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Furthermore, GC is not always available at times and places convenient for patients. There is little evidence that the in\u2010person model alone is always optimal and alternatives to in\u2010person GC have been studied in genetics and other areas of health care. This review summarizes the published evidence between 1994 and March 2014 for interactive e\u2010learning and decisional support e\u2010tools that could be used in pre\u2010test GC. A total of 21 papers from 15 heterogeneous studies of interactive e\u2010learning tools, with or without decision aids, were reviewed. Study populations, designs, and outcomes varied widely but most used an e\u2010tool as an adjunct to conventional GC. Knowledge acquisition and decisional comfort were achieved and the e\u2010tools were generally well\u2010accepted by users. In a time when health care budgets are constrained and availability of GC is limited, research is needed to determine the specific circumstances in which e\u2010tools might replace or supplement some of the functions of genetic counsellors.<\/jats:p>","DOI":"10.1111\/cge.12430","type":"journal-article","created":{"date-parts":[[2014,5,14]],"date-time":"2014-05-14T12:11:37Z","timestamp":1400069497000},"page":"209-217","source":"Crossref","is-referenced-by-count":40,"title":["Interactive e\u2010counselling for genetics pre\u2010test decisions: where are we now?"],"prefix":"10.1111","volume":"87","author":[{"given":"P.H.","family":"Birch","sequence":"first","affiliation":[{"name":"Department of Medical Genetics University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,7,21]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"NSW Health Centre for Genetics Education. 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