Effects of online genetics education on physician assistant interviewing skills

Objectives: This study was designed to evaluate the impact of an Internet-based educational program on clinically relevant communication behaviors. Methods: A randomized trial enrolled 50 physician assistants (PAs); 40 PAs completed the trial (18 in the intervention group and 22 in the control group). Participants conducted simulated visits that were coded for completeness of family history, referral for genetic services, and overall interviewing style using the Roter Interaction Analysis System (RIAS). R esults: Compared with PAs in the control group, PAs who took the Web course elicited more complete family histories (7.2 vs 5.0 of a 13-member pedigree; t = 2.3, P <.05) and more detailed cancer histories (3.2 vs 2.3 of five affected family members; t = 2.7, P <.001) but did not make more genetics referrals. Overall, intervention-group PAs used a less patient-centered interviewing style than controls (1.9 vs 3.2; t = 2.8, P <.01). C onclusions: More comprehensive assessment of family history was associated with lower patient-centeredness, suggesting a need for caution with regard to unintended consequences of targeted communication interventions on interviewing style.