Leadership, Literacy, and Translational Expertise in Genomics: Challenges and Opportunities for Social Work

Knowledge and Use of Cervical Cancer Prevention Services among Social Work and Nursing University Students

The present study examines: (a) the knowledge of healthcare students on cervical cancer (CC) issues and the use of related preventive services, as well as their association with the field of study and other sociodemographic characteristics; (b) the possible effect of social capital and its parameters. A cross-sectional study was conducted, using a convenience non-probability sampling technique. The final sample consisted of forty-nine social work and fifty-one nursing students. The two groups were similar regarding their sociodemographic characteristics and the knowledge and use of gynecological preventive services. However, the nursing students undertook a PAP smear check-up to a lesser extent (48.6%) compared to social work students (51.4%) (p = 0.026). The social capital scores were high for both groups, but social work students were significantly more ‘Tolerant to diversity’. For the total sample, only the ‘Family and friends connections’ subscale correlated with knowledge about the existing gynecological preventive services. Among the main reasons explaining university students’ avoidance of preventive testing were the feelings of fear and embarrassment associated with the PAP smear test. Given the significance of the future professional roles of healthcare students as information sources and leaders in women’s CC preventive behavior, understanding the individual factors contributing to their own adherence is essential. It is equally important to increase their scientific knowledge through the improvement of academic curricula regarding these issues.

Family Identity and Roles in the Context of Li-Fraumeni Syndrome: "No One's Like Us Mutants"

Li-Fraumeni syndrome (LFS) is a rare hereditary cancer syndrome in which individuals have a significantly increased risk of developing multiple cancers throughout the life span. An LFS diagnosis may shift the individual's sense of self and tolerance of cancer risk as they engage in cancer screening and cancer prevention activities. This study examined the impact of family identity on health decision making, communication, and role function. Forty-five families completed one or more interviews during an annual, protocol-specific cancer screening study. An interdisciplinary team analyzed 66 interviews using interpretive description and modified grounding theory. Thematically, identity emerged as an evolving construct regarding self and/or family, embedded in historical and ongoing experiences with LFS. Notions of individual and shared family identities guided decision making related to healthcare and influenced interpersonal communication and role function between supportive networks and families. Alignment between individual, family, and generational identities may shape engagement in genetic testing, risk management, and family life. Medical teams that are unequipped to address the psychosocial challenges that LFS populations face may include mental health professionals on interprofessional care teams to navigate risk management and consequential familial conflict.

The leadership behaviors needed to implement clinical genomics at scale: a qualitative study

PURPOSE

To investigate leadership in clinical genomics and identify likely implications of different leadership approaches for future implementation of clinical genomics.

METHODS

We undertook 37 interviews in a cross-sectional qualitative study examining implementation of clinical genomics in Australia. Participants were either nongenetic medical specialists working with genomic initiatives (e.g., immunologists, nephrologists) or working at a service/organizational level (e.g., department heads, chief medical officers). We identified participants as genomic migrants (long-established practitioners) and genomic natives (those medical specialists coming into independent practice with genomic technology in situ). Data were analyzed deductively with reference to leadership approach.

RESULTS

Leadership approaches were often blended or reported to iteratively support development of another. There was concern at both the absence or the excess of entrepreneurial leadership (i.e., risk-taking).

CONCLUSION

Entrepreneurial leadership is needed to promote innovativeness, risk-taking, and proactivity, essential in these early stages of clinical genomics. Shared decision-making is required from a wide range of clinicians, calling for both clinical and distributed leadership. Sharing leadership, and the potential loss of positional status from formal senior positions, may prove challenging to genomics "migrants," who are essential for nurturing genomic "natives." Clinicians will need support from their organizations and professional bodies to manage the transition.