Introduction: Recent years have seen dramatic advances in the field of medical genetics and a corresponding growth in the development of genetic testing technologies. The National Human Genome Research Institute (NHGRI) and the National Coalition for Health Professional Education in Genetics (NCHPEG) have communicated a great need for physician education about the Ethical, Legal, and Social Implications of genetic testing and counseling. Physicians and health care providers are not sufficiently trained to make decisions about genetic tests, interpret the tests, or counsel patients about the results.

Methods: With funding from NHGRI (R25-HG02266) and NCI (5R44-CA086720), we created a curriculum of web-based modules for medical students on genetic testing and counseling. We strove to prepare future physicians for the common and complex genetic issues they will encounter. A novel curriculum plan incorporated the genetics core competency guidelines from NCHPEG, the American Society of Human Genetics (ASHG), and the Association of American Medical Colleges (AAMC) with input from faculty, medical genetics instructors and instructional design experts. Five “Case Studies” of an hour’s length incorporated “think ahead” and “test yourself” interactive features, graphics, and one to two minute videos of patients. Additional modules reviewed the basics of genetics, clinical genetics, and cancer genetics. The online modules included, hyperlinks to supplemental material, high quality graphics and complete references. Medical school faculty chose the modules best suited to enhance their specific curriculum needs. We also developed and pilot-tested the use of “virtual” simulated patient assessment conducted via Internet based chat both with and without video.

Results: The evaluation reviewed which topic areas were in most demand by medical school faculty, and the overall effectiveness of the modules. Modules with case studies and clear clinical applications were well received by students and faculty alike; whereas more research focused modules were determined to be less relevant to medical students. Effectiveness was assessed using pre/post tests of knowledge, and retrospective surveys of attitude, self-efficacy, and intended behavior. Data from 897 medical students from 8 schools showed a statistically significant effect on knowledge, attitude, intended behavior and self-efficacy related to genetic testing. Students and faculty expressed high levels of satisfaction with the content, relevance, and usability of the course modules. We also implemented the virtual standardized patient assessment protocol and found that students had the necessary hardware and software to complete text as well as audio/video chat sessions. Importantly, they expressed interest in this type of assessment and a desire to use it in future coursework.

Discussion: Web-based supplemental training can be successfully integrated into traditional medical school educational programs to enhance student learning in a specialized medical topic such as genetics. Assessments can be built into the learning experience and performed automatically without placing an additional burden on the institution. Web-based training affects a range of outcomes including knowledge, attitude, and behavior and yields high satisfaction. Future evaluations can include standardized patient assessments via text and audio/video chat and thus assess the impact of web-based training on interpersonal skills development.

Alcohol use disorders continue to be a growing problem in the United States. Fifty-three percent of Americans consume alcohol on a regular basis (SAMHSA, 2006). Approximately 6% of those users meet the criteria for alcohol abuse or dependence (SAMHSA, 2005); 3% of the U.S. population. Currently, alcohol use disorders are only covered superficially in many medical schools. Future physicians may lack the necessary knowledge and skills to effectively screen, assess, and intervene with patients with alcohol use disorders. The topic of alcohol dependence is a topic well-suited to teach medical students about the role of practicing physicians in substance abuse treatment, complicated multi-disciplinary treatment issues, complex biological and social basis of addictions, and how new treatments are developed and moved into practice. During Phase I of the grant, we are developing a curriculum plan for a suite of modules on these issues as they relate to alcohol abuse and dependence with input from a focus group of medical school professionals with experience in substance abuse education. The prototype module entitled "Overview of Alcohol Use Health Issues" was developed and is undergoing usability and pilot testing with medical students in their 2nd through 4th years of study. More in-depth pilot testing will assess the impact of the pilot module on the attitudes, self-efficacy, and intended behavior of medical students, as well as changes in knowledge and satisfaction with the module material.

1. Objectives:
   1. The presenters will discuss the development of a curriculum plan for an Internet based educational program designed to teach medical students about alcohol use disorders.
   2. The presenters will provide needs analysis data and conclusions as supported by an asynchronous focus group of medical school faculty with substance abuse expertise.
2. Content (Topics):
   1. Research hypotheses and aims (Obj 1)
   2. Research methods with asynchronous faculty focus group (Obj 2)
   3. Research results of asynchronous faculty focus group (Obj 2)
   4. Implementation of research results into final curriculum plan (Obj 2)
3. Teaching Strategies:
   We will employ both didactic and case based learning approaches to educate medical students about alcohol use disorders. The outcome measures will assess learning and will emphasize clinical experience.