Building capacity for genomics in primary care: a scoping review of practitioner attitudes, education needs, and enablers

Kate L A Dunlop; Nehal Singh; Amelia K Smit; April L Morrow; Julia Steinberg; Anne E Cust; Meredith Makeham; Carissa Bonner; Bronwyn Terrill; Lynn V Monrouxe; David Wilkinson; Shailendra Sawleshwarkar; Alan S Ma

doi:10.3389/fmed.2025.1577958

Building capacity for genomics in primary care: a scoping review of practitioner attitudes, education needs, and enablers

Front Med (Lausanne). 2025 Apr 30:12:1577958. doi: 10.3389/fmed.2025.1577958. eCollection 2025.

Authors

Kate L A Dunlop^#^{1

2}, Nehal Singh^#¹, Amelia K Smit^{1

2}, April L Morrow³, Julia Steinberg¹, Anne E Cust^{1

2}, Meredith Makeham⁴, Carissa Bonner⁵, Bronwyn Terrill^{6

7}, Lynn V Monrouxe⁸, David Wilkinson⁹, Shailendra Sawleshwarkar¹⁰, Alan S Ma^{11

12}

Affiliations

¹ The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.
² Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
³ The Centre for Genetics Education, Health Education and Training Institute (HETI) NSW Health, Sydney, NSW, Australia.
⁴ Community and Primary Health Care, Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.
⁵ Leeder Centre for Health Policy, Economics and Data, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁶ Australian Genomics, Melbourne, VIC, Australia.
⁷ School of Clinical Medicine, Faculty of Health and Medicine, UNSW, Sydney, NSW, Australia.
⁸ School of Health Sciences, The Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁹ The Royal Australian College of General Practitioners Ltd (RACGP), East Melbourne, VIC, Australia.
¹⁰ Academic Education, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
¹¹ Specialty of Genomic Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
¹² Department of Clinical Genetics, Sydney Children's Hospital Network, Sydney, NSW, Australia.

^# Contributed equally.

Abstract

Introduction: Improving clinical capacity for genomics in primary care promises to lead to better health, but genomics uptake in the sector is slow and patchy. This review aimed to identify the attitudes of primary care practitioners (PCPs) and the education needs and enablers in applying genomics to inform priorities in education and implementation.

Methods: Searches were conducted across Medline, Scopus, CINAHL, Embase, and Cochrane CENTRAL until November 2023. Barriers and enablers were mapped to the Theoretical Domains Framework and the Genomic Medicine Integrative Research Framework.

Results: A total of 52 studies were included, and the most frequently mapped domains from the Theoretical Domains Framework were 'Knowledge' (65.4% of papers), 'Environmental context and resources' (40.4%), 'Skills' (38.5%), and 'Social/professional role and identity' (32.7%). Four key implications were identified: knowledge as a major barrier and enabler, education to build capacity, uncertainty about the role of PCPs, and additional needs beyond education alone.

Discussion: While PCPs are optimistic about genomics, long-standing barriers to delivery in primary care remain. Multifaceted, evidence-based education strategies, including interactive components to change behaviour, will help to address barriers. Clarifying the role of PCPs, referral pathways, and collaboration with tertiary genetics services will further build capacity for genomics delivery in primary care.

Keywords: education strategies; general practitioner; genomics; genomics education; primary care.

Publication types

Systematic Review