Personal genome testing in medical education: student experiences with genotyping in the classroom

Abstract

BackgroundDirect-to-consumer (DTC) personal genotyping services are beginning to be adopted by educational institutions as pedagogical tools for learning about human genetics. However, there is little known about student reactions to such testing. This study investigated student experiences and attitudes towards DTC personal genome testing.MethodsIndividual interviews were conducted with students who chose to undergo personal genotyping in the context of an elective genetics course. Ten medical and graduate students were interviewed before genotyping occurred, and at 2 weeks and 6 months after receiving their genotype results. Qualitative analysis of interview transcripts assessed the expectations and experiences of students who underwent personal genotyping, how they interpreted and applied their results; how the testing affected the quality of their learning during the course, and what were their perceived needs for support.ResultsStudents stated that personal genotyping enhanced their engagement with the course content. Although students expressed skepticism over the clinical utility of some test results, they expressed significant enthusiasm immediately after receiving their personal genetic analysis, and were particularly interested in results such as drug response and carrier testing. However, few reported making behavioral changes or following up on specific results through a healthcare provider. Students did not report utilizing genetic counseling, despite feeling strongly that the 'general public' would need these services. In follow-up interviews, students exhibited poor recall on details of the consent and biobanking agreements, but expressed little regret over their decision to undergo genotyping. Students reported mining their raw genetic data, and conveyed a need for further consultation support in their exploration of genetic variants.ConclusionsPersonal genotyping may improve students' self-reported motivation and engagement with course material. However, consultative support that is different from traditional genetic counseling will be necessary to support students. Before incorporating personal genotyping into coursework, institutions should lead multi-disciplinary discussion to anticipate issues and incorporate teaching mechanisms that engage the ethical, legal, and social implications of personal genotyping, including addressing those found in this study, to go beyond what is offered by commercial providers.

Advancing Pharmacogenomics Education in the Core PharmD Curriculum through Student Personal Genomic Testing

“…This apparent contradiction between perceived need and lack of use of counseling services is consistent with other educational trials of PGT. 13,31 We believe the program's focus on ethics training (expert lecturer, active discussions, the 4-week PGT decision-making period, and genetics counselor availability) was important in supporting students regarding potential psychosocial issues. Other investigators further advocate for student access to a multidisciplinary approach to consultative services (not just genetic counselors).…”

Primary Care Physician Experiences with Integrated Pharmacogenomic Testing in a Community Health System

“…According to another study, physicians found utility in providing PGx testing to improve patient outcomes by individualizing treatment to guide medication decisions and to decrease time and cost for maximizing the benefits of needed medications [35]. Utilizing PGx testing in order to avoid side effects from medication and improve medication effectiveness have been proposed as benefits in other studies as well [5,17,20,[35][36][37].…”

“…In order for PGx testing methods to be most effective, stakeholders, such as physicians, will need to better understand the process themselves in order to provide recommendations of such testing to their patients [20,35]. Other studies conducted with medical, graduate and pharmacy students who underwent personal genomic testing, which included PGx-related data, also revealed that this testing provided insight into the patient experience and increased understanding of genetic concepts [37][38][39][40]. Another study of physician assistant students who were specifically offered CYP2D6 testing reported similar results and noted that further exposure to PGx testing during rotations influenced perceptions of clinical utility as well [41].…”

How do students react to analyzing their own genomes in a whole-genome sequencing course?: outcomes of a longitudinal cohort study

“…3,[9][10][11] Despite several institutions offering personal genomic testing within the educational setting, only one-Stanford-has published results regarding students' experiences in these courses. 12,13 They used direct-to-consumer genotyping. As costs decrease, WGS will increasingly become the standard technology for clinical genomics.…”