DOI: 10.1097/01.ccm.0000424826.29608.58
,
Issn Print: 0090-3493
Publication Date: 2012/12/01
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Abstract
Introduction:Incorporation of genomics into clinical practice places new demands on healthcare providers. Characteristics unique to the critical care environment, such as intensity, time sensitivity and team approaches to care, create challenges and opportunities for training and education as personalized medicine unfolds.
Hypothesis:Critical care providers will have limited knowledge of genomic medicine and its integration into critical care practice.
Methods:A sample of critical care intensivists, nurses, social workers and genetic counselors from two pediatric hospitals in Los Angeles County was recruited to participate in 11 focus groups. Focus group discussions elicited knowledge of clinical advances of personalized medicine, and their opinions about using genomic data to guide treatment decisions in the critical care setting. Thematic content analysis was supported using Atlas.ti analytical software examining the following thematic codes: knowledge of genetic testing and personalized medicine and concerns about genetic data collection.
Results:Themes emerging from the analysis included: concern that providers may not fully understand the results of genetic analysis and their implications for patients; the likelihood that a geneticist would not be available to assist in interpretation of
Results:concern that the rapid evolution of personalized medicine will outpace providers’ capacity to stay current with new information.
Conclusions:As the clinical application of genomics evolves, genetic testing will play an integral part in all aspects of medicine, including critical care. These findings suggest that medical education and training for new and, especially, practicing healthcare providers, is not adapting as quickly as these advances are emerging in practice. In the critical care environment, all providers communicating with patients and families may be called upon to provide information about the purpose, use and protection of genomic data collected to guide treatment. The multi-disciplinary nature of critical care practice present unique opportunities to design cross-disciplinary education and training approaches to prepare critical care teams. NICHD 5R03HD057407-02 NICHD 3R03HD057407-01A2S1
