The Molecular Medicine Investigation Unit: Linking Patient Care and Scientific Inquiry in Physician-Scientist Training.

BACKGROUND: Medical innovation depends on translation, the process of applying clinical insights to solve biological problems, and vice versa, yet existing training programs provide few opportunities for physician-scientists to integrate their clinical and research training. OBJECTIVE: We developed and determined the feasibility and acceptability of a rotation on the Molecular Medicine Investigation Unit (MMIU), a novel program that engages trainees in the deliberate linkage of patient care and scientific inquiry to cultivate their interest and skills in translation. METHODS: Between July 2017 and January 2019, fourth-year medical students and internal medicine residents were offered a 4-week elective rotation on the MMIU. Supervised by 2 part-time faculty, trainees evaluated patients with unusual and perplexing presentations with the goal of generating hypotheses and a research plan to elucidate the underlying mechanisms of disease. We tracked the development of research hypotheses and resulting projects and surveyed participants about their satisfaction with the program. RESULTS: Over 18 months, 21 trainees (11 medical students and 10 residents) participated in the program and evaluated a total of 70 patients. Trainees generated a mechanistic hypothesis in 45 (64%) cases, and this resulted in a patient-centered research project in 38 (54%) cases. Trainees unanimously agreed that the program gave them an opportunity to integrate their clinical and research training, and many expressed that it reinforced their interests in translational research. CONCLUSIONS: With modest funding support, it was feasible to deliver authentic experiences of translational inquiry for medical students and internal medical residents, and these experiences were valued by trainees.

Teaching a difficult topic using a problem-based concept resembling a computer game: development and evaluation of an e-learning application for medical molecular genetics.

BACKGROUND: Genetic testing rapidly penetrates into all medical specialties and medical students must acquire skills in this area. However, many of them consider it difficult. Furthermore, many find these topics less appealing and not connected to their future specialization in different fields of clinical medicine. Student-centred strategies such as problem-based learning, gamification and the use of real data can increase the appeal of a difficult topic such as genetic testing, a field at the crossroads of genetics, molecular biology and bioinformatics. METHODS: We designed an electronic teaching application which students registered in the undergraduate Medical Biology course can access online. A study was carried out to assess the influence of implementation of the new method. We performed pretest/posttest evaluation and analyzed the results using the sign test with median values. We also collected students' personal comments. RESULTS: The newly developed interactive application simulates the process of molecular genetic diagnostics of a hereditary disorder in a family. Thirteen tasks guide students through clinical and laboratory steps needed to reach the final diagnosis. Genetics and genomics are fields strongly dependent on electronic databases and computer-based data analysis tools. The tasks employ publicly available internet bioinformatic resources used routinely in medical genetics departments worldwide. Authenticity is assured by the use of modified and de-identified clinical and laboratory data from real families analyzed in our previous research projects. Each task contains links to databases and data processing tools needed to solve the task, and an answer box. If the entered answer is correct, the system allows the user to proceed to the next task. The solving of consecutive tasks arranged into a single narrative resembles a computer game, making the concept appealing. There was a statistically significant improvement of knowledge and skills after the practical class, and most comments on the application were positive. A demo version is available at https://medbio.lf2.cuni.cz/demo_m/ . Full version is available on request from the authors. CONCLUSIONS: Our concept proved to be appealing to the students and effective in teaching medical molecular genetics. It can be modified for training in the use of electronic information resources in other medical specialties.

CRISPR in Sub-Saharan Africa: Applications and Education.

Clustered regularly interspaced short palindromic repeats (CRISPR) technology has enabled genetic engineering feats previously considered impracticable, offering great hopes for solutions to problems facing society. We consider it timely to highlight how CRISPR can benefit public health, medicine, and agriculture in sub-Saharan Africa (SSA) and offer recommendations for successful implementation.

Máster en Oncología Molecular. Un conocimiento indispensable en la práctica clínica / Master in Molecular Oncology: An indispensable knowledge in clinical practice

La formación que reciben los especialistas vinculados con la enfermedad oncológica no aborda en profundidad el conocimiento de las bases moleculares del cáncer. Hoy no se concibe una práctica clínica de excelencia sin el conocimiento de las bases moleculares de la enfermedad. Consecuentemente, resulta necesaria una formación específica en oncología molecular que le aporte al especialista médico una herramienta óptima en el diagnóstico y tratamiento. El cáncer tiene unas bases genéticas y moleculares estudiadas en profundidad por los mejores laboratorios del mundo. El diagnóstico, pronóstico y tratamiento se basa cada vez más en los marcadores moleculares de cada paciente. De esta necesidad surgió el Máster en Oncología Molecular: Bases Moleculares del Cáncer que se presenta en este artículo, y que es considerado en muchos servicios de oncología de hospitales españoles y latinoamericanos una formación esencial para sus residentes y especialistas. Este máster se imparte íntegramente online, permitiendo al especialista médico compaginar la formación con su trabajo, siguiendo las clases desde su propio ordenador. Otras ventajas para el alumno son el establecimiento de redes profesionales con otros especialistas y la adquisición de nuevas capacidades para participar en proyectos de investigación y colaboraciones científicas

The training received by the MDs in oncology does not allow enough time to look into the molecular basis of cancer. Nowadays, a clinical practice of excellence cannot be conceived without knowledge of the molecular basis of the disease. Consequently, specific training in molecular oncology will provide the MD with an optimal tool in the diagnosis and treatment of cancer. The genetic and molecular basis of cancer have been studied in detail by the best laboratories in the world. The diagnosis, prognosis and treatment are increasingly based on the molecular markers of each patient. The Master in Molecular Oncology: Molecular Basis of Cancer has been created for this need, which is presented in the following article. This course is considered an essential training for oncology residents and fellows in most Spanish and Latin-American hospitals. The full program is online. This allows medical specialists to combine their training with their clinical practice, following the courses from their own computers. Other advantages for the students are: creation of professional networks with other specialists from all over the world and the acquisition of new skills to participate in research projects and scientific collaborations

The Molecular Pharmacology of G Protein Signaling Then and Now: A Tribute to Alfred G. Gilman.

The recent, unfortunate death of Alfred G. ("Al") Gilman, M.D., Ph.D., represents a sad signpost for an era spanning over 40 years in molecular pharmacology. Gilman's discoveries, influence, and persona were dominant forces in research and training in pharmacology. Here, we review the progression of ideas and knowledge that spawned early work by Gilman and collaborators (among them, one of the authors) and later efforts (including those of the other author) that have recently yielded a comprehensive and precise structural understanding of fundamental topics in pharmacology: the binding of ligands to G protein-coupled receptors (GPCRs) and the interaction of GPCRs with heterotrimeric G proteins and effector molecules. Those data provide new and important insights into the molecular basis that underlies affinity and efficacy, two of the most important features of drug action, which represent the latest chapter in the saga that Al Gilman's work helped launch.

Found in translation.

In the quest to move more basic research discoveries into the clinic, the medical community is building training programs to help researchers gain "translational" skills. Sarah Webb explores how PhDs are learning to speak the language of the clinic.

5-years later - have faculty integrated medical genetics into nurse practitioner curriculum?

Abstract Many genetic/genomic educational opportunities are available to assist nursing faculty in their knowledge and understanding of genetic/genomics. This study was conducted to assess advance practice nursing faculty members' current knowledge of medical genetics/genomics, their integration of genetics/genomics content into advance practice nursing curricula, any prior formal training/education in genetics/genomics, and their comfort level in teaching genetics/genomic content. A secondary aim was to conduct a comparative analysis of the 2010 data to a previous study conducted in 2005, to determine changes that have taken place during that time period. During a national nurse practitioner faculty conference, 85 nurse practitioner faculty voluntarily completed surveys. Approximately 70% of the 2010 faculty felt comfortable teaching basic genetic/genomic concepts compared to 50% in 2005. However, there continue to be education gaps in the genetic/genomic content taught to advance practice nursing students. If nurses are going to be a crucial member of the health-care team, they must achieve the requisite competencies to deliver the increasingly complex care patients require.

Clinical requests for molecular tests: the 3-step evidence check.

Laboratory tests performed by molecular methods are increasing in volume and complexity at an unprecedented rate. Molecular tests have a broad set of applications, and most recently have been advocated as the mechanism by which providers can further tailor treatments to the individual patient. As the momentum behind molecular testing continues to increase, pathology practices may find themselves unprepared for the new wave of molecular medicine. This special article has been developed in an effort to provide pathologists who have limited molecular training with a simple and quick algorithm for determining whether a requested molecular test is appropriate for a patient. Additional recommendations for a more intensive and proactive review and management of molecular requests also are included. The principles discussed can easily be applied to requests for any test, including those not using molecular methods, which would be sent to an outside reference laboratory. This special article was developed from a Webinar for the College of American Pathologists targeting education for pathologists about the transformation of pathology practice in the new molecular and digital age.