Samuel Merritt University School of Nursing Is Nationally Recognized for Genomics Education
The sequencing of the Human Genome in 2003 has afforded unprecedented exploration of health and the impact the environment plays on disease development. On a practical level, these discoveries will radically change health-care delivery. Samuel Merritt University has begun to address this through integration of genomics into curricula for health-care providers. Dr. Patricia Brennan is at the forefront of this push.
For a nonscientist, genomics may seem kind of mysterious. What exactly is it?
Genomics is the study of all genes in the human genome together, including their interactions with each other, the environment, and other psychosocial and cultural factors.
Why would health care workers need to know about genomics?
This is a field that’s growing by leaps and bounds daily. We’re finding out about genomic influence on health constantly. We’re understanding that all of our genetic material interfaces with the environment and with potential toxins to affect disease. Before, we would basically treat someone’s symptoms. Now, we can look at risk of disease and potentially prevent the manifestation of it.
From a practitioner’s perspective, that’s a little scary, because if you haven’t been trained in this area, it can seem daunting. So, one of the things we’re trying to do at Samuel Merritt is to begin to integrate this information into the practitioner’s education and emphasize that this will be a lifelong learning situation.
This is not like when you study chemistry or calculus; it’s not something you learn and then all of a sudden it’s there. There’s an evolution to this. Right now, there’s not a ton of clinical application, but application of this information into everyone’s clinical practice is going to continue to expand and evolve. The discoveries of genomic variation associated with health, disease, and management options, when translated into practice can make a difference for a patient and his or her family.
What are the questions students typically have about genomics?
Similar to practicing clinicians, they want to understand the relevance to their clinical practice. This is a moving target, as clinical relevance continues to emerge. Genomics applies to the entire health continuum from pre-conception, prenatal, and neonatal screening through risk identification, screening and diagnosis, disease characterization, individualized therapy, and management at end of life. This relevance continues to amplify as we enter the era of personalized medicine and pharmacogenomics.
What if a student already has an interest in genomics. How can they prepare for this area of study?
First, they should seek out the resources that exist, and there’s lots of it. For instance, the NIH and National Human Genome Research Institute have wonderful resources on their website (Genome.gov). I sit on an editorial board of the National Human Genome Research Institute that has put together an interdisciplinary repository of resources (g-2-c-2.org). One of the challenges we face is that there’s so much information on the Internet, but all of the NHGR resources are vetted and deemed valuable and credible, and we review them routinely. So whether you’re a student, a practitioner, a physician, a PA, a genetics counselor, or a nurse, there are plenty of free, credible resources where you can learn more—and you can always learn more.
What’s unique about the study of genomics at Samuel Merritt University?
We are at the forefront of the integration of genetics and genomics into education. The National Institutes of Health and National Human Genome Research Institute have recognized us as leading this initiative.
Are there any tangible applications of genomics into clinical practice right now?
Genomic health starts with understanding your family history, and I think we rarely pay attention to that. So, if you’re going to see a doctor for the first time, and you’re filling out those four or five pages of stuff you need to fill out, one important thing to think about is what sorts of illnesses have occurred in your family over time. At a very basic level, health-care workers can have patients start thinking about how their health is related to their mom and dad, aunts and uncles, grandparents, siblings, children—what sorts of illnesses or problems have they had medically. The Surgeon General has a family history tool that people can use to get this information (hhs.gov/familyhistory/portrait), and that snapshot can help us begin to think about what genetic and genomic health implications may put someone at risk for certain things and better understand what kinds of tests they’ll need to take as they become available in the future.
How is genomics research different today than it was a generation ago?
A generation ago the whole human genome wasn’t even sequenced yet. The Human Genome Project was proposed to Congress in 1986, began in 1990, and concluded in 2003. Before that, the most we knew about were single genetic disorders, but we didn’t know about your whole genome and what that meant.
Once the human genome was sequenced, we had an opportunity to look at all of the genes and not just one gene that didn’t function right. So now, based on your genomic makeup, if we can do X, Y, and Z for you when you’re 20 or 30 or 40 to prevent disease when you’re 60 or 70 or 80, we can not only save money but also enhance your health and the health of your family. So we can think about this from a much bigger perspective than we could a generation ago.
What are the privacy implications of all this?
That’s one of the big pieces: How do the ethical and legal implications of this work? Maybe you don’t want to know everything that’s involved in your genome. Maybe you don’t want to understand that risk. Maybe it’s too scary for you. Maybe it could have an impact on your employment or your ability to get certain types of insurance. There are all these other issues; it’s almost a Pandora’s Box that is and will be opened. So we have to also think about how we’re going to protect patients against any type of discrimination. And we’re doing this, but we still have so much to learn.
What’s the future look like in terms of integrating genomics into clinical practices?
We have undergraduates and graduate students at Samuel Merritt who are either entering clinical practice as new nurses or coming back to get Master’s or Doctoral degrees in specialty practices. These folks come to us not necessarily to learn about genetics and genomics, but they have the advantage that we’re at the forefront of looking at how this integration is happening or should happen in education.
There’s a lot of great scientific work being done in genomics at all kinds of research institutions throughout the country, but until we can bridge the gap between that work and what actual health professionals are doing, we don’t really make it real. We need for health professionals to understand what the implications of this research are for their own patients, and how it will affect their practices in the future.
Samuel Merritt University, 3100 Telegraph Ave., Oakland, 1-800-607-6377, www.SamuelMerritt.edu