Assessment of genetics knowledge and skills in medical students: insight for a clinical neurogenetics curriculum.

The pace of discovery in biochemistry and genetics and its effect on clinical medicine places new curricular challenges in medical school education. We sought to evaluate students' understanding of neurogenetics and its clinical applications to design a pilot curriculum into the clinical neurology clerkship. We utilized a needs assessment and a written examination to evaluate the genetics knowledge of 81 third- and fourth-year medical students. The needs assessment surveyed students' self-perceptions of their own understanding of basic and clinically related genetic principles and clinical skills, as well as the most effective educational methods. Medical students reported more competence with basic science learned during the preclinical years than clinical concepts, and they demonstrated relatively low knowledge levels in clinical neurogenetics concepts on the examination, with an average of 29% correct on questions pertaining to genetic counseling compared with 82% correct with regard to inheritance patterns. Common, cross-specialty clinical skills were attained (e.g. internet search, family histories), while at least half of students reported minimal understanding or awareness of key genetics websites (e.g. OMIM) and indications for support group recommendations and genetics referrals. Teaching these more specific genetics skills and concepts needs to be emphasized in the clinical curriculum.

Canadian guidelines for the management of adult growth hormone deficiency.

PURPOSE: To develop guidelines for the management of growth hormone (GH) deficiency in Canadian adults to facilitate rational use of GH in appropriate indications. METHODS: The guidelines were developed by group of endocrinologists and an endocrine specialist nurse with an interest in neuroendocrine disorders, representing all regions of Canada and practicing in a variety of settings. A steering committee with broad expertise undertook a systematic review of the evidence relating to adult GHD and GH replacement. This evidence was reviewed by the whole group, and guidelines were developed using a consensus approach. RESULTS: The document addresses the causes and clinical characteristics of GHD in adults and reviews the evidence in support of GH replacement in this group. The authors provide recommendations for the identification of adult GHD, and guidelines for GH replacement in appropriate patients. Also, access to GH therapy across Canada is reviewed.