http://hdl.handle.net/2440/36312 Wed, 19 Jun 2013 16:51:17 GMT 2013-06-19T16:51:17Z http://hdl.handle.net/2440/77469 Title: Pharmacogenomics and personalized medicine: consumer perspectives, lessons learned in Australia and beyond Author: Anderson, Claire; Ward, Helena Mary; Corkindale, David; Ward, Michael B.; Sorich, Michael J.; McKinnon, Ross Allan Abstract: A decade after Francis Collins, then Director of the Human Genome Project, stated that: “Genetic prediction of individual risks of disease and responsiveness to drugs will reach the medical mainstream in the next decade or so” the uptake of therapeutic strategies informed by pharmacogenomic tests, often termed personalised medicine, has been limited. Several recent developments have been suggested as potential accelerating factors for the introduction of personalised medicine including the advent of commercially oriented pharmacogenomic testing and direct to consumer genetic testing. The advent of such testing has led to pharmacogenomic information becoming a commodity rather than simply medical information. Given this increasingly complex environment, the interpretation of pharmacogenomic testing has considerable implications for both health professionals and consumers. This paper asserts that both ‘push’ and ‘pull’ factors play a role for bringing pharmacogenomics tests to the clinic and public health practice. While scientists tended to concentrate on the ‘push’ factors, there has been relatively little discussion on the ‘pull’ factors such as consumer and enduser perspectives, let alone in developing countries and the Asia-Pacific region. This paper focuses on studies of consumer views concerning pharmacogenomics and discusses the implications of these views for health professionals including recent lessons learned in Australia and globally. Our review reflects a relative paucity of studies, a need for more widespread public consultation and education. It also highlights the need for a focus on educational strategies, possibly involving an increased role of pharmacists given their drug focus. Sat, 31 Dec 2011 13:30:00 GMT http://hdl.handle.net/2440/77469 2011-12-31T13:30:00Z http://hdl.handle.net/2440/77468 Title: Outcomes of longitudinal integrated clinical placements for students, clinicians and society Author: Walters, Lucie; Greenhill, Jennene; Richards, Janet; Ward, Helena Mary; Campbell, Narelle; Ash, Julie; Schuwirth, Lambert W. T. Abstract: CONTEXT Longitudinal integrated clerkships (LICs) have been widely implemented in both rural and urban contexts, as is now evident in the wealth of studies published internationally. This narrative literature review aims to summarise current evidence regarding the outcomes of LICs for student, clinician and community stakeholders. METHODS Recent literature was examined for original research articles pertaining to outcomes of LICs. RESULTS Students in LICs achieve academic results equivalent to and in some cases better than those of their counterparts who receive clinical education in block rotations. Students in LICs are reported to have well-developed patient-centred communication skills, demonstrate understanding of the psychosocial contributions to medicine, and report more preparedness in higher-order clinical and cognitive skills in comparison with students in traditional block rotations (TBRs). Students in LICs take on increased responsibility with patients and describe having more confidence in dealing with ethical dilemmas. Continuity of supervision reportedly facilitates incremental knowledge acquisition, and supervisors provide incrementally progressive feedback. Despite early disorientation regarding the organising of their learning, students feel well supported by the continuity of student–preceptor relationships and value the contributions made by these. Students in LICs living and working in rural areas are positively influenced towards primary care and rural career choices. DISCUSSION A sound body of knowledge in the field of LIC research suggests it is time to move beyond descriptive or exploratory research that is designed to justify this new educational approach by comparing academic results. As the attributes of LIC alumni are better understood, it is important to conduct explanatory research to develop a more complete understanding of these findings and a foundation for new theoretical frameworks that underpin educational change. CONCLUSIONS Longitudinal integrated clerkships are now recognised as representing credible and effective pedagogical alternatives to TBRs in medical education. Sat, 31 Dec 2011 13:30:00 GMT http://hdl.handle.net/2440/77468 2011-12-31T13:30:00Z http://hdl.handle.net/2440/77467 Title: Preparing interprofessional clinical learning sites: what the literature tells us Author: Gum, Lyn; Richards, Janet; Bradley, S. L.; Lindeman, Iris; Ward, Helena Mary; Bennett, Paul N. Abstract: PURPOSE: Infusing an interprofessional perspective into healthcare education in the university setting instils a collaborative approach in the provision of patient-centred care concepts for students. The purpose of this paper is to describe how one Australian health science faculty is modernising their healthcare education curriculum to develop this approach. METHOD: As part of the development process, a systematic literature review was undertaken to determine the elements required for the development of interprofessional clinical learning (IPCL) sites, including but not limited to, necessary organisational and professional considerations to effect interprofessional education (IPE). RESULTS: The results of this review identified four key factors for IPE development: 1) shared culture, 2) support and leadership, 3) strategic facilitation and planning, and 4) effective feedback, evaluation and dissemination of curriculum intent. DISCUSSION: These elements are discussed in association with curriculum change in this faculty to promote interprofessional collaboration and teaching. CONCLUSION: As a result of the review, the modernisation of our IPE curriculum is being underpinned by shared understandings between faculty and clinical site health providers about IPE. Our joint goal is for appropriate preparation and sustainability of IPCL sites. Sat, 31 Dec 2011 13:30:00 GMT http://hdl.handle.net/2440/77467 2011-12-31T13:30:00Z http://hdl.handle.net/2440/77437 Title: Reforming pharmaceutical education to enhance the global uptake of pharmacogenenomics and personalized medicine Author: Dias, Mafalda M.; Depala, Krupa; Ward, Helena Mary; Ward, Michael B.; Sorich, Michael J.; Anderson, Claire; McKinnon, Ross Allan Abstract: Personalized medicine has been defined as the tailoring of medical treatment based on individual patient characteristics. In practice, personalized medicine generally involves the stratifying of patient populations based on biomarkers, most frequently genetic in nature. This results in patient subpopulations likely to show differential responses to drug therapy in terms of efficacy and toxicity. While the potential for personalized medicine to positively impact on drug discovery and therapeutics has been widely hyped, clinical uptake has been markedly limited. Over the recent years, a number of potential barriers to the more widespread uptake of personalized medicine have been identified. These include technical, economic and social factors. One such barrier is the need for the significant up-skilling of health professionals in order to harness the potential of personalized medicine and ensure adequate information flow to consumers. Pharmacists are ideally positioned to be active participants in personalized medicine but to date, their role has been minimal. While the reasons are multifactorial, we argue that there is a clear need for significant reforming of current pharmacy curricula. Here we review progress in worldwide pharmaceutical education and practice relevant to global personalized medicine and public health pharmacogenomics and highlight salient points for future consideration. Sat, 31 Dec 2011 13:30:00 GMT http://hdl.handle.net/2440/77437 2011-12-31T13:30:00Z