eine Selbstwirksamkeitsskala zum Einsatz. Kontrastierende Einzelvergleichsanalysen ergaben, dass sich die Schüler der Treatmentbedingung RT+SRL im Vergleich zu den Schülern der Kontrollgruppe zum Post-Test signifikant stärker im Leseverständnis, in der Lesestrategieanwendung und in der Selbstwirksamkeit verbesserten. Gleiches galt für die Lesestrategieanwendung zum Follow-Up-Test. Schüler der Bedingung GP konnten im Vergleich zu KG0-Schülern weder zum Post- noch zum Follow-Up-Test vorteilige Ergebnisse in den drei Kriteriumsmaßen erzielen.

LRS-Elterngruppenprogramm: Teilnehmerzufriedenheit und subjektive Effektivität

2016 ◽  
Vol 5 (1) ◽  
pp. 44-57
Author(s):  
Anke Buschmann ◽  
Bettina Multhauf
Keyword(s):  
Goal Attainment ◽  
Goal Attainment Scaling ◽  
Eine Hohe ◽  
Post Test

Zusammenfassung. Das Ziel vorliegender Studie bestand in einer Überprüfung der Akzeptanz und Teilnehmerzufriedenheit eines Gruppentrainings für Eltern von Kindern mit Lese- und/oder Rechtschreibschwierigkeiten. Zudem sollten erste Indikatoren bezüglich der Wirksamkeit des Programmes untersucht werden. Dazu wurden Daten von 25 Müttern zu 2 Messzeitpunkten (Post-Test, 3-Monats-Follow-up) analysiert. Die Probandinnen nahmen über einen Zeitraum von 3 Monaten an 5 Sitzungen des Programms «Mein Kind mit Lese- und Rechtschreibschwierigkeiten verstehen, stärken und unterstützen: Heidelberger Elterntraining zum Umgang mit LRS» teil. Ein Paper-Pencil-Fragebogen diente zum Post-Test der Erhebung von Teilnahmeparametern, der Zufriedenheit mit dem Training, der Relevanz einzelner Themen und der wahrgenommenen Veränderungen in wichtigen Zielbereichen. Zusätzlich kam eine für das Gruppensetting adaptierte Form des Goal Attainment Scaling zum Einsatz, um das Erreichen persönlich relevanter Ziele unmittelbar nach dem Training sowie 3 Monate später zu erfassen. Die Analyse des Fragebogens zeigte eine hohe Partizipationsbereitschaft der Mütter. Die Rahmenbedingungen des Trainings (Gruppengröße, Dauer des Trainings und der Sitzungen) sowie die didaktischen Methoden wurden als ideal und die Themen als relevant eingeschätzt. Die Mütter sahen sich in der Lage, die Inhalte im Alltag anzuwenden und nahmen positive Veränderungen hinsichtlich Einfühlungsvermögen, Unterstützung des Kindes, Hausaufgabensituation und Beziehung zum Kind wahr. Das Ausmaß des Erreichens individueller Ziele zum Post-Test variierte je nach Zielbereich: Einfühlen und Verstehen (75 %), Optimierung der Hausaufgabensituation (76 %), Unterstützung psychosozialer Entwicklung (86 %), Lese-Rechtschreibförderung (60 %) und war auch 3 Monate später noch vergleichbar hoch. Die Überprüfung der Wirksamkeit hinsichtlich einer Belastungsreduktion und Kompetenzstärkung seitens der Eltern erfolgt aktuell im Vergleich zu einer unbehandelten Kontrollgruppe.

The effectiveness of positive training on happiness, aggression and hope in adolescents with leukemia in Ahvaz

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Marzieh . Shamkhani ◽  
Ali . Khalafi
Keyword(s):  
Sampling Method ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Positive Attitudes ◽  
Measurement Tools ◽  
Post Test ◽  
Aggression Questionnaire ◽  
Experimental Group ◽  
Period Measurement

The purpose of this study was to determine the effectiveness of positive learning on happiness, Aggression and hope for adolescents with leukemia in Ahvaz. The sample consisted of 30 people who were selected by available sampling method. 15 subjects in the experimental group and 15 in the control group were randomly assigned. The experimental design was a pre-test-post-test type with control group and follow-up period. Measurement tools included Oxford Happiness Inventory (Argyle, 1989); Ahwaz's Aggression Questionnaire (Zahedifar, Najarian, and Shokrkon, 2000); Hope Scale (Schneider, 1991). To run, at first, the pre-test was taken from both groups. Then, the experimental group was trained in 14 sessions of 90 minutes, and after each group, they were subjected to post-test. And one month later, the follow-up process was completed. Data analysis was performed using multivariate covariance analysis (MANCOVA) and one-way analysis of covariance (ANCOVA). The results showed that positive attitudes toward happiness, aggressiveness and hopefulness of adolescents with leukemia in Ahvaz were effective.

Melatih Kepemimpinan Perangkat Desa Kebonharjo Kulonprogo: Membangun Sikap Anti Korupsi

2018 ◽  
Vol 1 ◽  
pp. 107
Author(s):  
Adi Heryadi ◽  
Evianawati Evianawati
Keyword(s):  
Transformational Leadership ◽  
Data Collection ◽  
Paired Samples ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
Sample Test ◽  
Corruption Perception ◽  
Measuring Tool

This study aims to prove whether transformational leadership training is effective for building anti-corruption attitudes of villages in Kebonharjo village, subdistrict Samigaluh Kulonprogo. This research is an experimental research with one group pre and posttest design.Subject design is 17 people from village of 21 candidates registered. Measuring tool used in this research is the scale of anti-corruption perception made by the researcher referring to the 9 anti-corruption values with the value of reliability coefficient of 0.871. The module used as an intervention made by the researcher refers to the transformational leadership dimension (Bass, 1990). The data collected is analyzed by statistical analysis of different test Paired Sample Test. Initial data collection results obtained sign value of 0.770 which means> 0.05 or no significant difference between anti-corruption perception score between before and after training. After a period of less than 1 (one) month then conducted again the measurement of follow-up of the study subjects in the measurement again using the scale of anti-corruption perception. The results of the second data collection were analysed with Paired Samples Test and obtained the value of 0.623 sign meaning p> 0.05 or no significant difference between post test data with follow-up data so that the hypothesis of this study was rejected.

scholarly journals P34 Characteristics, diagnosis and management of Cushing’s disease - A systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Danyal Z Khan ◽  
Ronneil Digpal ◽  
Hugo Layard Horsfall ◽  
Hani J Marcus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
A Priori ◽  
Pituitary Surgery ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Diagnosis And Management ◽  
Over Time

Abstract Introduction The clinical practice and research in the diagnosis and management of Cushing’s disease remains heterogeneous and challenging to this day. We sought to establish the characteristics of Cushing’s disease, and the trends in diagnosis, management and reporting in this field. Methods Searches of PubMed and Embase were conducted. Study protocol was registered a-priori. Random-effects analyses were conducted to establish numerical estimates. Results Our screening returned 159 papers. The average age of adult patients with Cushing’s disease was 39.3, and 13.6 for children. The male:female ratio was 1:3. 8% of patients had undergone previous transsphenoidal resection. The ratio of macroadenomas: microadenomas:imaging-undetectable adenomas was 18:53:29. The most commonly reported preoperative biochemical investigations were serum cortisol (average 26.4µg/dL) and ACTH (77.5pg/dL). Postoperative cortisol was most frequently used to define remission (74.8%), most commonly with threshold of 5µg/dL (44.8%). Average remission rates were 77.8% with recurrence rate of 13.9%. Median follow-up was 38 months. Majority of papers reported age (81.9%) and sex (79.4%). Only 56.6% reported whether their patients had previous pituitary surgery. 45.3% reported whether their adenomas were macroadenoma, microadenoma or undetectable. Only 24.1% reported preoperative cortisol, and this did not improve over time. 60.4% reported numerical thresholds for cortisol in defining remission, and this improved significantly over time (p = 0.004). Visual inspection of bubbleplots showed increasing preference for threshold of 5µg/dL. 70.4% reported the length of follow up. Conclusion We quantified the characteristics of Cushing’s disease, and analysed the trends in investigation and reporting. This review may help to inform future efforts in forming guidelines for research and clinical practice.

scholarly journals Improving conceptual understanding of gas behavior through the use of screencasts and simulations

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Brianna L. Martinez ◽  
Ryan D. Sweeder ◽  
Jessica R. VandenPlas ◽  
Deborah G. Herrington
Keyword(s):  
Learning Gains ◽  
Particle Behavior ◽  
Formal Instruction ◽  
Diverse Backgrounds ◽  
Usage Patterns ◽  
Post Test ◽  
Particle Level ◽  
Support Students ◽  
Post Assessment

Abstract Background Engagement with particle-level simulations can help students visualize the motion and interactions of gas particles, thus helping them develop a more scientifically accurate mental model. Such engagement outside of class prior to formal instruction can help meet the needs of students from diverse backgrounds and provide instructors with a common experience upon which to build with further instruction. Yet, even with well-designed scaffolds, students may not attend to the most salient aspects of the simulation. In this case, a screencast where an instructor provides narrated use of the simulation and points students towards the important observations may provide additional benefits. This study, which is part of the larger ChemSims project, investigates the use of simulations and screencasts to support students’ developing understanding of gas properties by examining student learning gains. Results This study indicates that both students manipulating the simulation on their own and those observing a screencast exhibited significant learning gains from pre- to post-assessment. However, students who observed the screencast were more than twice as likely to transition from a macroscopic explanation to a particle-level explanation of gas behavior in answering matched pre- and post-test questions. Eye-tracking studies indicated very similar viewing and usage patterns for both groups of students overall, including when using the simulation to answer follow-up questions. Conclusion Significant learning gains by both groups across all learning objectives indicate that either scaffolded screencast or simulation assignments can be used to support student understanding of gas particle behavior and serve as a first experience upon which to build subsequent instruction. There is some indication that the initial use of the screencast may better help students build correct mental models of gas particle behavior. Further, for this simulation, watching the instructor manipulate the simulation in the screencast allowed students to subsequently use the simulation on their own at a level comparable to those students who had manipulated the simulation on their own throughout the assignment, suggesting that the screencast students were not disadvantaged by not initially manipulating the simulation on their own.

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