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Pharmacogenomics primer course for first professional year pharmacy students Background: The importance of pharmacogenomics (PGx) is widely recognized in healthcare; however, PGx knowledge and confidence is lacking among many healthcare professionals. Pharmacists are the most logical PGx experts, yet most pharmacy schools do not require the basic science foundations of PGx as admission prerequisites. Methods: A PGx primer course was developed for first year pharmacy students. In addition to genomics-based didactic material, this course also contains ‘journaling’ exercises and a group term paper based on a self-genotyping/phenotype exercise. The effectiveness of this course was evaluated by anonymous genomics knowledge surveys, course evaluations and unsolicited student comments. Results: Data demonstrate this course engendered a significant increase in genomics knowledge and a positive perspective towards PGx. Conclusion: A course such as this bridges the current PGx basic science knowledge gap and can serve as a template for providing fundamental genomics knowledge until admissions prerequisites ensure that all incoming students are ready to embrace PGx. Original submitted 15 July 2013; Revision submitted 26 September 2013 KEYWORDS: curriculum n education n first year n genomics n guidelines n pharmacogenomics n pharmacy n term paper

Tracey J Nickola1,2 & Amanda M Munson*1,2 Department of Pharmacogenomics, Bernard J Dunn School of Pharmacy, Shenandoah University, Ashburn, VA 20147, USA 2 Department of Pharmacology & Physiology, Pharmacogenomics Program, The George Washington University, Ross Hall Suite 640, 300 Eye Street NW, Washington, DC 20037, USA *Author for correspondence: Tel.: +1 703 726 4218 Fax: +1 703 726 3558 [email protected] 1

Personalized medicine is the future of healthcare and often is synonymous with pharmacogenomics (PGx). While a patient-specific treatment regimen is not new in concept, in the postgenomic era this may include incorporating genomic information in the treatment decisionmaking process. Indeed, many new and even existing pharmaceuticals have a genetic/genomic basis [101–103]. However, many practicing healthcare professionals do not feel comfortable with the field of genomics/PGx and lack the confidence to incorporate this information into their practice [1–7]. Continuing education of current professionals will help address this deficiency, but the number and scope of such offerings is limited and the willingness of different health professionals to embrace genomics is variable [1,8,9,104]. Furthermore, to truly understand and apply PGx, practitioners need a solid basic science education in genomics before endeavoring to become up to date in PGx [10,105]. Recognizing this, in the last decade there have been proposals to incorporate the basic science foundations of genomics/PGx into healthcare curricula [9,11–17]. For example, the National Coalition for Health Professional Education in Genetics (NCHPEG) published the first version of its core competencies in 2001 and revised them in 2005 and 2007. These guidelines focus

heavily on increasing the knowledge, skills and attitudes of health professionals in or towards genetics [105]. Individual healthcare disciplines have also issued recommendations regarding inclusion of more genomics into healthcare education. For example, The American College of Physicians acknowledged that familiarity with genetic testing and counseling was important [106], the American Nurses Association developed genetic competencies for inclusion in nursing curricula [107], and the Accreditation Council for Pharmacy Education included PGx/genetics in their accreditation standards [108]. Taking this one step further, the American College of Clinical Pharmacy (ACCP) Educational Affairs Committee recommended the integration of basic science foundations, particularly molecular biology and biochemistry as it pertains to genetics, into pharmacy school curricula [10]. Although progress has been made on this front, deficiencies in PGx content in the healthcare curricula remain. A 2010 study of US and Canadian physicians (e.g., Doctor of Medicine, Doctor of Osteopathic Medicine) programs indicated that although 82% of programs incorporated PGx into their curricula, only 10% of the programs had more than 8 hours of PGx coursework [18]. This lack of genomic/PGx preparedness spans the majority of healthcare

10.2217/PGS.13.197 © 2014 Future Medicine Ltd

Pharmacogenomics (2014) 15(1), 39–48

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Research Article

Nickola & Munson

providers and students [2] such that physician assistants [16] genetic counselors [109] and nursing programs [4] also report that PGx is not adequately incorporated in their existing curricula. It is worth noting that a study conducted among pharmacy schools in 2010 revealed that 92% of pharmacy schools offered PGx in their curricula with 57% offering more than ten didactic hours [19]. Based on this and the pharmacists’ expertise in pharmacotherapy and pharmacology and accessibility to patients, pharmacists have been targeted to be the PGx experts [1,6,17,20,21]. Recognizing that pharmacists are the most logical PGx experts, we have taken a new approach toward increasing PGx knowledge, interest, and confidence among future pharmacists as follows: first, a partnership between The George Washington University School of Medicine and Health Sciences (GWU; Washington, DC, USA) and the Bernard J Dunn School of Pharmacy at Shenandoah University (SU; VA, USA) created an undergraduate baccalaureate degree program in PGx [22] that serves as a pipeline into SU’s pharmacy program. Second, as part of this partnership, SU has implemented a pharmacy school curriculum rich in genomics, with dedicated PGx offerings in all 4 years. Third, faculty members from these two institutions developed a genomics outreach program to generate interest in and demystify the field of genomics in the surrounding community [14,15,23]. This article describes the development and evaluation of a PGx primer course designed for first professional year (P1) pharmacy students. The first year was selected for several reasons. As recommended [10], a solid foundation in the basic sciences behind genomics (genetics, molecular biology and biochemistry) is critical for advanced discussions of genomic applications in basic and applied pharmaceutical sciences; however, our pharmacy school does not require the aforementioned coursework for admission into the program. In fact, for the 2013–2014 academic year less than 20% of US pharmacy schools required genetics, molecular biology or biochemistry as an admission prerequisite [110]. Additionally, the P1 year of our Doctor of Pharmacy (PharmD) program concomitantly serves as the fourth year for students in GWU’s PGx degree program [22,111] and this is the capstone course for the GWU students.

Course design „„ Participants The ‘Essentials of Pharmacogenomics’ course was implemented in 2007 for students in GWU’s 40

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PGx degree program and SU’s P1 PharmD students. Additionally, this course is offered as part of SU’s nontraditional PharmD program for practicing pharmacists holding a Bachelor of Science (BS) in Pharmacy degree who are working toward earning a PharmD. „„ Course content The initial 2007 course was designed with an eye towards the 2005 NCHPEG guidelines and PGx clinical applications. Based on instructor and student feedback from the first 3 years of this course, it became evident that students did not have an adequate basic science background to fully appreciate the information being presented (historically

Pharmacogenomics primer course for first professional year pharmacy students.

The importance of pharmacogenomics (PGx) is widely recognized in healthcare; however, PGx knowledge and confidence is lacking among many healthcare pr...
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