A three-level model of precision cancer nursing practice is proposed to differentiate foundational capabilities from advanced practice roles, distinguishing precision-informed, enhanced, and specialist precision cancer nursing practice.
Abstract
Summary Background Nurses contribute across the precision cancer care pathway, providing continuous, person-centred care and supporting genomic testing integration. However, the scope of nursing competencies required for precision cancer care and the extent to which current education prepares nurses for these roles remain unclear. This scoping review maps and synthesises evidence on nurses’ roles and competencies in precision cancer care, and educational provision in this field. Methods A JBI scoping review was conducted; MEDLINE, CINAHL, PsycINFO, Embase and Scopus were systematically searched on July 18th 2025. International postgraduate and continuing professional education programmes relevant to nurses were identified via a generative artificial intelligence grey literature search undertaken between July 25th and July 30th 2025. Data were synthesised using convergent integrated thematic synthesis. Findings Fifty-two publications were included, addressing nursing roles and/or competencies (n = 44) and educational interventions (n = 23). Sixty-five education programmes were identified. Five themes captured nursing roles: 1) genomic risk assessment and stratification; 2) genomic communication and shared decision-making; 3) precision cancer care pathway coordination and clinical navigation; 4) interprofessional collaboration and genomic service integration; and 5) professional governance, quality assurance, and advanced practice roles. Educational provision predominantly addressed foundational competencies, with less explicit preparation for roles requiring professional autonomy, interpretive expertise, leadership, and governance. Interpretation Alignment between nurses’ competency expectations and educational preparation is uneven. We propose a three-level model of precision cancer nursing practice to differentiate foundational capabilities from advanced practice roles, distinguishing precision-informed, enhanced, and specialist precision cancer nursing practice. Explicit mapping of postgraduate curricula to stratified competency levels may support safe expansion of nursing scope within mainstreamed genomic cancer care. Funding This research was supported with funding from the 10.13039/501100001638Dublin City University Undergraduate Summer Research Internship 2025, which supported AC’s time on the project. The authors alone are responsible for the content of this presentation.
Genomics-informed cancer care is central to precision oncology; however, integrating genomic competencies into routine practice remains challenging. Despite the development of competency frameworks, limited clarity exists regarding how these competencies are operationalised within oncology settings.
AIM
To synthesise and critically examine how genomic competencies are conceptualised across the literature, identify areas of convergence and gaps and examine implications for clinical implementation and cancer nursing workforce development.
DESIGN
Scoping review.
METHODS
The review followed Joanna Briggs Institute (JBI) methodology and was reported in accordance with PRISMA-ScR guidelines.
DATA SOURCES
CINAHL, Embase, PubMed, Google Scholar and grey literature sources were searched (2010-2026). Evidence describing genomic competencies for healthcare professionals was included. Data were extracted and analysed using inductive thematic analysis.
RESULTS
Forty-one sources were included. One overarching theme (holistic patient-centred care), two major themes (genomic knowledge and genomic literacy) and seven interconnected competency domains were identified: social, ethical and legal considerations, communication, assessment, care planning, collaboration, professional practice and systems and process. Although these domains were consistently described across the literature, competencies were frequently articulated at a high level with limited specificity regarding their application within genomics-informed cancer care and oncology workflows.
CONCLUSION
Genomic competencies are well described across healthcare frameworks; however, a significant gap exists between their conceptualisation and translation into cancer care practice. While educational initiatives support genomic knowledge development, integration requires sustained workforce and implementation approaches that enable competencies to be enacted through clinically embedded oncology roles, pathways and service models.
IMPLICATIONS FOR PRACTICE
Existing genomic competencies provide a foundation for education and practice; however, their application within cancer care requires contextualisation within oncology workflows and roles. Aligning competencies with cancer nursing practice may support development of clinically relevant pathways and workforce models for genomics-informed care.
IMPACT
This review highlights the need for workforce and service-level approaches, including clinically embedded nursing roles, to support the integration of genomics into cancer care. WHAT PROBLEM DID THE STUDY ADDRESS?: Global healthcare systems are working to integrate genomic testing into routine cancer care; however, there is limited clarity on how existing genomic competency frameworks translate into clinical practice. This review addresses the gap between the conceptualisation of genomic competencies and their operationalisation within oncology settings, particularly in relation to cancer nursing roles. WHAT WERE THE MAIN FINDINGS?: Genomic competencies are consistently described across the literature but are often articulated at a high level and lack specificity for application in cancer care. While these competencies align with established nursing capabilities, education alone is insufficient to support their implementation, highlighting a gap between competency frameworks and clinical practice. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This review demonstrates that the challenge is no longer defining genomic competencies, but creating the clinical, educational and organisational conditions that enable genomic competencies to be enacted within routine cancer care.
REPORTING METHOD
Inductive thematic analysis with findings descriptively summarised and narratively reported according to JBI methodology and PRISMA-ScR guidelines.
PATIENT OR PUBLIC CONTRIBUTION
This study did not include patient or public involvement in its design, conduct or reporting.
Libby Rea Brownlee, Sandra Fitzgerald, John Parsons et al.· Journal of Clinical Nursing· 0 citations
Purpose: This scoping review identified the core components of nursing competence required for general ward nurses to recognize and manage clinical deterioration and examined how this competence has been conceptualized in previous studies. It also synthesized individual- and system-level factors associated with competence and identified research gaps relevant to nursing education, future research, and patient safety initiatives. Methods: This scoping review was conducted using Arksey and O’Malley’s framework and reported in accordance with the PRISMA-ScR guidelines. Six databases—PubMed, CINAHL, Embase, the Cochrane Library, Scopus, and Web of Science—were searched for studies published between January 2016 and December 2025 using search terms related to clinical deterioration and nursing competence. Results: Twenty-one studies met the inclusion criteria. The findings were organized into two domains: nursing competencies and factors associated with competence. Technical competencies included physical assessment, vital-sign monitoring, surveillance, information analysis, and application of escalation protocols. Non-technical competencies included situational awareness, clinical decision-making, intuition, leadership, interprofessional communication, and teamwork. Individual-level factors included clinical experience, self-confidence, skill acquisition, and clinical judgment. System-level factors included education and training, relationship-building with physicians, supportive work environments, electronic tools, organizational support, and teamwork culture. Conclusion: Nursing competence in managing clinical deterioration is multidimensional and reflects the interaction of individual capabilities with system-level supports. Future research should develop educational strategies that strengthen both technical and non-technical skills while reinforcing organizational systems that support timely and effective responses to deterioration.
Unknown authors· Korean Journal of Adult Nurs...· 0 citations
A significant gap exists between Kenya's digital health policy ambitions and nursing graduates' competencies and context-appropriate digital tools are urgently needed.
Francisca Mibei, D. Ongori, D. Adero· International Journal of Dig...· 0 citations
INTRODUCTION
Competency-based assessment (CBA) is central to competency-based education (CBE) in nursing, yet the evidence about its effectiveness is fragmented across methods, settings, and outcomes.
AIM
To synthesize the strengths and limitations of CBA approaches in nursing education and to map them onto established educational frameworks.
METHODS
An umbrella review of reviews was conducted, including systematic, scoping, integrative, and theoretical reviews of CBA in pre-registration and early-career nursing. Searches of PubMed, CINAHL, Scopus, Web of Science, and ERIC (from inception to November 2025) were conducted in accordance with Joanna Briggs Institute and PRISMA guidance, with eligibility defined using the Population, Concept, and Context (PCC) framework, and data were integrated through narrative synthesis.
RESULTS
Twenty reviews, encompassing more than 700 primary studies, identified six CBA domains: simulation-based and Objective Structured Clinical Examination (OSCE) assessments, workplace-based assessments (WBAs), technology-enhanced assessments, learning-based and reflective assessments, research competency assessments, and program-level CBE evaluations. Across domains, CBAs predominantly targeted higher-order cognitive and performance outcomes aligned with the upper levels of Bloom's taxonomy and Miller's pyramid. Simulations and OSCEs showed strong validity and acceptability but were resource-intensive and often anxiety-provoking. Workplace-based tools captured authentic performance but were constrained by assessor variability and limited psychometric properties. Technology-enhanced and reflective approaches fostered engagement and self-regulation yet frequently relied on heterogeneous, weakly validated measures. Evidence for research competencies and program-level CBE remained limited and methodologically modest.
CONCLUSION
CBAs in nursing provide rich information on complex competencies but are unevenly developed. Integrated, theory-informed, and programmatic assessment systems are required to optimise their contribution to practice-ready graduates.
R. K. Ibrahim, A. Darwish, Lisa Bayliss-Pratt et al.· Nurse Education Today· 0 citations
CONTEXT
A robust, expertly trained nursing workforce is needed to care for over 13 million people living with serious illness in the United States (US). However, palliative nursing workforce needs remain poorly characterized.
OBJECTIVE
To describe the current state and future demands for palliative nursing in the US.
METHODS
We conducted a narrative review of the palliative nursing workforce in the US. Literature was identified through PubMed and CINAHL (1981-2025) using terms related to palliative care, nursing, workforce, training, and certification. Articles were selected based on relevance, with additional sources identified through snowball sampling. Findings were synthesized qualitatively.
RESULTS
We identified 39 sources, grouped into three categories: education, certification, and workforce. Palliative nursing education was not formally integrated into US nursing curricula until 2021 with the AACN publication of The Essentials, and only 12 healthcare organizations offer specialty nurse residency or fellowship programs. The National Board for Certification of Hospice Nurses was established in 1992 in the US and awarded the first certification to registered nurses in 1994; in 2025 nearly 12,000 nurses are certified. Workforce data remain limited due to the diversity of nursing roles in hospice and palliative care. No comprehensive estimate exists for the broader palliative nursing workforce; however, a 2024 national survey estimated 56,619 registered nurses working in hospice.
CONCLUSION
Limited targeted measurement of the specialty palliative nursing workforce constrains the ability to quantify supply and gaps. Research linking education, training, and certification to patient outcomes could inform planning for the future US palliative nurse workforce.
S. Hurley, Morgan E. Murphy, M. Grant et al.· Journal of Pain and Symptom...· 0 citations
Purpose Advanced Practice Nurse roles are increasingly adopted to address health system challenges; however, theoretical approaches guiding Advanced Practice Nurse role management remain fragmented. This scoping review aimed to synthesize international theories, models, and frameworks related to Advanced Practice Nurse role management and to identify shared and category-specific core elements to support stage-specific role development. Methods A scoping review was conducted following Arksey and O’Malley’s framework and Joanna Briggs Institute (JBI) guidance, and reported in accordance with the PRISMA-ScR checklist. Five databases (Web of Science, CINAHL, PubMed, Cochrane Library, and Embase) were searched from inception to August 2025. Two reviewers independently screened studies and extracted data. Data were synthesized using a combined approach of word frequency analysis and iterative cross-framework content mapping to identify shared and framework-specific elements. Results In the final review, 22 Advanced Practice Nurse role management models and frameworks were included. They were categorized into four purpose-based groups: comprehensive frameworks (n = 2), role definition (n = 7), role implementation (n = 8), and role evaluation (n = 5). Twenty shared core elements were identified within role definition frameworks, 20 within role implementation frameworks, and 21 within role evaluation frameworks, with substantial overlap across categories. Shared elements consistently emphasized advanced patient-centered practice, theoretical and professional foundations, and evidence-informed role development, while category-specific elements reflected stage-related priorities. Conclusion Advanced Practice Nurse role management frameworks form a coherent continuum across role definition, implementation, and evaluation. Shared core elements highlight universal foundations for Advanced Practice Nurse role development, whereas category-specific elements provide stage-sensitive guidance. This synthesis offers a theoretical resource to support policy development, organizational implementation, and sustainable integration of Advanced Practice Nurse roles, particularly in settings where Advanced Practice Nurse roles are emerging.
Shifan Han, Xuan Duan, Wenjing Dong et al.· International Journal of Nur...· 0 citations
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