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Preparing healthcare providers to use polygenic risk scores: a qualitative study of learning needs and educational preferences

Por: Clark · A. · Wallingford · C. K. · Berkman · J. · McInerney-Leo · A. · Nisselle · A. · Terrill · B. · Palpant · N. · Young · M.-A. · James · P. A. · Yanes · T.
Objectives

Polygenic risk scores are increasingly available to consumers to provide an estimate of the genetic contribution to health conditions. However, healthcare providers report limited knowledge and confidence using polygenic risk scores. Clinical implementation necessitates educational programmes to support clinicians to integrate this new test into practice. This study aimed to identify healthcare providers’ learning needs and preferences for polygenic risk education to inform the design of tailored education initiatives.

Design, setting and participants

This pragmatic qualitative study used focus groups to capture healthcare providers’ perspectives. To ensure informed responses, genetic healthcare providers with prior experience using polygenic risk scores, and/or who had completed polygenic risk education were recruited to participate in focus groups or interviews (n=30). There were no exclusions based on country of practice. Recordings were transcribed and content analysis conducted to identify learning needs. Themes related to education engagement were mapped to the capability, opportunity and motivation model for behaviour change.

Results

Among this cohort of experienced providers, residual gaps existed in polygenic risk-related knowledge, skills and local guidelines to inform practice. Learning needs encompassed: (i) polygenic risk-specific knowledge, and (ii) communication skills needed to discuss results and facilitate risk management. Themes related to engaging with polygenic risk education mapped to capability included awareness of, and access to educational resources and initiatives, including practice resources and position statements from professional bodies. Time-poorness was a primary barrier to accessing education. Opportunities comprised of building on existing workplace training and activities such as multidisciplinary team meetings and journal clubs. All participants noted that motivation for completing polygenic risk training was primarily driven by a desire to improve patient-centred care and clinical outcomes.

Conclusion

This study highlights priority learning areas to inform the development of tailored polygenic risk education initiatives, and resources and delivery strategies that meet the identified needs. Participants’ expert insights reveal potential barriers as well as solutions to engaging healthcare providers with polygenic risk score education to ultimately facilitate implementation into clinical practice.

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