Continuous medical education approaches for clinical genetics: a postal survey of general practitioners.

The Human Genome Project has begun reporting its findings and it is anticipated that genomic medicine will be incorporated into many aspects of medical practice, including primary care. Increasing numbers of patients are approaching their general practitioners (GPs) with concerns regarding their familial breast cancer risk. GPs readily identify a role for themselves in cancer genetics services, but admit to a lack of confidence in this area. They also lack the appropriate educational knowledge and skills to provide prenatal genetic advice. A traditional educational approach to improve GPs’ knowledge is through the distribution of clinical guidelines. It is still unclear which is the most useful approach for primary care based genetics. A recent scenario based study showed that guidelines can improve the appropriateness of referral but educational outreach visits do not make the referrals any more appropriate. However, outreach genetic facilitators can improve health care professionals’ knowledge and uptake of screening for haemoglobin disorders. Evidence from other specialities suggests the effectiveness of such outreach and liaison visits in improving GPs’ performance and appropriateness of referral. There is currently no research indicating British GPs’ preferences for continuing genetic medical education. This survey was designed to investigate GPs’ views on how appropriate training should be provided. Determining which GPs’ attributes are associated with which method of education may help postgraduate general practice tutors to tailor genetic continued medical education to the needs of particular groups of GPs.