Fit for Practice in the Genetics/Genomics Era - Nursing & Midwifery

In collaboration with Professor Heather Skirton (Plymouth University) and funded by the NHS National Genetics Education and Development Centre, Professor Maggie Kirk and Dr Emma Tonkin have undertaken a review of the 2003 genetics competence framework for nurses, midwives and health visitors. Recognising the pace of genetics/genomics research, the original team recommended (in 2003) that a review of the framework take place within 5-10 years. In this intervening period, our knowledge and understanding of genetics and genomics has grown significantly and its translation into patient benefit continues.

Two national, expert consensus meetings were convened involving practitioners, educators, patient representatives and policy makers. We used real stories from patients, family members and professionals (taken from the Telling Stories, Understanding Real Life Genetics web resource to focus discussion). Through small group work, participants generated statements having considered for each story 1) the needs of the client/family and 2) what the nurse or midwife needed to know, think and do in order to meet those needs. Following an iterative process of review and refinement the statements were mapped to the current ‘joint’ genetics framework for nurses and midwives. Gaps and content that required updating were identified and changes made.

Two frameworks tailored for each profession have been produced. Each sets out the minimum competence that should be required at registration and the framework specifically for midwifery is believed to be the first of its kind.

The nurse education and training framework now contains 8 statements. The new competence (Statement 8) has been added and highlights the importance of ongoing nursing care to address the needs of both the individual and their family/carer that may change over time. Revisions were made to all of the original statements. In particular, Statement 1 now reflects the need to include family history information as part of a comprehensive nursing assessment (as set out in the new NMC Standards) and Statement 6 emphasises the responsibility of nurses to keep up to date in their own area of practice. Detailed learning outcomes (LOs) and practice indicators are provided. The LOs are linked to Levels 4, 5 & 6 of the QAA Framework and correspond to years 1, 2 and 3 respectively of a pre-registration undergraduate nurse training programme. Outcomes in subsequent years build on those set out in the previous year and the indicators for practice sit alongside the learning outcomes allowing a means of measuring and confirming that competence has been attained.

An Open Access paper detailing both the approach and the final framework is available: Kirk M, Tonkin E, Skirton H (2014) An iterative consensus-building approach to revising a genetics/genomics competency framework for nurse education in the UK. Journal of Advanced Nursing 70 (2): 405-410 (DOI: 10.1111/jan.12207)

The midwifery education and training framework contains 7 statements. Revisions were made to all of the original statements and were approved by those that attended the consensus meeting. As is the case with the revised nursing framework, Statement 1 now reflects the need to include family history information as part of a comprehensive midwifery assessment and Statement 6 actively emphasises the responsibility of midwives to remain current in their own sphere of practice. In addition, the time critical nature of information giving, decision making, testing and referral during pregnancy has been emphasised within Statements 1 and 5. Learning outcomes and practice indicators that build on those developed for the new nursing framework have been written and are under review and a manuscript is in preparation.