Genetics in the OR--implications for perioperative nursing practice

Genetics education in the nursing profession: literature review

AIM

This paper reports a literature review exploring genetics education for nursing professionals. The aim was to contribute to the debate about the future direction of such education.

BACKGROUND

Advances in genetics science and technology have profound implications for health care and the growing importance and relevance of genetics for everyday nursing practice is increasingly recognized.

METHOD

A search was conducted in February 2005 using the CINAHL and Google Scholar databases and the keywords nurse, midwife, health visitor, education and genetics. Papers were included if they were published in English between 1994 and 2005 and included empirical data about genetics education in nursing. In addition, attempts were made to access the grey literature, with requests for information on research, for example, to members of the Association of Genetic Nurses and Counsellors and searches of relevant websites.

FINDINGS

Agreement on the relevance of genetics for nursing practice is extensive. Empirical evidence of the learning needs of practitioners highlights widespread deficits in knowledge and skills, and low confidence levels. Provision of nursing education in genetics is patchy and insubstantial across a number of countries, further hampered by lack of strategic development. Significant progress has been made in the identification of learning outcomes for nurses. Research on the delivery of genetics education is limited, but the role of skills-based training, use of clinical scenarios, and importance of assessment have all been identified as factors that can promote learning.

CONCLUSION

Whilst areas of good performance were revealed, many studies identified gaps in professional competence and/or education. New initiatives are underway to support genetics education and its integration into professional practice, but further research is needed on the most effective forms of educational delivery, and an international collaborative approach to this should be considered.

Nurses as information providers: facilitating understanding and communication of statistical information

Nurses are increasingly being called upon to be the conveyers of important statistical information to patients. This trend is particularly evident in the domains of genetics and cancer screening. These new roles, however, demand new competencies, such as the ability to solve statistical problems, and the skill to communicate the answers effectively, as effective communication is an important ingredient in shared decision making. Genetic testing, perhaps more than other medical domains, relies heavily on the use of statistics. Being able to convey statistical information effectively is vital. In this paper, we illustrate the problems health care professionals have had in tackling and communicating statistical information. We introduce the natural frequencies method of solving Bayesian inference problems and review empirical evidence that shows the superiority of this format. Being able to transform probabilities into natural frequencies facilitates correct Bayesian inferences. It is argued that the conventional approach to educating nurses in Bayesian problem solving should be reconsidered and their statistical curriculum should be supplemented with instruction in using the natural frequency format.

Education for genetics and nursing practice

Genetic factors influence the risk for disease, selection of treatments, and overall health of persons throughout the life span. Nurses in critical care practice participate in assessing genetic risks for disease, implementing treatments, educating people about genetic aspects of health and disease, supporting the client's abilities to cope with the information, and assisting the individual and family to make health-related decisions involving genetic information. Opportunities for critical care nurses to become knowledgeable about genetic aspects of critical care nursing exist through academic courses, continuing education, and summer institutes. Recently, new guidelines for the genetic education of nurses have been developed. However, genetic education opportunities are not available to all nurses throughout the United States. Genetic nursing education programs based on guidelines for integration of genetic knowledge into professional nursing practice are needed.