Competencies & Outcome Objectives
Carolyn Jones, M.D., Ph.D.
Jack Lee, M.D., PhD
Alan Frankfater, PhD
Kelly Moyer, M.S.
Monica Barth, M.S.
Bhuma Krishnamijara, M.S.
Competencies and Outcome Objectives:
The course will provide study of common genetic disorders individuals from infancy through adulthood. Students will broaden their understanding of medical genetics , begin to incorporate that understanding into their practice of medicine. At the completion of their 4 year undergraduate medical education, medical students should demonstrate abilities expected for a fourth year student for specific outcomes in six competencies in the practice of primary care specialties.
Competency 1: Medical Knowledge
Twelve genetic disorders to be covered throughout the 4 year curriculum. The disorders were selected based upon the criteria we had determined in the “Integrated Medical Genetics Curriculum Topic Categories” in the past”. These disorders are common; represent a variety of different inheritance patterns (autosomal dominant, autosomal recessive, X-linked, multifactorial, cytogenetic, and acquired cytogenetic abnormalities). The genetic disorders are:
- Breast/Colon cancer
- Chronic Myelogenous leukemia
- Cystic Fibrosis
- Down syndrome
- Fragile X syndrome
- Gaucher's disease
- Huntingtons chorea
- Prader-Willi/Angelman syndrome
- Turner/Klinefelter syndrome
These 12 genetic disorders will be taught throughout the curriculum in both the first 2 years as well as the clinical rotations. These disorders will be taught through Cell Molecular Biology and Genetics, Patient cared Medicine I, II and III, Neurososcience and Mechanisms of Human Disease. During the third year rotation these concepts will be further taught during Pediatrics, Obstetrics and Gynecology, Surgery and Internal Medicine.
Competency 2: Communication and Interpersonal Skills
By the end of the undergraduate medical education students will be able to:
- Elicit, record, and present focused history and physical examinations for common genetic disorders.
- Communicate risk assessment and facilitate decision making in a nondirective manner.
- Elicit informed consent including cost, legal, social and health issues.
- Explain the findings of clinical exams and lab results and the risks, benefits and alternatives for possible therapies to patients, families, physician and non-physician healthcare workers.
- Instruct patients and their families to modify appropriate health care maintenance specific for the particular genetic disorder.
- Demonstrate awareness when communicating with patients and families of how age culture, religion and personal beliefs and educational level can influence provider-patient interactions and perception of risk.
Competency 3: Professionalism, Moral Reasoning, and Ethics
At the end of the Medical school undergraduate education:
- Display behaviors that foster and reward the patients trust in the physician such as appropriate dress, grooming, punctuality, honesty, courtesy, and respect for patient confidentiality.
- Converse appropriately and behave with personal integrity in all elective activities and in interactions with peers, faculty, residents and non-physicians staff involved in the care and treatment of Clinical Genetic patients.
- Work collaboratively as a member of a healthcare team including nurses, genetics counselors and laboratory personnel in providing comprehensive clinical genetic care.
- Demonstrate a commitment to collect appropriate screening histories, participate in neonatal screening programs, provide initial counseling and utilize resources for genetic counseling.
- Advocate the interests of patients over self-interests while developing an appropriate balance between personal and professional beliefs and obligations.
- Safeguard privacy and confidentiality of genetic information to the extent possible.
Competency 4: Patient Care
At the end of the undergraduate medical educaton students will be able to:
- Effectively observe, communicate, and interact with patients, families, and other healthcare workers to obtain histories, deal with difficult situations, and insure proper record keeping.
- Perform, record, present, and interpret appropriately focused physical exams pertinent to Pediatric Clinical Genetics.
- Integrate data obtained from the history, physical exam, and laboratory to construct a differential diagnosis for possible syndromes .
- Provide primary care and participate as a team member in a medical and educational planning for patients with genetic disorders.
- Perform appropriate oriented physical examination on proband and family with emphasis on identifying major and minor dysmorphic features which may be signs of underlying genetic syndromes.
- Participate in the process of genetic counseling.
- Collect and document history with emphasis on family history for genetic issues.
- Identify risks when present.
- Participate in informing families of “bad news” with regards to a pregnancy or child.
- Obtain support information for the family.
- Review the counseling experience with an experienced genetics counselor.
- Recognize and accept varying cultural, social, and religious attitudes.
- When appropriate, encourage patients to participate in medical research with informed consent.
Competency 5: Problem Solving and Lifelong Learning
Students completing the 4 year undergraduate education:
- Identify and use resources to obtain up-to-date information dealing with genetic disorders and specific anticipatory guidance.
- Use information technology to access and manage clinical information and perform online searches about their patients and acquire knowledge of specific topics including testing.
- Search, evaluate, and present a critical review of scientific information in the medical literature on major topic relevant to a case or an area of knowledge and practice in which they are uncertain.
- Demonstrate a willingness to update genetic knowledge at a frequent interval.
Competency 6: Social and Community Context of Healthcare
At the end of this curriculum, the student will be able to:
- Describe the impact of economic and health insurance issues on patient care with regards to testing for symptomatic and presymptomatic genetic disorders.
- Interact with Social services and the home care team to facilitate access to nursing care and home care services for patients with chronic genetic disorders.
- Participate in professional and public education concerning genetic topics
- Support patient focused policy with regards to medical genetics.