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Table of Contents
ORIGINAL ARTICLE
Year : 2023  |  Volume : 6  |  Issue : 1  |  Page : 12-17

Needs assessment to incorporate Saudi human genome project and personalized medicine into saudi undergraduate medical curriculum


Department of Community and Family Medicine, College of Medicine, Jouf University, Sakaka, Kingdom of Saudi Arabia; Medical Education Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Date of Submission18-Jan-2021
Date of Decision06-Apr-2022
Date of Acceptance18-Apr-2022
Date of Web Publication3-Jan-2023

Correspondence Address:
Marwa Ahmed El Naggar
King Abdulaziz Road, Skaka, Aljouf

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jnsm.jnsm_10_21

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  Abstract 


Introduction: The Saudi Human Genome Program (SHGP) is one of the groundbreaking national programs and the largest genome initiative in the Middle East. His Royal Highness has put the growth of the health-care sector at the top of government priorities to ensure and increase the welfare of the Saudi nation. There are a few studies about needs assessment to incorporate the Saudi Human Genome and personalized medicine in Saudi Arabia's medical curricula until now. Aim: This study aimed to assess the need to incorporate Saudi Human Genome theme and personalized medicine into the Saudi undergraduate medical curriculum. Methodology: A cross-sectional descriptive study was implemented and a simple random sample of 28 faculty members and medical educationists working inside KSA was taken. The study followed Kern's six-step approach to curriculum development designed by Kern et al. 2005, by the application of its first four steps: (i) problem identification and general needs assessment, (ii) targeted needs assessment, (iii) goals and objectives, (iv) educational strategies, (v) implementation, and (vi) evaluation and feedback. A self-administered questionnaire was designed on Google Forms and distributed electronically by E-mail and WhatsApp groups to assess faculty members' needs determine course objectives and teaching methods, and level, and determine the departments that will manage it, and students' assessment tools. Results: Twenty-eight medical educationists and faculty members from different specialties participated in the study. 26 (92.9%) and 16 (57.10%) of the study population stated that their undergraduate medical curriculum did not address the topics of the Saudi Human Genome and personalized medicine, respectively. Twenty-two (78.60%) agreed that there is a need to incorporate both topics in the curriculum. Twenty-four (85.70%) agreed that incorporating SHGP will familiarize students with the importance of genetic counseling in reducing and preventing hereditary and genetic diseases. Conclusion: There is a lack of incorporation of the Saudi Human Genome Project and personalized medicine into the Saudi medical curriculum, and there is a need to incorporate both topics into it to gauge its effectiveness and identify areas for its implementation improvement.

Keywords: Personalized medicine, undergraduate medical curriculum, Saudi Human Genome, six-step approach


How to cite this article:
El Naggar MA. Needs assessment to incorporate Saudi human genome project and personalized medicine into saudi undergraduate medical curriculum. J Nat Sci Med 2023;6:12-7

How to cite this URL:
El Naggar MA. Needs assessment to incorporate Saudi human genome project and personalized medicine into saudi undergraduate medical curriculum. J Nat Sci Med [serial online] 2023 [cited 2023 Jan 30];6:12-7. Available from: https://www.jnsmonline.org/text.asp?2023/6/1/12/366992




  Introduction Top


The Custodian of the Two Holy Mosques, His Royal Highness, has put the growth of the health-care sector at the top of government priorities to ensure and increase the welfare of the Saudi nation. The Saudi Human Genome Program (SHGP), launched at King Abdulaziz City for Science and Technology in Riyadh in 2014, is one of the groundbreaking national programs and the largest genome initiative in the Middle East that has entered the Kingdom to the 100K Genome Group, a club of 10 member states. SHGP is a groundbreaking Saudi Vision 2030 national transformation project.[1] The program objectives are to reduce the incidence of genetic diseases in the Kingdom, establish a genetic database, and document the first Saudi genetic map by sequencing the genome of the Saudi population. Consequently, the program will establish the foundation for personalized medicine and genomic sciences in the Kingdom of Saudi Arabia. This is the biggest initiative in the Middle East to uncover genetic diseases and will enable the Kingdom to claim its global lead in genetic science for diseases and personalized medicine.[1]

Personalized medicine is a medical concept that strives to give patients individually tailored preventative and treatment techniques.[2] The European Health Ministers defined personalized medicine as: a medical model using the characterization of individuals' phenotypes and genotypes (e.g., molecular profiling, medical imaging, lifestyle data) for tailoring the right therapeutic strategy for the right person at the right time, and/or to determine the predisposition to disease and/or to deliver timely and targeted prevention.[3]

SaudiMED framework is competence-based formwork that guides curriculum development and reform inside KSA and it reflects principles of professional practice in Saudi Arabia. Community-oriented practice emphasizes that Saudi students should have the ability to practice based on an understanding of the Saudi health-care system and epidemiology and to apply health promotion and advocacy roles for the benefit and well-being of individual patients, communities, and populations.[4] By incorporating both topics in Saudi undergraduate medical curriculum we hope to Increase Saudi medical students' awareness with the great project as part of vision 2030. Education on what implications should be taken from this genomic knowledge and the alignment of genomic education with basic genetic values currently learned in academic settings is a crucial field that must be tackled.[5] It is also clear that genomic education should be a focus for students, doctors, and health-care providers as it increases their understanding, trust, and capacity to better communicate important genome information clearly and accurately. Physicians are often the first health-care professional with whom patients want to discuss genetic test results; however, many practicing physicians who have not been trained in genomics in medical school do not feel prepared to use or interpret genetic test results.[5]

The research questioned if the medical undergraduate curriculum inside the KSA addresses the topics of the Saudi Human Genome and personalized medicine and if there is a need to incorporate both topics into it. The aim of the study is to assess the need to incorporate Saudi Human Genome theme and personalized medicine into the Saudi undergraduate medical curriculum from faculty members working in medical colleges in KSA prospective.


  Methods Top


Study design

This cross-sectional study includes a survey targeting faculty members and medical educationists working in different medical colleges in Saudi Arabia. The survey was designed and converted to an online survey using google forms after validation. It was distributed to the target population using Email and WhatsApp.

Data collection

The survey includes three main parts: personal data of faculty members, their knowledge about SHGP and personalized medicine and their familiarity with it, and faculty members and medical educationists' opinions about SHGP and personalized medicine course development.

Following Kern's six-step approach to curriculum development designed by Kern et al. 2005, the application of each step was made: (i) Problem identification and general needs assessment, (ii) targeted needs assessment, (iii) goals and objectives, (iv) educational strategies, (v) implementation and (vi) evaluation and feedback. The study identifies the problem: the lack of coverage of the two topics in the Saudi medical undergraduate curriculum. The targeted needs assessment of faculty members working in KSA regarding the need to incorporate the two topics into the curriculum. In the first step of kern et al. 2015, the author identifies the problem from a literature review: the lack of coverage of the SHGP and personalized medicine in the Saudi publications of curriculum development and implementation. The second step was to investigate the needs of faculty members and medical educationists working in KSA regarding the need to incorporate the two topics into the undergraduate Saudi medical curriculum. In the third step, the study population were questioned regarding the objectives of the course; in the fourth step, they select the methods of instruction to be used for teaching the two topics, the level and duration of the course; the last two steps were not investigated in the current study.[6] The main aim of the current study is to assess the need to incorporate awareness of the Saudi Human Genome Project and personalized medicine into the Saudi Undergraduate Medical Curriculum. The survey included closed-ended questions with answers (Yes) or (No) or (Maybe) and open-ended questionsThe main aim of the current study is to assess the need to incorporate awareness of the Saudi Human Genome Project and personalized medicine into the Saudi Undergraduate Medical Curriculum. The survey included closed-ended questions with answers (Yes) or (No) or (Maybe) and open-ended questions.

Participants

Medical educationists and faculty members working in Saudi Medical colleges are included in the survey. As a result, those who were not working in KSA were excluded.

In addition, all questionnaires that were not completed were disqualified. The information was gathered on an Excel file and displayed using frequencies and percentages.

Statistical analysis

The numerical data were entered and analyzed in Microsoft Excel using SPSS Statistics, version 25.0 (IBM Corporation, Armonk, NY, USA). Descriptive statistics (frequencies and percentages) were used to summarise the study and outcome variables.

Ethics approval and consent to participate

The study was approved by the Institutional Review Board (IRB), College of Medicine, Jouf University Ref. No. 1-4-42 IRB on 17/09/2020.


  Results Top


Twenty-eight medical educationists and faculty members participated in the study. 20 (71.50%) were female and 8 (28.50) were male. 14 (50.00%) were medical educationists, 4 (14.28%) were pediatricians, 8 (28.57%) were pharmacists, and 2 (7.14%) were biochemistries. 18 (64.283%) ranged their age from 35 to 45 years. Twelve (42.80%) were from Jouf University College of Medicine, 4 (14.28%) from Ibn Sina National College for Medical Studies, Jeddah, 4 (14.28%) from Taibah University College of Medicine, Al Madinah, 2 (7.14%) from King Saud University College of Medicine, Riyadh, 2 (7.14%) from College of Medicine at Prince Sattam bin Abdulaziz University, and 4 (14.28%) from Fakeeh College for medical sciences.

[Table 1] shows that 26 (92.90%) and 16 (57.10%) of the study population undergraduate medical curriculum did not address the topics of the Saudi Human Genome and personalized medicine, respectively. Twenty-two (78.60%) agreed that there is a need to incorporate the topics of the Saudi Human Genome Project and personalized medicine in the undergraduate medical curriculum. 100% agreed that incorporating SHGP will familiarize students with the project personalized medicine. Twenty-four (85.70%) agreed that incorporating SHGP will familiarize students with the importance of genetic counseling in reducing and preventing hereditary and genetic diseases.
Table 1: Medical educationists' and faculty members' knowledge about Saudi Human Genome and personalized medicine and their familiarity with them

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[Table 2] shows that from experts' opinions, the most suitable year to start teaching SHGP and personalized medicine is 7.10% in the 1st year, 21.40% in the 2nd year, 35.70% in the 3rd year, 21.40 in the 4th year, and 14.30% in the 5th year. The experts suggested the following the department/s to be responsible for teaching SHGP and personalized medicine medical genetics, legal, clinical-like oncology, pediatrics, internal medicine, family medicine, genetics, pharmacology, and biochemistry pathology. Experts agreed that SHG and personalized medicine should be compulsory courses (18, 64.3%), and 10 (35.7%) agreed to be implemented as elective courses. Regarding study population suggestions for the duration of the course, (39.25%) 11 faculty members suggested that it should be two weeks, (28.60%) 8 suggested three weeks, (14.30%) 4 suggested four weeks, (10.71%) 3 suggested more than one month, (7.1%) 2 suggested two months, and (7.10%) 2 suggested that duration should be based on the curriculum content and instructional methods. They suggested that SHG and personalized medicine should be integrated with other courses or modules, 22 (78.6%) as integrated and 6 (21.4%) as a separate course.
Table 2: Medical educationists' and faculty members' opinions and suggestions regarding implementing Saudi Human Genome and personalized medicine into their undergraduate curriculum

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[Table 3] shows medical educationists' and faculty members' opinions of the objectives of the Saudi Human Genome and personalized medicine course; numbers and percentages are shown.
Table 3: Medical educationists' and faculty members' opinions of the objectives of the Saudi Human Genome and personalized medicine course

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[Table 4] shows that medical educationists and faculty members suggested that interactive lectures (20, 71.40%), paned discussion with experts (18, 64.30%), and problem-based tutorials (16, 57.10%) are the most suitable instructional methods to incorporate the Saudi Human Genome and personalized medicine into the Saudi medical curriculum.
Table 4: Medical educationists' and faculty members' opinions of the most suitable instructional methods to incorporate the Saudi Human Genome and personalized medicine into the Saudi medical curriculum

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[Table 5] shows that the most suitable assessment methods to assess students in SHG and personalized medicine are from an experts' point of view; 21 (75%) agreed that multiple-choice question (MCQ) will be suitable for assessing students' knowledge, 16 (57.10%) for modified essay questions (MEQs), 14 (50.00%) for short essay examinations, 15 (53.37%) for case-based MCQs, and 19 (67.58%) suggested to be aligned with course intended learning outcomes and instructional methods.
Table 5: Medical educationists' and faculty members' opinions of the most suitable students' assessment methods to assess students' knowledge and skills about the Saudi Human Genome and personalized medicine

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  Discussion Top


Using six-step approach for curriculum development as its first step to do proper problem identification, by literature review, we found that there is a lack of Saudi medical students' awareness of the SHGP and personalized medicine in a study conducted in KSA in 2020, they found that 51.56% of had never heard of these terms.[2]

The second step is the needed assessment of targeted learners: faculty members and medical students at Saudi colleges of medicine stated that the undergraduate curriculum did not address and incorporate information on personalized medicine and SHGP, as shown in our study results. Our results are consistent with a study of Ahmed et al., 2020, they recommend more focus on this topic, and that it should be introduced into the health colleges' curricula.,[2] also Arafah et al. 2022 stated that "there is a need to introduce an up-to-date curriculum for pharmacy courses other pharmacogenomics-based health education programs in Saudi Arabia."[7]

Study results showed that most (22, 78.60%) of the study population agreed that there is a need to incorporate Saudi Human Genome Project and personalized medicine into the undergraduate Saudi Medical Curriculum. Twenty-two (78.57%) of the study population suggested suggestions to integrate both topics with other courses, and 6 (21.37) suggested it could be implemented as a separate course. Ten (35.70) faculty members suggested implementing the course in the third year. Regarding the department/s that will be responsible to organise and teach SHGP and personalized medicine courses, 22 (78.57%), 18 (64.25%), 14 (50.00%), and 10 (35.70%) agreed that pharmacology, family medicine, internal medicine, pediatrics, and medical genetics can manage the course.

Regarding the aim and the specific objectives of the course, experts agreed on the aim of the course to demonstrate the role of the Saudi Genome Program and personalized medicine in reducing and preventing hereditary and genetic diseases.

Many objectives were agreed upon these are the ones with the highest agreement percentage discuss the characteristics of personalized medicine and its implementation in various diseases such as lung cancer and renal, explain the ways in which genetic variants can contribute to human disease susceptibility, discuss the advantages of personalized medicine over conventional medicine, mention the different methods to reduce the incidence of genetic diseases in the Kingdom, and explain the basic principles of pharmacogenomics and genomics.

Regarding the educational strategies

The selection of educational strategies depends on whether the college adopted an innovative problem-based learning curriculum or traditional curriculum. Integrate genomics can be into genetics, pharmacology, or other medical courses.[5] Based on the study results, the course can be incorporated as one short block (2–3 weeks) that can cover the theme from a multidisciplinary perspective and all educational activities to be focused on SHGP theme and personalized medicine. The intergradation of different disciplines promotes integrative thinking in students.[8] Problems can address this topic and ask students to brainstorm about the project and its benefit and future impact on society, with objectives covering diagnostics and prevention genetic disease, premarital and genetic counseling, and personalized medicine.[1] Students-centered seminar and panel discussion with subject area experts from biochemistry, internal medicine, genetics, pediatrics, and pharmacology departments who are familiar and interested in the topic are another instructional method to be used.

The biochemistry department and the medical genetic specialists can organize a one-day workshop for all students from the 1st to the 5th year; an announcement to students should be done before the workshop. The workshop can be held face to face or online using a learning management system adopted by the college (blackboard). To measure the effectiveness of this workshop, The pre–post-test can be constructed to measure the effectiveness of the workshop [Table 4]. Test students' knowledge which represents the second level of Kirkpatrick's evaluation of educational interventions.[9] Google Forms or SurveyMonkey can be easy ways to deliver surveys to students. Link to the survey can be sent by batch E-mail, blackboard as an announcement, WhatsApp groups. Topics to be covered in the workshop are the foundation and importance of the project, its vision and mission, goal and objectives of the project, technologies, and infrastructures, and its achievement.

Study results show that 100% (28) of the study population agreed that they need a faculty development program that should be conducted before introducing courses or workshops to students, the need for teacher education, and curriculum development related to this emerging area of genomics also needs to be understood. Teachers may be uncomfortable or hesitant to enforce modern teaching methods after preparation and revised instruction.[6] Use backward design to fill in knowledge gaps of practicing physicians and faculty members and provide materials in easily accessible formats such as online modules or E-mailing options.[10],[11]

Implementation of the themes has several components: procurement of political support for the theme, our study results show that 85.70% (24) agreed that there is a need for support from higher administration to conduct the course. Based on the study results, the ideal time for the curriculum to be implemented in the 3rd year, as students in this year in most KSA medical colleges had acquired the prerequisite knowledge to build on its course objectives. Personnel is biochemistry, genetics, internal medicine, pediatrics, family medicine, and pharmacology departments who are familiar and interested in the topic. Implementation of developed course needs support from the dean, vice dean of the academic affairs, curriculum and study plan committee, and head of departments. Administration: Curriculum coordinators can coordinate interactive lectures, students centered seminars, discussions, workshops, and online webinars. Course coordinators can coordinate interactive lectures, student-centred seminars, discussions, workshops, and online webinars, update syllabus material, review evaluation results, and facilitate communication among faculty regarding course evaluation and feedback: Study results show that (78.57%) of 22 agreed that there is a need for students' feedback and formative evaluation to students and curriculum coordinator to help achieve objectives, the percentage of students aware with SHGP. Based on study results, MCQs and MEQs and SAEs and case-based MCQs can be used as tools for students' assessments in this course. An analysis of test results can reveal important clues about the strengths and weaknesses. Another source of information to be used in the evaluation process of the course after implantation is students' expectations of different aspects of the block or workshops (content, formats, learning resources, organization, test, study load, etc…).[12],[13],[14] Questionnaire to students and teachers involved in the implementation about its weak and strong points.[9]

The main aim of this study was to assess the needs of faculty members and medical educationists working in Saudi medical colleges to incorporate SHGP and personalized medicine into the curriculum of (KSA) medical colleges, with the main aim to increase awareness of both faculty and students with the project, familiarize students with the project and the term personalized medicine, genetic counseling, help students to dream big and align their personal vision with KSA vision 2030; encourage them to has the enthusiasm to be part of the project.


  Conclusion Top


There is a lack of incorporation of the Saudi Human Genome Project and personalized medicine into the Saudi medical curriculum, and there is a need to incorporate both topics into it, to gauge its effectiveness and identify areas for its implementation improvement.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Ahmed N, Alrawili A, Alkhawaja F. Knowledge and awareness on personalized medicine amongst health care specialists and university students in health colleges in Saudi Arabia. J Pharm Res Int 2020;32:177-83.  Back to cited text no. 2
    
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Whitley KV, Tueller JA, Weber KS. Genomics education in the era of personal genomics: Academic, professional, and public considerations. Int J Mol Sci 2020;21:768.  Back to cited text no. 5
    
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Kern DE, Thomas PE, Hughes MT, Chen BY. Curriculum Development for Medical Education: A Six-Step Approach. 2nd ed. Baltimore, MD: Johns Hopkins University Press; 2009.  Back to cited text no. 6
    
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Arafah A, Rehman MU, Syed W, Babelghaith SD, Alwhaibi A, Al Arifi MN. Knowledge, attitude and perception of pharmacy students towards pharmacogenomics and genetics: An Observational Study from King Saud University. Genes (Basel) 2022;13:269.  Back to cited text no. 7
    
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Gerhard GS, Jin Q, Paynton BV, Popoff SN. The Anatomy to Genomics (ATG) Start Genetics medical school initiative: Incorporating exome sequencing data from cadavers used for Anatomy instruction into the first year curriculum. BMC Med Genomics 2016;9:62.  Back to cited text no. 8
    
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Heydari MR, Taghva F, Amini M, Delavari S. Using Kirkpatrick's model to measure the effect of a new teaching and learning methods workshop for health care staff. BMC Res Notes 2019;12:388.  Back to cited text no. 9
    
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Rubanovich, C.K.; Cheung, C.; Mandel, J.; Bloss, C.S. Physician preparedness for big genomic data: A review of genomic medicine education initiatives in the United States. Hum. Mol. Genet. 2018, 27, R250–R258.  Back to cited text no. 10
    
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Aronson, S.J.; Rehm, H.L. Building the foundation for genomics in precision medicine. Nature 2015, 526, 336–342.  Back to cited text no. 11
    
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LaRue, K.M.; McKernan, M.P.; Bass, K.M.; Wray, C.G. Teaching the Genome Generation: Bringing Modern Human Genetics into the Classroom Through Teacher Professional Development. J. STEM Outreach 2008, 1, 48–60.  Back to cited text no. 12
    
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Snellen-Balendong H, Dolmans D. Block Construction. Maastricht University, Datawyse; 2005. p. 9-13.  Back to cited text no. 13
    
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Sweet LR, Palazzi DL. Application of Kern's Six-step approach to curriculum development by global health residents. Educ Health (Abingdon) 2015;28:138-41.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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