Readiness of clinical genetic healthcare professionals to provide genomic medicine: An Australian census

Abstract

We aimed to determine capacity and readiness of Australian clinical genetic healthcare professionals to provide genomic medicine. An online survey was administered to individuals with genetic counseling or clinical genetics qualifications in Australia. Data collected included: education, certification, continuing professional development (CPD), employment, and genetic versus genomic clinical practice. Of the estimated 630 clinical genetic healthcare professionals in Australia, 354 completed the survey (56.2% response rate). Explanatory interviews were conducted with 5.5% of the genetic counselor respondents. Those working clinically reported being involved in aspects of whole exome or genome sequencing (48.6% genetic counselors, 88.6% clinical geneticists). Most genetic counselors (74.2%) and clinical geneticists (87.0%) had attended genomics CPD in the last two years, with 61.0% and 39.1% self‐funding, respectively. Genetic counselors desire broad involvement in genomics, including understanding classifying and interpreting results to better counsel patients. The majority of respondents (89.9%) were satisfied with their job and 91.6% planned to work in genetics until retirement. However, 14.1% of the genetic counselors in clinical roles and 24.6% of the clinical geneticists planned to retire within 10 years. This is the first national audit of clinical genetic healthcare professionals, revealing the Australian workforce is motivated and prepared to embrace new models to deliver genomic medicine but consideration of education and training is required to meet demand.

Development of an Evidence-Based, Theory-Informed National Survey of Physician Preparedness for Genomic Medicine and Preferences for Genomics Continuing Education

“…Exclusion criteria were: • Medical geneticists-we have conducted a separate study of genetic health professionals' workforce readiness (Nisselle et al, 2019a); • General practitioners (GPs)-excluded due to the differences in practice between primary, secondary and tertiary care. We have undertaken a separate study with GPs to understand their current practice of genomic medicine, including their experience with direct-to-consumer/personal genomic testing (manuscript in preparation).…”

“…The purpose of this article is to describe in detail the methodology for developing this robust survey. Survey development was informed by literature (Chen and Kim, 2014;Gray et al, 2014;Chow-White et al, 2017;Carroll et al, 2019;Nisselle et al, 2019a;Stark et al, 2019b), theory and qualitative data, has had input from experts for content validity and was reviewed by non-genetic medical specialists representing target respondents for usability and functionality.…”

Preparing Medical Specialists for Genomic Medicine: Continuing Education Should Include Opportunities for Experiential Learning

“…The term "medical specialists" is used in this study to mean "doctors specialized in a field other than general/family practice or clinical/medical genetics" (Crellin et al, 2019, pg 1-2). We have separate studies ( Figure 1) underway or completed with clinical (or medical) geneticists (Nisselle et al, 2019a) and general practitioners (GPs) as we anticipated that the needs of those who are specialized in genetics or those in primary care (i.e. GPs) may be quite distinct and therefore require separate consideration.…”

“…To achieve this, our research program has three work streams around education and clinical practice: mapping the current landscape; identifying needs and future preferences; and ensuring effective education through evaluation. The present study is shown in grey and has only included medical specialists, defined as "doctors specialized in a field other than general/ family practice or clinical/medical genetics" (Crellin et al, 2019, pg 1-2 (Janinski et al, 2018); h (Nisselle et al, 2019a); i First meeting held August 2018, Sydney; j (Stark et al, 2019b). Participants groups represented in the studies within this program of research are: medical specialists (3,(9)(10)(11)(12)(13)(14)(15)(16), genetic counselors (4, 11-15), clinical geneticists (2,4,(11)(12)(13)(14)(15), bioinformaticians and medical scientists (11-15), genomic education providers (2, 12-15), general practitioners (5,6,(12)(13)(14)(15), patients or parents of patients (7, 15), system influencers and policy makers (8), oncologists (10), community practitioners (pharmacists, nutritionists, private practice genetic counselors (6).…”

Australian Genomics: A Federated Model for Integrating Genomics into Healthcare

“…19 The Genomics Workforce and Education program (Program 4) provides evidence to inform the education and training of those whose professional roles will be impacted by clinical genomics. Broadly, this program is mapping the current landscape of education delivery in genomics, identifying the genomic education needs and preferences of genetic and non-genetic health professionals, [20][21][22] and developing tools to support the development and evaluation of effective education programs. A combination of qualitative and quantitative methods are examining perspectives of a wide range of stakeholders, including health professionals, educators, patients, the community, scientists, and policy makers.…”