Case‐Based Discussion Improves Medical Student Application of Pharmacogenetics Knowledge
Authors: Benjamin Michele , Athauda Gagani , Tempest Helen , Petroianu Georg , Weiler Tracey 
Published: June 2021

With the advent of precision medicine, practitioners now consider patient genotypes when selecting pharmacotherapy and dosing for drugs that exhibit significant genotype‐specific morbidity. It is therefore prudent to incorporate pharmacogenetics training into undergraduate medical education. To improve student understanding of pharmacogenetics, we exposed 1st year medical students to pharmacogenetics through case‐based discussions (CBD) within a pharmacology course.

The pharmacogenetics module included a short, prerecorded lecture on warfarin pharmacogenetics. During the CBD, 3 patient cases with varying indications for warfarin therapy were presented. Students in small groups discussed and answered questions relating to warfarin sensitivity, bleeding/clotting risk, warfarin dose optimization, and patient counseling. At the end of the CBD, answers were elicited using voting cards and students explained their reasoning in a large group setting. Anonymous pre‐ and post‐CBD surveys were administered to determine student satisfaction and understanding of pharmacogenetics concepts. Pre‐CBD survey results indicated that 80% of students watched the prerecorded lecture and only 20% of students agreed that they had not considered the role of genotype in drug metabolism and response prior to watching the lecture. After the CBD, 90% of students agreed that the CBD increased their awareness of how different genotypes can affect drug metabolism and response; 92% of students agreed that the CBD improved their understanding that drug response is a result of both the drug acting on its target and drug metabolism/excretion; 98% of the students agreed that the CBD effectively applied pharmacogenetics to clinical presentations; 93% agreed this session increased their confidence to anticipate and discuss the use of pharmacogenetics in clinical practice. In an open response question regarding patient factors affecting warfarin dose, 86% of students identified genotype as a major factor on the pre‐session survey vs. 76% in the post‐session survey. In comparison to the pre‐session survey, post‐session responses identifying patient demographics, BMI, medication, diet, and alcohol use as important factors in warfarin dosing increased by at least 10% and up to 50%.

The clinical relevance and interactive nature of the exercise resulted in excellent student engagement. Informal polling of CBD group voting revealed that most groups answered correctly and a satisfaction survey revealed that the activity was well‐received. The pharmacogenetics exercise provided students with a foundation for understanding modifiable and non‐modifiable patient factors that affect warfarin dosing. The session's effectiveness at improving students' knowledge in pharmacogenetics was further validated by students' high performance (mean = 81%) on pharmacogenetics exam questions. We believe student comprehension was facilitated by student application of knowledge from the pre‐session recording to disparate cases of warfarin therapy.

Support or Funding Information

This study was not grant funded.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.