 So, the third concept is titled Entry-Level Training Modules. This is a PAR, and Renee Ryder, Program Director in Genomic Medicine, will give the concept presentation. Thank you very much. I'm really excited to be presenting this concept today, but first I'd like to acknowledge that this was a huge team effort, and I wanted to thank Lucia, Teri, Win, and Rob for all working on this with me. This concept really has two main purposes. The first one is to increase genomic knowledge in the workforce of our entry-level genomics workforce. And then secondary to that is that we want to enhance diversity within the field of genomics. So, first, when we're talking about this, I think it's important to really define what it is we mean when we're talking about the entry-level research workforce. And what we're talking about is positions that don't require bachelor's degrees, but they often require dedicated training and specific skills that they obtain in community, technical, or tribal colleges. Some examples of the positions that we're talking about are medical assistants, nursing assistants, research assistants, and laboratory assistants. And when we're talking about where they fit into the research workforce, these are the people who are, you know, a medical assistant that might be in a clinical research program who's taking a medical history for a patient, but is now in a genomics research program, and we really would like them to also take a family history. Or it's the laboratory assistant who's now in a genomics laboratory, and we really would like them to know the genomics terminology of things like somatic versus germline. So those are the types of positions that we're talking about. Now when we're talking about modules, we're not talking about recreating whole curriculums for these different types of positions. Instead, what we're talking about is standalone units of curriculum that will supplement existing training programs. So maybe that medical assistant training program is already existing at a community college, but they need to have some genomics information put into their program to help bolster it. There are many types of ways that people can actually make these modules, that they could make online coursework, or they could make lesson plans for in-person classes. They could have suggested readings or activities to enforce the lessons. We would encourage people applying for these grants to be completely creative in making education available for the students. And after these are made, they would be made freely available so that other institutions could also use them. And when we're talking about the modules, some example areas are we're looking at topics that could be from basic genomic concepts or genomic research testing strategies or methodologies, or maybe topics from ethical, legal, and social aspects of genomic research. When we're looking at putting this together, what we'd like to see is a collaboration between lead sites and partner institutions. So the lead site would be the grant institution. They would be the ones with the content expertise in genetics and genomics. They would have a demonstrated capacity for relationships with their identified partner institutions. And they'd be the ones who actually develop the educational modules to be implemented at the partner institutions. They would then provide training on the modules and support the implementation at their partner institutions. We're looking at having three to five lead sites be granted. Then the next component to this is those partner institutions. By the partner institutions, we're talking about the community colleges, the technical colleges, the tribal colleges, who are actually the ones that already have those training programs. They're the ones who are training the entry-level research workers and staff at the partner institutions are going to work with the lead institutions to get training on those modules. And then they're going to be the ones who actually provide the genomics education to the students. Next, when we look at that second purpose for this concept, is to enhance diversity within the field of genomics. And we really want to do that on two different levels. First, we know that the entry-level workforce is much more diverse when compared to graduate postdoctoral senior research positions. And what we would like to do is there is money set aside in our budget to enhance diversity at the entry level. So it's $100,000 that we would expect each lead site could use to support tuition and education of the students at the partner institutions. And we would expect that this would reduce barriers to entry and increase enrollment in those programs that are actually educating on genomics. And then second to that, we also think that this is going to enhance diversity throughout the workforce. We know that some of these people who are medical assistance researchers shown that they often do switch careers, that they go back, get more education, and switch careers. Many of them become nursing. If we can provide exposure and training in genomics, we might be able to funnel some of those to learning and switching careers into the genomic field. So we can attract a more diverse workforce in genomics, not just at the entry level, but at all levels of the workforce. Now, funding. We're looking at the first two years of being a three-year award with the first two years having a little bit more money than the third year. And that's because in the first two years, that's the creation and implementation of the modules. So it's going to be a little bit more resource intensive. Year three, it's a little bit lower budget, but that's because that's the year that they're going to evaluate and refine the modules. We expect each award to have a total of about $600,000 if we grant three awards. That would be about 1.8 million total costs over three years. I did want to point out the fact that we have included an 8% indirect. That's because of the mechanism that we're using. The R25 does have the 8% cap on indirects. The funding will be provided to the lead sites, which they can then use subcontracts to support implementation at the partner institutions. We have already been talking to NSF, and they are very interested in collaborating on this idea. And then we would also like to talk to you some ICs for cosponsoring. I'm now going to open up the floor for discussion. We have two discussants today, Dr. Brothers and Dr. Cox. Dr. Brothers, would you like to start the conversation? Sure, thank you very much. When I first heard about this idea, I was skeptical, I admit. I didn't think about this audience as a group of folks who might be interested in genomics training and who could help in HGRI achieve its mission. But as I thought more about it, I thought about the medical assistants that I work with. I'm a primary care pediatrician, so I thought about the folks that we work with who ask me what I do and I tell them, but they don't know anything about that. And then also in the clinical research group that I work with, many folks with this type of background who are doing that types of clinical research often not touching on genomics, but really could build that experience and really help us in the genomic medicine research domain. So I think this is, I'm really convinced that this is a useful thing to do, a really helpful thing to do. Also, I really like the framing of looking to this group of students as tomorrow's more advanced genomics workforce. You know, folks coming from underserved backgrounds often pursue these sort of associate level training programs because they don't have enough resources to go for a bachelor's right off the bat, but there's a lot of skill, a lot of potential in those students. And so I think creating opportunities to kind of interest these folks in genomics really creates an opportunity to build a more diverse workforce throughout genomics all the way up to the doctorate level. So yeah, I'm a big supporter of this. Thank you. Thank you very much. Dr. Cox, do you have something you'd like to say? I'm also a big supporter. I thought this was a very creative way of addressing several of the recommendations that came out of the NHGRI strategic planning activities. And so I agree, I mean, it is novel. It's a really different way of thinking about it, but I think it hits a lot of buttons and not just in the spaces that I think you originally tried to hit, but I love the way it democratizes genetics within medicine in important ways and especially directly to the people who have the most contact with patients and who are gonna know and care the most about what's best for the patients, what the patients are really getting. So I see this as a really useful two-way street in getting feedback from people also who get these education materials over time, getting feedback from them on what's really worked with the patients in terms of further explaining things to people and so forth. I'm very excited about this initiative, but it did make me think that this is another one that would benefit from some thoughtful data collection so that we really do track as much as we can more people who might be then as they choose to go into nursing, subspecializing in some aspect of nursing that includes genetics and genomics maybe in the cancer space or whatever. I'd love to be able to see how the investment from NHGRI may accumulate benefits in the genomic spaces. And I know that's gonna be hard data to track, but I think it's really worth making an effort to think about how we might track some of this information. Thank you. Dr. Jarvik. Thanks, Renee. That was great presentation. I really appreciate it. I have a comment and then a question. My comment is I think those of us who have a role in admissions for medical school and graduate school recognize that those programs are more and more valuing people who have post-bachelors, research assistant or medical assistant training so that some of those people are planning actually to go on and they're in that role. And so that's a great place to expose people to genomics who may go on to do other things with their career. My question is if you could comment a little bit more on the dissemination of the materials that are developed beyond the partnering programs and then also what do you think the lifespan is? I think this is more basic information has a longer lifespan, but nonetheless, a lot of things I learned were changed over the years. And so if you could comment on those two things. Absolutely. So as far as dissemination beyond the original programs is first we do expect sharing between the lead sites. So the lead sites would share. So automatically it would just in the lifespan if this grant be what's developed for one set of lead site partner institutions would then go the other ones. Beyond that, we do want to make sure that they're freely available. And that we have not specified in exact manner that they make them freely available. Instead they would be that's part of the application that we would judge to make sure that they have a plan. And then I'm sorry, your second part. Lifespan of the material. The lifespan, I think that a lot of this is going to have a very long lifespan, especially when we're talking about things like terminology, how to gather a family history. I do expect that there will need to be updates because even in my lifespan, the way we draw a pedigree is changing when we talk about gender inclusivity. So those types of updates will need to happen, but I suspect that that's going to be a self motivating aspect of this program because if it's a genetic counseling program that is the one who actually makes these modules, they're going to have assistants who come into them to help them with their research. So they're going to have that self interest to updating the modules that they've made. So we expect there to need to be updates, but to be self motivated. Dr. Craven, oh sorry. So I noticed on your list of possible training topics that it didn't include genomic data analysis and I assume your list is not complete, but do you see that as within the scope of what someone might propose and do you think that there's part of the audience you're trying to target would be interested in genomic data analysis and have the right background? That's actually an interesting topic because it's one we have been discussing. That's not my area of expertise at all. So in my mind, you would need to have a bachelor's degree in order to really contribute to that, but I'm probably wrong about that. So that's a part where I don't know exactly how the entry level fits into genomic data analysis, but I would hope that someone who's applying for this, if they have partnerships with people who do genomic data analysis, that's an area that they would investigate. Do you want to add to that, Lucia? I'm not really a genomic data science expert either, but some of the examples that we were talking about in our small group were a laboratory technician who's working with sequencing data and that sequencing data goes as an input into something else or if they're working with a research project that involves biobank data, that's large scale and so there could be data science components to that too. So I do think it's relevant. I think we would see applicants propose that as part of their curricula. I could definitely see that. Okay, I've got Iftacar, Tim, and then Steve. Go ahead. I really love this concept, great idea, and I love the comments by Nancy. I think tracking would be really important. My question was, most of the budget would be development and dissemination of the material, but you mentioned tuition and I wasn't clear what that meant. Right, we've actually, when we were developing a sample budget, we actually allocated $100,000 per year to support tuition and education of the students. It would be at the lead site's discretion on how they thought to best use that. We would expect them to use it to enhance the diversity of the programs. When we were looking at the cost of tuition for a lot of these programs, they could, there are some certificate programs. They're as low as $1,000. They could completely support students, you know, 100 students at that or they could offset some, just some of the tuition for a more costly program. And one other thing about the activity code we chose, the R25, is it's one of the activity codes that we use in the training program for course development, curriculum development, and that activity code does include costs for evaluation, it includes costs for tuition and education, and so like a lot of these things are built into the way that these RFAs are actually written. Renee wanted to focus at a pretty high level in terms of the concept, but we do have the ability to write very clearly what we expect applicants to do with respect to those costs. So there could be a certificate that the person could obtain, and the tuition would be paid as part of the budget? Is that what you were saying? Yes, absolutely. A lot, we would expect that, you know, if it's a medical assistant program that already grants a certificate, that's the certificate that they're working for, we're not adding a new certificate. So there are existing certificates that they would be going for and they could get tuition offset so that that could help them get that certificate, yes. Tim, go ahead. Yeah, I love this, I'm highly supportive. You mentioned that all the funding would go to the Lead Institute and then get disseminated out through subcontract, is that the only way to do that or are there other potential mechanisms of distributing the funds that you considered? I'm new, so that's the only one I know about. So I think the unit here is talking about the development of the curriculum and I think it's an interesting concept to figure out who would be sort of responsible for developing that curriculum. I think as we sort of initiated this idea, that idea would be at least start with the people who could develop the content to sort of build on what they've already done but I think what's new here is really the partnerships with the tribal colleges, community colleges, institutions which traditionally haven't gone NIH funding and so if we could make sure that the institutes that developed the curriculum did have good partnerships, that's how we sort of viewed the contribution. Are there other ways that you would think about structuring it? No, I mean I guess what I'm worried about is the partner institutions feeling that they're playing a second fiddle kind of role in that sort of reinforcing some sort of power structures that you don't really want to reinforce but I don't know if there's an alternative mechanism that actually is possible, that's why I'm asking. Right, and that's why I think as part of when we write it, we really want to encourage them to make it a partnership from the very beginning. So when they're looking at creating curriculum, it's not we want a lead institution to create curriculum and then give it to people. We want them actually to do a needs analysis to figure out what it is that the partner institutions need and to fit those needs. So we really want to encourage it to be a true partnership and I think Rob has. Well, we did, when we talked to NSF, we actually, there was a representative from the community colleges and the challenge with them is they don't have the infrastructure to get the grants and support the grants. Now we know there's an expense there and so that's one of the things that they said that would be very difficult for them to do. And so that was really our rationale for that and they thought it was actually very, I mean, we respected that impression that we could give but they weren't to the point that they could actually accept a grant directly. So it was a low cost way of getting it to them. Thank you. Steve. Yeah, I'm very supportive of this. It would be nice to somehow fold what is being produced by this initiative and with the existing healthcare provider, genomics education resources page at NHGRI, which is a lot of great information and maybe even having a welcome for every module by Eric Green, that he can then put on his Twitter feed to get that distributed so it gets even greater audience. But I do think that it's something that is really focused on an important area and a population that is really critical for developing this type of support infrastructure. Well, and thank you. Now, when we ask Dr. Green to do stuff for us, we can say, but counsel set. Yeah, excuse me. You got 10,000 followers on Twitter. I wanted that button Rudy where we could cut the mic off. Steve, by folding in, you mean that we should use that vehicle to get anything that's developed out, which would be easy to do. Yeah, agree. Hal Dietz. Okay, I too am very excited about this program. I think it's likely to be very impactful during the years that the materials are being created and actively disseminated, but getting back to Gail's question about the lifespan of these materials, I would worry that even if they are disseminated, that someone's engagement with the materials would become more casual over time. The materials would lose their timeliness. They become obsolete in some way, and it would dilute the impact of the program over time. So I'm wondering, is there thought about making this a permanent online learning vehicle that would need to be updated and that there would be some assurance that a participant views the entire program, for example, and exhibits their competency by some online test, and then gets appropriate recognition, like a certificate that could add to their motivation in completing the program and career development after completing the program. I would just hate to see the impact window over time. That is a concern that we have talked about in our team, and that's also the idea of creating a certificate program is another idea that we talked about in our team. But what we really realized is that by focusing on such a broad, diverse set of entry-level positions, it would be hard to create a single certificate program because the needs in a laboratory might be different than the needs of a medical assistant. So we really wanted to make these modules kind of a pick and choose, so that if a specific MA program thought that for their students, modules one, three, and five were important, but for the laboratory assistant program, they really thought modules four and five were important, that they could put what was appropriate for their students. And that's something that we really valued and wanted to stick with, which is why we really can't create an independent certificate program. So we are definitely thinking about the concerns you brought up and we're trying to balance that with other needs. I think Wynn wanted to add one more thing to that. One of the other reasons why we wanted to target this population is because there's gonna be a projected increase in terms of the occupational workforce. So there's a projected 16% increase just for medical assistance alone. And so these programs are very competitive. There are over 1200, just again, just speaking in the medical assistant workforce. And so if you put out into the space that, well, these programs have genomic modules and they're gonna make your graduates more competitive for the jobs that are out there, you can imagine that the competitive nature of these programs is going to increase the interest in this and also foster more interest in creating more information. Say, well, we have the most up to date. And so again, it's the same type of self-motivated self-interest, unfortunately, for these programs, but great for the students who would be interested in it. The idea, too, is that if we have, when a person hires a doctor, if their students are coming from a certain program without good information, they're not gonna keep getting hired. So I think that's part of the feedback cycle that we're looking at on this program. Howard? Thank you for that presentation. I, too, am very supportive of this program. I think there's a lot of opportunity here to really engage in a segment of the workforce that we have not before. My question is about whether this program is in vision only for students who are in a full-time training or is it compatible with somebody who is still holding down a job and continuing to do this kind of enrichment. I think that's gonna be very important to really have a broad access to this opportunity. I absolutely agree with you. I mean, I go to school at night, so I really agree with that point. So this, I think, can be incorporated into any program. There are a lot of programs out there that are meant to be done part-time. These modules can be put into those programs. They can also be put into the full-time programs. As a genetic counselor, I often had, we hired genetic counseling assistants who needed training. These are modules that, as a hiring person, I could put into my clinic and actually, you know, tell them, hey, can you please do the module on family history? So we really view this as being very flexible in where it could be implemented. Additional questions or comments? Okay, can I get a motion to approve the concept? Second, all in favor? Anyone opposed? Anyone wish to abstain? Great, thank you very much, Renee. Thank you.