Sample Genetics/Genomics Course in Nursing

Sample Genetics/Genomics Course in Nursing
Created and contributed by Rachel Choudhury MSN, MS, RN, CNE, OCN

Genetics and genomics are life-span issues with potential implications for individuals, from pre-conception through death. This seminar course provides an overview of genetics and genomics concepts with discussions on the nursing implications of the concepts in clinical practice. The course will prepare students to recognize the relationship of genetics and genomics in providing care in all health care settings.

NOTE: Although most programs do not allow the luxury of offering this wonderful course in it’s entirety, you can harvest many useful resources from this syllabus to include in appropriate places within your curriculum. Definitely check out some of the assignments and the rubrics! These can easily be adapted for use in courses that have nothing to do with genetics.

Suggestions for the Course Syllabus

I. Course Information

Course Number and Title: NR3XX Genetics and Genomics for Nurses
Course Credit: 2 – 3 Credits (8-week course)
Placement in Curriculum: Year 3, Semester 2 or later as an elective seminar course
Pre-requisites: Adult Health Nursing, Maternal/Newborn Nursing, Pediatric Nursing, and Mental Health Nursing
*** Rationale: Provides students the context to apply the genetics and genomics concepts based on clinical experiences; Allows students opportunity for much deeper and richer learning opportunities.

Course Description
This 8-week elective seminar course will prepare nursing students with basic competencies in genetics and genomics for providing care to individuals, families, and communities. Basic genetic/genomic concepts are reviewed and applied in the context of nursing clinical practice. Students will explore the role of caregiver, advocate, teacher, care manager, and researcher within the scope of legal and ethical nursing guidelines in a variety of healthcare settings. Case studies, debates, group activities, dialogue, and critical reflection about clinical practice will provide opportunities to integrate theory and practice.

Course Outcomes:

1. The student will demonstrate comprehension of the basic human patterns of biological inheritance and variation within families and within populations.

2. The student will utilize knowledge of disease-associated genetic variations to facilitate development of nursing interventions – independently and collaboratively – for the prevention, diagnosis, and treatment options for patients, families, and populations.

3. The student will be able to design a holistic approach to nursing care of patients with genetic disorders with consideration to legal and ethical issues, as well as the various factors that influence the patient’s ability to use genetic information and services.

4. The student will be able to use effective communication skills to process and provide genetics/ genomics information in nursing care of patients, families, and communities.

5. The student will evaluate own competence of practice, identifying areas of strength and areas where professional development related to genetics and genomics would be beneficial.

Course Competencies

1. Demonstrate ability to generate a minimum of three-generation family health history information.

2. Conduct comprehensive assessments that incorporate knowledge about genetic, environmental, and genomic influences and risk factors.

3. Demonstrate understanding of the relationship of genetics and genomics to health, prevention, screening, diagnostics, selection of treatment, and monitoring of treatment effectiveness.

4. Appraise credible, accurate, appropriate, and current genetic and genomic information, resources, services, and/or technologies specific to given clients.

5. Demonstrate a culturally sensitive approach to nursing care of patient, families, and communities in providing genetic/genomic information and services.

6. Determine ethical and legal considerations, such as advocacy, autonomy, and confidentiality, related to genetic/genomic decision-making.

7. Examine one’s competence of practice, identifying areas of strength and areas where professional development related to genetics and genomics would be beneficial.

II. Course Instruction:

Instructional Methods:
Multimedia: Audiovisual aids, Animations, PowerPoint Presentations, and Web Interactives.
Guest lectures via podcast or live in class.
Class Discussions, On-Line Discussion, Case Studies, Debates, Demonstration, and Guided
Practice with Problem-based Learning.

Suggested Textbook(s) and Course Materials:

  • Kenner, C. & Lewis, J.A. (2013). Genetics and genomics in nursing. Boston, MA: Pearson.
  • Beery, T.A. & Workman, M.L. (2012). Genetics and genomics in nursing and healthcare.Philadelphia, PA: F.A. Davis
  • Black Monsen, R. (2009). Genetics and ethics in healthcare. Silver Spring, MD: American Nurses Association.
  • Lashley, F.R. (2007). Essentials of clinical genetics in nursing practice. New York, NY: Springer Publishing Company.

Suggested Web Resources:

Other Resources:

III. Suggested Course Content Outline

A. Basic Concepts in Genetics and Genomics
1. DNA Structure and Function
2. Cell Growth, Cell Differentiation, and Gametogenesis
3. Gene Expression
 a. Genetic and Genomic Variation
 b. Chromosomal and Mitochondrial Inheritance/Disorders
 c. Congenital Anomalies and Basic Dysmorphology
 d. Patterns of Inheritance
4. Population Genetics and Genomics
5. Genetic Risk Assessment: Family History and Pedigree Construction

B. Genomic Health
1. Genetics and Genomics: Professional Nursing Practice Implications
2. Lifespan Issues
 a. Common Adult-Onset Genetic Disorders
 b. Common Childhood-Onset Genetic Disorders
 c. Selected Complex Health Problems
  i. Cardiovascular Disorders
  ii. Cancer
  iii. Psychiatric and Behavioral Disorders

C. Genetic Disorders and Genomics: Management
1. Genetics and Genomics Testing
2. Pharmacogenomics
3. Legal, Ethical, Sociocultural, and Financial Considerations
4. Advocacy

IV. Suggested Learning Evaluation Strategies

  • Quizzes  (Content Mastery; Knowledge/Comprehension)
  • Discussions  (Comprehension/Application/Analysis)
  • Case Studies (Comprehension/Application/Analysis)
  • Paper        (Analysis/Synthesis/Evaluation)
  • Debate     (Analysis/Synthesis/Evaluation)
    • The quizzes can comprise 15-20 multiple-choice, matching, and fill-in-the blank questions.
    • Allow students ample time (1.5 – 2 minutes per question) to complete each quiz.
    • Quiz administration will depend on the course format, i.e. face-to-face or online.

Quizzes  (Content Mastery; Knowledge/Comprehension)
The quizzes are designed to evaluate students’ mastery of the content presented in the course lessons.

Discussions (Comprehension/Application/Analysis)
Threaded discussions are designed to promote dialogue between faculty and students, and
students and their peers. In the discussions students:

  • Demonstrate understanding of course concepts
  • Integrate professional resources
  • Engage in meaningful and respectful dialogue with classmates and faculty
  • Express thoughts clearly and logically.

Participation Requirements (may vary depending on online requirements for the program):
Students are required to post an initial response to the discussion topic and a minimum of
two (2) responses to other students’ initial posts for each graded thread. Postings should be
done on at least two (2) separate days within the week.

Sample Discussion Topic
1. Go to the Telling Stories website: http://www.tellingstories.nhs.uk/
2. Choose a story related to the theme Competencies: Utility and Limitations of Testing.
3. For your initial post, discuss the following areas in relation to the case study you chose:
 a. Result(s) of the genetic test
 b. Significance of the results
  i. Impact on the affected individual(s) and family
  ii. Clinical recommendations (eg. further testing, treatments, etc)
 c. Nursing Implications –  How would you apply your knowledge of genetic testing used in this case study? Here are some considerations:
  i. Risk assessment
  ii. Patient education
  iii. Referrals
4. Guidelines for your responses to other students’ initial posts:
 a. additional insights about the significance of the results.
 b. additional insights about nursing implications.
 c. present supporting information relevant to the topic.
 d. ask questions and/or respectfully debate your position.

Discussion Rubric

(Points may vary based on allocation of course grade distribution and requirements).

 

Discussion Criteria

Exceeds minimum requirements

 

Meets minimum requirements

Does not meet minimum requirements

Understanding and application of concepts

 

Postings apply concepts to professional practice, personal experience or examples from health care delivery system

Posting reflects full understanding of concepts but does not apply them

Posting does not fully reflect understanding of concepts

Application and analysis of professional resources

 

Postings integrate assigned readings, lessons, expert opinion and outside professional resources, articles or web sites. (sources are cited)

 

Postings integrate only assigned readings or lessons.

Postings demonstrate little or no integration of readings, lessons or professional sources.

Meaningful and respectful dialogue with classmates

Actively responds to peers and engages in meaningful and respectful dialogue with them.

Responds but does not engage in meaningful dialogue.

Does not actively engage or respond to peers.
-OR-
Reacts defensively or disrespectfully to feedback or questions

 

Clear and logical expression

Presents information using clear and logical language. Grammar, spelling and punctuation are accurate.

Presents information using clear and logical language. Grammar, spelling and punctuation have minimal errors.

 

Information is unclear and difficult to follow. Grammar,

Participation requirements

Initial post submitted by (day/time due)

Responses/additional posts submitted by

(day/time due)

Does not meet minimum requirements

 

Case Studies (Comprehension/Application/Analysis)

Case studies provide an opportunity for students to apply theoretical concepts to real-life situations. Each case study will have a scenario related to the course contents covered and will have specific tasks and questions to be completed. The case studies can be assigned as an in-class group assignment. Case scenarios with the required tasks/questions is provided in class. The assignment is submitted by the end of the class session if facilitated as an in-class activity.

Suggested general guidelines for case studies (will vary with class size):

  • Groups will consist of 3-4 students.
  • The groups will have 45 minutes to complete the assignment.
  • The groups may use course materials for resources, but may not collaborate with other groups.
  • Each group will submit ONE completed case study for grading.

Sample Instructions for an In-Class Case Study Assignment/Learning Activity

1. Refer to Case Study Guidelines described in the syllabus:

  • You will have 45 minutes to complete the assignment.
  • You may use course materials for resources, but may not collaborate with other groups.
  • Each group will submit ONE completed case study for grading.

2. Case Study Scenario: Choose ONE of the five (5) Case studies presented in your textbook: Black Monsen, R. (2009). Genetics and ethics in healthcare. (Refer to Part 4, pg. 345).
3. Review the background information provided in the scenario and answer these questions related to your group case study.

(Points assigned to each question/task may vary based on allocation of course grade distribution and requirements).

Questions/Tasks

  1. What other information would you like to have or ask the patient/family that may be helpful in your assessment of the patient situation/needs?  
  2. Identify the issues in this case study related to each of the following:
         Financial/Socioeconomics, Cultural, Religious, and Lifestyle
  3. Describe strategies you would use to address the issues in Question #2.
  4. Prioritize your nursing care management of this patient situation.
  5. Identify ethical/legal concepts related to this case study. Include concepts from the ANA Scope & Standards of Genetics/Genomics Nursing Practice.
  6. Describe how these ethical concepts influenced your approach to the case.
  7. Identify two (2) challenges your team had with this case. Describe the reasons why you feel those items were challenging. How did this assignment help you recognize the challenges and to identify strategies to overcome those challenges?  

 

Paper (Analysis, Evaluation, and Synthesis)

The purpose of this assignment is for the student to explore topic areas learned in the course, with the integration of knowledge-base, discussion experiences, personal perceptions, and nursing research, through writing a professional (APA formatted) paper.

Sample Paper: Reflective Analysis
The guidelines for this paper may include:
1. The student will choose a specific genetic disorder and incorporate the following concepts:

  • Professional Practice & Roles: Advocacy, Teaching, Researcher
  • Ethical & Legal Concepts: ANA Standards, Screening & Treatment Options, Counseling
  • Clinical Nursing Practice: ANA Competencies, Healthcare Settings, Management of Care

2.Nursing Research

  • Find at least three (3) peer-reviewed nursing research articles related to your topic.
  • Articles must be printed within the last 5 years.
  • Summarize relevant content from the articles to be presented (see #3).

3. Explorethe topic based on the following:

  • Class lectures/readings
  • Experience(s) from course threaded discussions, case studies, and clinical practice (from other nursing courses)
  • Please make note to keep patient confidentiality when giving specific examples
  • Personal Perceptions: What are your feelings, thoughts, and opinions about the topic before taking this course?  And now? What changed your perceptions, if any?
  • Nursing Research Article: Does the article support or negate knowledge you have learned in class?
  • Does the article support or negate what you have experienced in the course discussions, case studies, and/or clinical practice?
  • Does the article support or negate your personal perceptions about the topic before/ now?

4. Paper Length andFormat using APA:

  • 4-5 pages in length, not including the Title and Reference pages.
  • APA Format

5.  Papers are due no later than the beginning of class Week 7.

 

7. Reflective Analysis Paper Grading Guidelines: (Points may vary based on allocation of course grade distribution and requirements).

NOTE: You will find a rubric for this at the bottom of this page.

Debates (Analysis, Synthesis, and Evaluation)
Debates prompt students to seek out information and derive an explanation or decision related to the topic areas presented in this course.  The debate exercises will facilitate students’ personal and professional development through reflection on their own decisions and conclusions made based on reliable evidence.

Sample Debate Assignment
The guidelines for the debate exercises may include:

1. Students will be assigned in groups of four (4). Each team will comprise of two (2) students, where one team will present arguments “for” and the other team will present arguments “against” the chosen debate topic.

2.  Student groups will choose a debate topic by Week 3 of the course. Suggestions for debate topics include, but are not limited to the following:

  • Genetic screening requirements, testing procedures, and follow-up care
  • Research related to genetics/genomics in humans
  • Nursing scope of practice and competencies in genetics/genomics
  • Healthcare policies related to clinical applications of genetics/genomics *** It is recommended that groups present a comprehensive perspective genetics/genomics
    from the following areas:

    • Professional Practice & Roles: Advocacy, Teaching, Researcher
    • Ethical & Legal Concepts: ANA Standards, Screening & Treatment Options, Counseling
    • Clinical Nursing Practice: ANA Competencies, Healthcare Settings, Management of Care
  • 3. Research Arguments and perspectives presented in the debates must be supported by research from peer-reviewed journals and/or credible resources (eg. National Human Genome

    Research Institute (NHGRI), NIH, etc.)

    • At least 5 (five) research references related to your topic per debate group.
    • Articles must be recently published (within the last 5 years).
    • Summarizes relevant content from the articles presented in arguments (see #2)

      Debate GuidelinesDebate Exercise to be held Week 8 of the Course Session.

      Each group will have 30 minutes to present/debate their topic of choice (see agenda below).
      Each team will have 5 minutes to present their argument, and another 5 minutes to present
      their counterarguments in response to the other team. The debate group will have 10
      minutes to address questions from the audience. Teams may use notes during the debate
      exercise.

      00-05         Arguments for selected topic (Team A)
      05-10         Arguments against selected topic (Team B)
      10-15         Counterargument/Rebuttal by Team A
      15-20         Counterargument/Rebuttal by Team B
      20-30         Q & A / Audience participation

    Grading of the debates will comprise of faculty and audience scores: [## points] from the faculty and [## points] from the average of the audience scores – for a total of ### points.
    (Points may vary based on allocation of course grade distribution and requirements).

    Debate Grading Criteria and Scoring Sheet for Instructor and Audience

    Debate Topic: ___________________________________________________

    Team Member Names: Indicate For or Against (circle one)
    (1) _______________________________
    (2) _______________________________

    Criteria

    Rating

    Comments

    *Considerations for rating the criteria.

    Opening statement was clear, well organized, factual, and relevant.
    (1-10)

     *Minus one point for each: clarity, organization, factual, and relevance.

    Arguments in support of its position (for or against) was stated clearly, was relevant, and well- informed. At least 3 (up to 5) arguments were presented.
    (1-20)

    *Very strong and persuasive arguments given throughout.

    * Tone of voice, clarity of expression, precision of arguments all contribute to keeping audience’s attention and persuading them of the team’s case.

    Rebuttal to opposing side’s arguments was clear, relevant, well informed, and effective.
    (1-20)

    *Identification of weakness in the other team’s arguments and/or ability to defend itself against the counterargument/ rebuttal of the other team.

     

    Closing statement was stated clearly, was relevant, and effectively summarized the team’s position.
    (1-10)

     *Minus one point for each: clarity, organization, factual, and relevance.

    Answers to audience questions were clear, well-informed, and relevant. Utilized information from evidence/research to support response.
    (1-20)

    * Addresses the question appropriately by providing reasons for/against the resolution, and well-supported by research literature.

     

    Overall preparedness, organization, effectiveness, and professionalism in the debate.


    (1-10)

    *Minus one point for each: preparation, organization, effectiveness, and professionalism. 

    TOTAL POINTS EARNED

    (out of 100)

     Reflective Analysis Paper Grading Guidelines: (Points may vary based on allocation of course grade distribution and requirements).

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