Workforce Skilling
Increasing capacity and capability in genomics is necessary to support the improved health outcomes promised by genomic medicine. The issue of workforce skilling recognises that many types of healthcare professionals will need varying degrees of genomic literacy as the implementation of genomic medicine proceeds.
There is also an awareness that there is great potential to share training and education material to avoid duplication of effort. With this in mind a number of entities have made their training material freely available for others to use and adapt.
Issues
Within the Catalogue of Global Genomic Medicine Implementation Initiatives, over half of the initiatives (34/61)* gave some acknowledgement to workforce issues.
The implementation initiatives show there is a need to develop, deliver and maintain genomic education, training and skills for a range of different professional groups including clinicians/specialists, primary care practitioners, clinical geneticists and genetic pathologists, genetic counsellors, nurses, infection control staff, pharmacists and bioinformaticians. These programs must be created and delivered to ensure they are culturally appropriate and should also have certification and or accreditation attached to provide consumers with confidence in the health workforce.
In most places the role of genomics in medicine will continue to change over the coming years. As a result, most health systems need to develop workforce plans and strategies including new service delivery models. Many initiatives have identified that an audit or assessment of the roles and skills that will be needed in the future is a high priority as well as identification of the current training resources. This is generally followed by the development of new training programs and resources at different levels and for different groups. A wide variety of approaches have been suggested or developed for clinical genetics and genomics, genetic counselling and bioinformatics including undergraduate and postgraduate courses, academic exchange, internships, continuing professional development, online course, training visits, mentorship, laboratory classes, case scenarios, workshops and seminars.
Some key organisations and professional bodies working in this area and workforce education resources are provided.
Resources on workforce skilling:
Nisselle A, Martyn M, Jordan H, Kaunein N, McEwen A, Patel C, et al. Ensuring Best Practice in Genomic Education and Evaluation: A Program Logic Approach. Frontiers in Genetics. 2019;10(1057). https://www.frontiersin.org/article/10.3389/fgene.2019.01057
NHS Health Education England. Genomics Education Program. Facilitating Genomic Testing: A Competency Framework. 2019. https://www.genomicseducation.hee.nhs.uk/consent-a-competency-framework/
Jackson L, O'Connor A, Paneque M, Curtisova V, Lunt PW, Pourova RK, et al. The Gen-Equip Project: evaluation and impact of genetics e-learning resources for primary care in six European languages. Genet Med. 2019;21(3):718-26. https://doi.org/10.1038/s41436-018-0132-3
The Topol Review - Preparing the healthcare workforce to deliver the digital future. An independent report on behalf of the Secretary of State for Health and Social Care. NHS Health Education England. 2019. https://topol.hee.nhs.uk
Ingrid Slade DNSaHB. Genomics education for medical professionals – the current UK landscape. Clinical Medicine. 2016;16(4):347-52. https://doi.org/10.7861/clinmedicine.16-4-347
Talwar D, Tseng T-S, Foster M, Xu L, Chen L-S. Genetics/genomics education for nongenetic health professionals: a systematic literature review. Genetics In Medicine. 2016;19:725. https://doi.org/10.1038/gim.2016.156
Rubanovich CK, Cheung C, Mandel J, Bloss CS. Physician Preparedness for Big Genomic Data: A Review of Genomic Medicine Education Initiatives in the United States. Hum Mol Genet. 2018;27(R2):R250–R8. https://doi.org/10.1093/hmg/ddy170
Korf BR, Berry AB, Limson M, Marian AJ, Murray MF, O’Rourke PP, et al. Framework for development of physician competencies in genomic medicine: report of the Competencies Working Group of the Inter-Society Coordinating Committee for Physician Education in Genomics. Genetics In Medicine. 2014;16:804. https://doi.org/10.1038/gim.2014.35
Abacan M, Alsubaie L, Barlow-Stewart K, Caanen B, Cordier C, Courtney E, et al. The Global State of the Genetic Counseling Profession. Eur J Hum Genet. 2019;27(2):183-97. https://doi.org/10.1038/s41431-018-0252-x
Dwarte T, Barlow-Stewart K, O'Shea R, Dinger ME, Terrill B. Role and practice evolution for genetic counseling in the genomic era: The experience of Australian and UK genetics practitioners. J Genet Couns. 2018. https://doi.org/10.1002/jgc4.1053
Maiese DR, Keehn A, Lyon M, Flannery D, Watson M, Working Groups of the National Coordinating Center for Seven Regional Genetics Service C. Current conditions in medical genetics practice. Genet Med. 2019. https://doi.org/10.1038/s41436-018-0417-6
Liehr T, Carreira IM, Aktas D, Bakker E, Rodriguez de Alba M, Coviello DA, et al. European registration process for Clinical Laboratory Geneticists in genetic healthcare. Eur J Hum Genet. 2017;25(5):515-9. https://doi.org/10.1038/ejhg.2017.25
Bronwyn Kerr on behalf of the Working Party of the Association of Genetic Nurses and Counsellors and Clinical Genetics Society. Professional Roles in the Multidisciplinary Team in Clinical Genetics. 2016. http://www.clingensoc.org/media/43550/wp_agnc_cgs_v2.pdf
Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49-61. https://doi.org/10.2147/JMDH.S117945
Calzone KA, Kirk M, Tonkin E, Badzek L, Benjamin C, Middleton A. The Global Landscape of Nursing and Genomics. J Nurs Scholarsh. 2018;50(3):249-56. https://doi.org/10.1111/jnu.12380
Hickey KT, Taylor JY, Barr TL, Hauser NR, Jia H, Riga TC, et al. Nursing genetics and genomics: The International Society of Nurses in Genetics (ISONG) survey. Nurse Educ Today. 2018;63:12-7. https://doi.org/10.1016/j.nedt.2018.01.002
Camak DJ. Increasing importance of genetics in nursing. Nurse Educ Today. 2016;44:86-91. https://doi.org/10.1016/j.nedt.2016.05.018
Tonkin ET, Skirton H, Kirk M. The first competency based framework in genetics/genomics specifically for midwifery education and practice. Nurse Educ Pract. 2018;33:133-40. http://doi.org/10.1016/j.nepr.2018.08.015
Smith SE, Drake LE, Harris J-GB, Watson K, Pohlner PG. Clinical informatics: a workforce priority for 21st century healthcare. Australian Health Review. 2011;35(2):130-5. https://doi.org/10.1071/AH10935
Williams MS, Ritchie MD, Payne PRO. Interdisciplinary training to build an informatics workforce for precision medicine. Applied & Translational Genomics. 2015;6:28-30. https://doi.org/10.1016/j.atg.2015.07.003
* Initiatives from the catalogue that acknowledge Workforce themes
Africa (2) -Human Heredity and Health in Africa (H3Africa) Initiative, Human Heredity and Health in Africa (H3Africa) White Paper
Australia (7) - National Health Genomics Policy Framework, NSW Health Genomics Strategy, Genetic and genomic healthcare for Victoria 2021, Australian Genomics, Queensland Genomics Health Alliance, SA Genomics Health Alliance, Australian Genomics Health Futures Mission
Belgium (1)- Genomics and public health in Belgium
Brazil (1)- Human Genome and Stem-Cell Research Center (HUG-CEL)
Canada (3) - Genome BC - Strategy for Genomics in the Health Sector in British Columbia, Genome Canada, Genome Canada National Initiative for the Clinical Implementation of Precision Health
China – Hong Kong (1)– Hong Kong Genome Project
Denmark (1)– National Strategy for Personalised Medicine 2017-2020
Estonia (1) - Estonian Genome Center of the University of Tartu (EGCUT) Development Plan for 2015-2021
Europe (2) - Shaping Europe’s Vision for Personalised Medicine-Strategic Research and Innovation Agenda (SRIA), Ubiquitous Pharmacogenomics (U-PGx)
Finland (1) - Improving Health through the use of Genomic Data
France (1) - French Plan for Genomic Medicine 2025
Italy (1) -National Plan for Public Health Genomics
Japan (1) -Implementation of Genomic Medicine Project
Mexico (1)- Promotional Consortium of the National Institute of Genomic Medicine National Institute of Genomic Medicine (INMEGEN)
Middle East (1)- Centre for Arab Genomic Studies
New Zealand (1) -Genomics Aotearoa
Philippines (1) -Philippine Genome Center (PGC)
Qatar (1) - Qatar Genome Programme (QGP)
Thailand (1)- Genomics Thailand
United Kingdom (3) - Building on our inheritance - Genomic technology in healthcare, The 100,000 Genomes Project Protocol, Generation Genome- Annual Report of the Chief Medical Officer 2016
USA (2) - The 2011 NHGRI strategic plan - Charting a course for genomic medicine from base pairs to bedside, All of Us (Precision Medicine Initiative)
