Translating Genomic Competencies Into Cancer Nursing Practice: A Scoping Review

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.