Abstract
This report addresses the application of genomics in current nursing education and practice. It is stated that this field of scientific knowledge wields an increased potential in terms of genetic disease identification, prevention, and treatment. However, the observed misconceptions and ignorance prevent genomics from becoming a more important part of the nursing framework. This paper synthesizes the academic body of knowledge in regard to the current state of research and the most promising avenues of improvement. It is concluded that nursing education is the essential level at which genomics expertise needs to be embedded. This idea mainly concerns advanced nursing practice degrees, starting from the Master’s level. This way, the inner strengths of such nurses can be utilized to raise the awareness of the professional communities and address policy-makers for meaningful changes.
Summary
George M. Church once said: “If you get very fine, accurate, and inexpensive control over your genome, you can fundamentally change the kind of organism you are. You are extending human capacity.” In other words, the human genome contains invaluable data in regard to the various diseases’ predispositions and treatment options. This area of knowledge has been at the center of rigorous research ever since its discovery. Simultaneously, it raised heated debates regarding genome studies’ feasibility, ethics, and possible repercussions. It is theorized that decoding this data will provide insight into the origins of multiple conditions that were previously deemed incurable. In a way, the genome reflects the laws of nature itself, and this feature has never ceased to fascinate experts and researchers in the fields of medicine and microbiology. While the opponents of genome studies argue that tampering with the foundation of life is unwise, the current body of knowledge suggests an increased potential for such research in disease examination and eradication. Thus, the novelty of this area, combined with its colossal potential, determines the interest in the topic.
From a nursing perspective, one of the key objectives is to provide each patient with a better quality of life, enhancing their well-being and resilience on both physical and mental levels. Each nurse is bound to encounter people suffering from serious, virtually incurable conditions throughout their career. Under such circumstances, the most they can do is to reduce the pain and prolong life to the maximum extent possible. In this context, nurses’ interest to advanced practices and the new, breakthrough solution is natural. Genomics is exactly the discipline that wields serious potential in terms of introducing such profound changes into the field. Calzone et al. (2018a) state that nurses play “a pivotal role in bringing the benefits of genomics and precision medicine to everyday health care” (p. 249). The application of genomics in prenatal and newborn screening is particularly important since it ensures a better understanding of a child’s condition, enabling the prevention of serious complications. As such, the knowledge of genomics incorporated into nursing practice can practically change the world by improving the health and well-being of entire generations.
At the same time, there remains a strong need for further research of genomics, especially at the point of its intersection with nursing practice. The overall novelty of the subject, combined with conservative views surrounding it, impedes this area of knowledge from taking a leading role in the actual clinical context. Genomics is a highly complex field that requires profound knowledge, enhanced expertise, and serious efforts and resources to be efficient. Furthermore, it has mostly been associated with novelties in science rather than immediate medical practice. Hence, new knowledge in genomics comes a long way from discovery to practical environments (Kalzone et al., 2018b). For the benefit of communities, this process is to be accelerated in order to introduce breakthroughs in genomics into the actual nursing practices. One of the most efficient ways of doing so consists of laying a stronger emphasis on genomics as a part of nursing curricula, namely in the case of advanced nursing practice degrees. This idea represents the subject matter of the present report that focuses on the current state of research and the envisaged benefits of genomics in nursing education and practice.
Review of the Literature
The investigation of the contemporary body of knowledge reveals an increased interest to genomics application in nursing education and practice of today. Calzone et al. (2018a) provide a comprehensive overview of how the two disciplines intersect in the current environment. According to them, nurses can become the key link in the transformation chain that will introduce the benefits of genome research into nursing practice. However, “a concerted global effort is needed to transform nursing policy and practice to address widely acknowledged deficits in nurses’ genomic literacy” (Calzone et al., 2018a, p. 250). This idea points to the most serious impediment that is currently observed in regard to the subject matter. Aside from the technical and financial resources, nurses lack the knowledge in regards to the genomics potential in the clinical setting. The primary survey conducted by the authors implies that the current attempts to apply this knowledge in prenatal and newborn screening face considerable barriers observed on both education and practice levels. This piece of knowledge points toward the lack of the subject matter’s proper coverage in today’s nursing education, which is a flaw to be addressed for positive change.
These authors did not limit their research to the presented survey and further elaborated on the subject matter. In their subsequent research, Calzone et al. (2018b) concentrated on the concept of genomic literacy in healthcare professions as the key enabler of quality transformations. As per the authors’ consensus, the deficit of genomics knowledge in the clinical environment is tangible, accounting for an array of lost opportunities. A better understanding of genomics would ensure new avenues of timely screening and early prevention of major complications that currently entail the suffering of thousands of patients. However, this understanding is to be built throughout the process of nursing education, becoming the foundation of the practice rather than an addition to it. Calzone et al. (2018b) insist on their prior identification of nurses as the essential enablers of change within healthcare as a whole. Their primary survey data illustrates that only 9 out of 23 global nursing leaders can successfully identify genomic resources for academic and continued education. This information is crucial for the present study as it shows the origins of the current knowledge deficit.
At the same time, some nursing leaders attempt to instill positive change by organizing themselves into new groups of professional activists. The primary research by Hickey et al. (2018) revolves around The International Society of Nurses in Genetics (ISONG). The members of this organization have voluntarily received advanced genomics training to compensate for the knowledge deficit resulting from primary training. According to the survey results obtained by Hickey et al. (2018), 660% of the members held a Master’s degree of higher. This data points at the value of advanced nursing education in terms of enhancing the scope of professional practice and acquiring the key competencies for the current nursing landscape. 95% of the members report the increased relevance of genomics in the upcoming years, stating that they intend to incorporate their newly obtained knowledge into professional practice (Hickey et al., 2018). Thus, this information illustrates that the absence of stable genomic practices in nursing is largely caused by the lack of available resources and precise information. Advancing the level of genomics knowledge in nursing education curricula is likely to attract more professional interest to the subject matter.
In this regard, nursing education remains the essential element of building genomics awareness and competency. More specifically, the emphasis is laid on the Master’s level as the primary descriptor of sufficient interest in making meaningful changes in the nursing practice. However, this knowledge needs to be introduced with the framework of effective strategies that ensure proper understanding of the material on a profound level rather than a mere exchange of information. McCurry et al. (2020) explore the efficiency of consensus testing in regard to enhancing the genomics competencies of nursing doctorate students. As per their primary findings, collaborative work contributes to a better understanding of the importance and applicability of advanced nursing methods. More specifically, students performed better when approaching the issue from the perspective of team efforts, discussions, and cooperative problem-solving.
Such results illustrate the value of professional collaboration in ensuring profound transformations within the professional field. Meaningful change does not occur in a vacuum, as individual initiatives can be easily outweighed by the surrounding doubts or ignorance. In the case of enhanced genomics application, the subject matter is to be approached by a united front of nursing experts and leaders who work in a collaborative manner. In this regard, the work of activist organizations, such as ISONG, is essential in profoundly improving nursing education.
As per the synthesis of findings, the advanced knowledge of genomics will make a meaningful contribution to the development of nursing within the framework of its key objectives. Moreover, the pivotal role is attributed to the advanced practice nurses who possess the required knowledge and expertise to be the drivers of the change. Such experts can act as the leaders of the professional community, approaching policy-makers with an evidence-based, informed roadmap for change. According to Alotaibi and Al Anizi (2020), the field already possesses examples of APRNs’ positive impact on patient experience and clinical outcomes. In the case of older patients with cancer, advanced practice nurses applied their competencies to alleviate the stress and provide new avenues of improving their quality of life. This effect became possible through the use of advanced knowledge that resulted from enhanced educational experiences. This data implies that the expertise of APRNs can be successfully implemented for the benefit of the field. Accordingly, a similar transformation can be completed in terms of the genomics knowledge application in healthcare and nursing, in particular.
Research Experience
The experience of the research groups has made a considerable contribution to the selection of the study direction. More specifically, the research preceptor becomes the cornerstone of the study, illustrating its immense practical relevance. In addition to the profound professional knowledge of the subject matter, the professor has first-hand experience with the value of genomics. Her daughter has been diagnosed with Fibular hemimelia, which is a genetic condition resulting in a complete or partial absence of the fibula bone. According to the National Center for Advancing Translational Sciences (n.d.), the prevalence of Fibular hemimelia is estimated to be at the level of 1 in 50,000 with an equal sex distribution. It is theorized that the condition develops between weeks four and seven of the gestation period. In this regard, the preceptor’s interest to the subject is deeply personal, as she seeks to estimate the level of today’s advanced practice nursing students’ preparedness to address genetic conditions. Naturally, genomics is the discipline that has the potential to improve the system’s ability to screen and prevent such complications in a timely manner. This experience explains the selection of the subject matter and its relevance.
Link to the American Association of Colleges of Nursing (ANCC) Essential
The importance of genomics awareness and research for contemporary nursing education and practice aligns with the vision of the American Association of Colleges of Nursing (ANCC). More specifically, ANCC (2021) distinguishes ten core competencies that serve to reflect the key development areas of the professions. Within the framework of the present study, a strong link is observed between the subject matter and competency number one. It is formulated as “Knowledge for Nursing Practice” and defined as the “integration, translation, and application of established and evolving disciplinary nursing knowledge and ways of knowing, as well as knowledge from other disciplines” (ANCC, 2021, p. 27). Genomics is an evolving discipline that reflects the growing body of scientific knowledge in regard to genome decoding and application. In relation to nursing education and practice, this field provides new avenues for early screening and prevention. Within the envisaged framework, advanced practice students and professionals acquire previously underexamined knowledge of genetic testing and interventions while enhancing their perspective on the practice. This process corresponds with the topical objective embedded in ANCC’s first competency.
Future Plans/Summary
Overall, genomics represents a scientific area of increased interest for experts and researchers across various disciplines. For the sphere of healthcare, such findings can provide insight into the development mechanisms and prevention tools for various previously incurable conditions. Genomics accounts for precise screening, especially in the prenatal and newborn contexts, which, in turn, enables early prevention. This knowledge can be applied to improve the patient’s quality of life in many respects, which aligns with the key objective of nursing. However, genomics remains severely underrepresented in the clinical setting, namely at the level of nursing education. The current body of knowledge reflects the lack of clarity in regard to the subject matter. As a result, the general uncertainty serves as the ultimate barrier to embedding the benefits of modern genetic science into screening and treatment procedures. It is suggested that nurses can be the driver of the change, prompting policy-makers to redefine the paradigm of advanced education from the Master’s level. More specifically, advanced practice nurses can play a crucial part in increasing the awareness of genomics advances because of their increased leadership potential.
References
Alotaibi, T., & Al Anizi, A. (2020). The impact of advanced nurse practitioner (ANP) role on adult patients with cancer: A systematic quantitative review. Applied Nursing Research, 56, 1–13.
American Association of Colleges of Nursing (ANCC). (2021). The essentials.
Calzone, K. A., Kirk, M., Tonkin, E., Badzek, L., Benjamin, C., & Middleton, A. (2018b). Increasing nursing capacity in genomics: Overview of existing global genomics resources. Nurse Education Today, 69, 53–59.
Calzone, K. A., Kirk, M., Tonkin, E., Badzek, L., Benjamin, C., & Middleton, A. (2018a). The global landscape of nursing and genomics. Journal of Nursing Scholarship, 50(3), 249–256.
Core competencies for professional nursing education.Â
Hickey, K. T., Taylor, J. Y., Barr, T. L., Hauser, N. R., Jia, H., Riga, T. C., & Katapodi, M. (2018). Nursing genetics and genomics: The International Society of Nurses in Genetics (ISONG) survey. Nurse Education Today, 63, 12–17.
McCurry, M. K., Rudd-Arieta, M., & Viveiros, J. (2020). Using consensus testing to enhance genomic understanding and teamwork in doctoral advanced practice nursing students. Nursing Education Perspectives, 41(3), 168–170.
National Center for Advancing Translational Sciences. (n.d.). Fibular hemimelia.Â