Genomics FAQ for Advanced-Practice Nurses: Nurse Educators

Many curricula for nursing education in the U.S. are based on The Essentials: Core Competencies for Professional Nursing Education, published by the American Association of Colleges of Nursing (AACN). The 2021 update to the Essentials book highlights the importance of genomics in nursing:

• Nurses must apply foundational knowledge from other disciplines, including the natural sciences, which includes genomics (Essential 1.2). Nurses are expected to apply knowledge from a broad knowledge base to support clinical judgments (Essential 1.3).
   
• Genomics is an essential element of delivering personalized healthcare. Nurses must be able to communicate with patients in an effective manner by applying individualized information, which includes genomic health information (Essential 2.2i).
   
• Nurses must be able to recognize the key determinants of health that affect individual and population health; genomics is one of these key determinants of health (determinants of health definition) (AACN, 2021).

When designing learning assessments, nurse educators should consider the purpose of each item used in an assessment and be able to distinguish between knowledge and competency.  Knowledge generally refers to the knowledge required to perform a role, while competency is the ability to apply knowledge in practice. Genomic knowledge is defined as genomic literacy, which is required to achieve genomic competency. Assessing genomic literacy and competency requires different approaches.

Genomic literacy can be assessed using knowledge questions. Some instruments (e.g. the Genomic Nursing Concept Inventory [GNCI]) have been developed for this purpose, but educators often draw questions from test banks or develop their own questions.

Assessing genomic competency is more difficult, and fewer validated tests of genomic competency have been developed. Test questions framed on nursing actions are useful to measure competency and can be built into case studies. Educators can also measure competency by embedding genomics-informed care into simulations or exams.

Questions should be designed to distinguish learners who do and do not understand key information underlying essential genomic competencies for nurses and should have evidence of reliability and validity in distinguishing understanding of the concept being tested.

There are many free websites with resource repositories or email subscriptions to remain up to date on genomic advancements or find genomic education resources. Here is a description of just a few:

• GenomeEd: a repository of high-quality genomic resources for interprofessional members of the healthcare team and educators. This repository is supported by the National Human Genome Research Institute (NHGRI). The resources are vetted by an interprofessional panel and then reviewed every three years.
   
• International Society of Nurses in Genetics (ISONG) Repository: a collection of educational resources for nurses and healthcare providers that cover a range of genomic topics. The resources are systematically reviewed and updated every six months.
   
• National Human Genome Research Institute (NHGRI): option to subscribe to get updates on learning opportunities and new scientific discoveries.
   
• National Coordinating Center for the Regional Genetics Networks (NCC): an assortment of education modules, evidence-based practice guidelines and genetics policy information. There is an option to subscribe to free newsletter.
   

Courses on Genomics for Nurses:

• Genomic Competencies for Nurses from Theory to Application: a free, self-paced course for nurses pursuing or possessing a doctoral degree (PhD, DNP, or other) seeking to improve their literacy in genetics and genomics to benefit their research, clinical practice and teaching. No previous genetic or genomic training is required. Contact hours offered. Supported by NHGRI grant R25HG011228.
   
• Translation and Integration of Genomics is Essential to Doctoral NuRsing (TIGER): a free, train-the-trainer and collaborative mentorship program geared towards doctoral-prepared nurses aimed to improve the knowledge and skill of nurses in genomics. Contact hours offered. Supported by NHGRI grant R25HG011018.
   

For additional interactive online resources, see "In addition to the resources listed above, are there other interactive learning experiences that can help nursing students understand genomics?".

Interactive online resources can facilitate genomics-focused education for nursing students. Nurse educators can access a wide variety of resources to support students as they learn about genomics. They should use their judgment and expertise to determine which resources are most applicable for their students. Educational resources for genomics include:

Jackson Laboratories Education Clinical & Continuing Education in Genomics – Online modules about precision medicine implementation, cancer genetic clinical education (case-based modules), risk assessment screening toolkit (cancer specific), and precision oncology education.

Jackson Laboratories Education Online Minicourses – Minicourses on a variety of topics relevant to genomics.

Learn.Genetics – Interactive and video resources on topics including genetics, evolution, cell biology, human health, and others. Resources include virtual labs (i.e. animated videos depicting steps of an experiment), or instructions for how students can do some things at home (e.g., extract DNA). Resources may be more appropriate for high school/undergraduate students but can also be used to review or introduce basic principles to graduate students.

Global Genetics and Genomics Community (G3C) – A set of unfolding, interactive genomic case studies that allows participants to interview patients and make recommendations.

Centers for Disease Control and Prevention (CDC) Family history case studies

AACN Essentials Domains/Competencies for Professional Nursing Education and Advanced-level Nursing Education

Domain 1: Knowledge for Nursing Practice

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  The genomics nurse attains knowledge and competence that reflect current nursing practice (Std 13). 
   
• Example learning objective for nursing genomics competency: 
  Describe how the interaction of genetic and environmental factors influence health and disease across the lifespan. 
   
• Courses in which this content could apply: 
  Pathophysiology.

Domain 2: Person-Centered Care

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  Gathers historical data including the patient’s health history, family health history, familial relationships, and relevant hereditary and non-hereditary risk factors (Std 1 – Assessment). 
   
• Example learning objective for nursing genomics competency: 
  Collect a comprehensive family health history. 
   
• Courses in which this content could apply:
  Health assessment.
   

Domain 3: Population Health

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  Champions the voice of the patients, families, communities, and populations with genomic conditions and/or in need of genomics healthcare (Std 8 – Advocacy).
   
• Example learning objective for nursing genomics competency:
  Identify strategies to advocate for those with genomic conditions and/or in need of genomics healthcare. 
   
• Courses in which this content could apply:
  Leadership.
   

Domain 4: Scholarship for Nursing Discipline

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  Identifies clinical questions involving genomics in the healthcare or practice setting that can be answered through scholarly inquiry (Std 14 – Scholarly Inquiry).
   
• Example learning objective for nursing genomics competency:
  Generate relevant and focused genomics-based hypotheses and/or quality improvement topics in which to base clinical inquiry. 
   
• Courses in which this content could apply:
  Evidence-based practice or research.
   

Domain 5: Quality and Safety

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  The genomics nurse contributes to quality genomics nursing practice (Std 15 – Quality of Practice). 
   
• Example learning objective for nursing genomics competency:
  Apply quality improvement principles in delivery of genomics nursing care. 
   
• Courses in which this content could apply: 
  Evidence-based practice or Research 
   

Domain 6: Interprofessional Partnerships

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  The genomics nurse collaborates with patient, family, and others in the conduct of nursing practice (Std 11 – Collaboration).
   
• Example learning objective for nursing genomics competency:
  Collaborate with patients, families, and interprofessional team members to establish mutual genomics-focused healthcare goals. 
   
• Courses in which this content could apply:
  Core clinical courses.
   

Domain 7: Systems-Based Practice

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  Contributes to resolving genomics-related ethical, legal, and social issues involving patients, colleagues, community groups, systems, nations, and other stakeholders (Std 7 – Ethics).
   
• Example learning objective for nursing genomics competency: 
  Recognize system processes that perpetuate genomics-related ethical, legal, and social issues.
   
• Courses in which this content could apply: 
  Ethics.
   

Domain 8: Informatics and Healthcare Technologies

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  Advocates for resources, including genomics technology, that enhance nursing practice (Std 17 – Resource Stewardship).
   
• Example learning objective for nursing genomics competency:
  Demonstrate the use of technology to gather data, create information, or generate knowledge in genomics. 
   
• Courses in which this content could apply:
  Healthcare informatics.
   

Domain 9: Professionalism

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  The genomics nurse evaluates their own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations (Std 16 – Professional Practice Evaluation).
   
• Example learning objective for nursing genomics competency:
  Identify relevant laws, policies, and regulations in genomics nursing practice. 
   
• Courses in which this content could apply:
  Leadership or healthcare policy.
   

Domain 10: Personal, Professional, and Leadership Development

• Genomics Nursing Scope and Standards of Practice 3rd Edition* 
  Demonstrates a commitment to continuous, lifelong learning and education for self and others (Std 12 – Leadership).
   
• Example learning objective for nursing genomics competency:
  Engage in guided and spontaneous reflection of one’s own genomics nursing practice.
   
• Courses in which this content could apply:
  Leadership.

AACN essentials, Copyright 2021 by The American Association of Colleges on Nursing (AACN).
*ISONG in collaboration with American Nurses Association (currently under revision).

Johns Hopkins University has extensive resources for nurse educators seeking to integrate genetics and genomics into their courses, programs, and curricula. Resources include tools for evaluating courses and curricula, links to educational webinars and other videos, and exemplar instructional materials.

A PDF of their curriculum evaluation toolkit is available.

American Association of Colleges of Nursing. The Essentials: Core Competencies for Professional Nursing Education. Washington DC: American Association of Colleges of Nursing. 2021.

International Society of Nurses in Genetics and American Nurses Association. Genomics Nursing: Scope and Standards of Practice 3rd Ed – Draft for Public Comment.

Ward LD, Purath J, Barbosa-Leiker C. Assessment of genomic literacy among baccalaureate nursing students in the United States. Nurse Educator. 2016;41(6):313-318. doi:10.1097/nne.0000000000000272