The analysis of the genomic content across the 12 Portuguese nursing programs (NP001 to NP012) revealed substantial variability in the number of covered topics. Each program was assessed for the inclusion of 14 distinct genomic topics, with notable differences in the extent of coverage. NP004 emerged as the most comprehensive program, addressing nine of the 14 possible genomic topics. Similarly, NP001 also demonstrated a relatively high level of coverage, incorporating nine genomic topics. In contrast, programs such as NP002, NP003, and NP010 exhibited minimal inclusion, with NP010 notably lacking any genomic content. This variability underscores the inconsistency in the integration of genomics across nursing programs, highlighting significant disparities in the depth and range of genomic education provided. This lack of integration persists despite the well-established recognition in the literature of the critical role that genomics plays in nursing practice.

Similar results have been identified in nursing programs in the United States. However, despite a longer tradition of establishing competencies in genetics and genomics and greater recognition of their importance in nursing education, significant gaps in curricular integration still persist (Joffe et al. 2024). In a research study conducted by Joffe et al. (2024) that examined the integration of genomics in nursing programs utilizing an approach that include the analyses of publicly available course descriptions, only 5.6% of the programs include a fully dedicated genomic course, 50.9% of the programs have genomic content in the specifications of at least one course and the remaining 43.5% did not mention genomic content.

The genetic topics related to basic molecular biology and fundamental genetic principles tend to be more emphasized in nursing curricula compared to those focused on psychosocial aspects or patient-centered care. For instance, descriptions of chromosomes, genes, and DNA and the transcription of DNA to protein structure were coded more frequently. However, critical areas such as the communication of genetic information to families, psychological impact of a genetic condition, basic risk assessment and the collection of family history were significantly underrepresented. The distribution of genomic content across scientific areas reinforces the dominance of biomedical sciences in genomic content, with 68% of courses falling under this category. This is consistent with Joffe et al. (2024) findings, which also showed a strong emphasis on biomedical topics at the expense of psychosocial, ethical, and nursing-specific content. This suggests that nursing education places a stronger emphasis on the scientific foundations of genetics, perhaps reflecting a traditional biomedical approach. While a solid understanding of molecular genetics is essential, the limited attention to psychosocial and practical aspects highlights a crucial gap. Preparing nurses to apply genomic knowledge in clinical settings requires not only theoretical understanding but also the ability to provide holistic, patient-centered care, including counselling and ethical decision-making (Bayrak and Eren 2024; Calzone et al. 2024).

The literature highlights that gaps in genomics education contribute to persistently low levels of knowledge and confidence in genomic practice among both nursing students and clinical nurses (Ballad et al. 2024; Godino and Skirton 2012; McLaughlin et al. 2024; Seven et al. 2015). Some studies measure knowledge using The Genetic and Genomic in Nursing Practice Survey (GGNPS) developed by Calzone et al. (2014) and studies consistently report a low level of knowledge in genomics among both nursing students and practicing nurses (Ceylan et al. 2024; Chow et al. 2023; Wang et al. 2023; Yesilcinar et al. 2022). Other studies use the Genetic Nursing Concept Inventory (GNCI) developed by Ward et al. (Ward et al. 2016), and these studies also demonstrate low levels of knowledge in genomics (Adejumo et al. 2021; Dewell et al. 2020; Parviainen et al. 2023).

A recent study developed by Seed et al. (2024) shows that medical students generally have high confidence in basic genomics principles, however, this confidence drops significantly in clinical applications of genomics, with only 50% reporting a good understanding of the genetic contribution to diseases and just 28% feeling knowledgeable about clinically used genomic tests. The lack of confidence in these areas is attributed to gaps in knowledge, particularly in more complex topics. The study suggests that undergraduate curricula should be updated to better integrate genomic medicine (Seed et al. 2024). This includes enhancing the teaching of both basic science and clinical applications of genomics to address these knowledge gaps and ensure that future doctors are well-equipped to practice in an increasingly genomic healthcare environment (Seed et al. 2024). These findings align with our study, which also highlights gaps in the integration of genomic content within nursing curricula, emphasizing the need for a more comprehensive approach to preparing healthcare professionals for genomic healthcare.

Whitley et al. (2020) further elaborate on these challenges by emphasizing the critical importance of integrating genomics education into both foundational and advanced learning contexts. Their study highlights that equipping healthcare professionals and the public with the necessary knowledge to navigate the complexities of personal genomics is essential for addressing ethical, societal, and clinical challenges. Moreover, the authors stress the need for education that bridges the gap between basic genomic principles and their real-world applications, ensuring that professionals are prepared to leverage genomic advancements effectively in healthcare practice (Whitley et al. 2020).

In fact, if a nursing curriculum fails to encompass all relevant domains of genomics, it cannot be considered as fully competent in providing nurses with the comprehensive knowledge required for effective clinical practice. In this study, the maximum number of genomic topics identified within a nursing program was nine out of 14, indicating significant deficiencies in the breadth of genomic content offered.

These educational weaknesses are associated with difficulties in applying genomic knowledge effectively in clinical settings, which can compromise patient care and decision-making. Previous research has identified several strategies to address these educational gaps and enhance genomics education in nursing curricula. These strategies include the integration of genomics modules from the early stages of nursing education, the use of case-based learning and clinical simulations to apply genomic knowledge in real-world contexts, the involvement of genetic specialists in delivering lectures and hands-on workshops (Sharoff 2015; Tully et al. 2020; Zureigat et al. 2022) and even WhatsApp-based educational programs (Ceylan et al. 2024). Additionally, continuing education programs for practicing nurses are considered essential for keeping them up to date with the latest advancements in genomics, ensuring that they are better equipped to incorporate genomic knowledge into patient care and also in nursing research (Barbato et al. 2019). These strategies aim not only to improve theoretical understanding but also to build confidence and practical competence among nursing professionals in the application of genomics (Calzone et al. 2018a; Dewell et al. 2024).

Despite strategies to integrate genomics into nursing curricula, the research in genomic nursing field also identifies numerous barriers to the integration of genomics into nursing curricula. These barriers include insufficient resources, such as a lack of qualified faculty with expertise in genomics, and the limited time available within the already crowded nursing curriculum to adequately address complex genomic topics (Hines-Dowell et al. 2024; Parviainen et al. 2023). Additionally, many educators and healthcare professionals report low levels of confidence and knowledge in genomics, which can impede their ability to effectively teach the subject (Barbato et al. 2019; Mathis 2022; Read and Ward 2016; Smania et al. 2022). Furthermore, there is often no standardized approach to the core genomic content that should be included in nursing programs, leading to variability in the depth and breadth of genomics education across different institutions, as shown in this study.

These challenges underscore the need for systemic changes to overcome both structural and pedagogical obstacles, ensuring the comprehensive inclusion of a genomic knowledge matrix in nursing education and an early integration of genomic content at all levels of nursing education is crucial to ensure that future nurses recognize the importance of genomics in care delivery and research (Regan et al. 2019; Schluter 2023).

Our findings reveal significant gaps in the integration of genomic content within nursing programs, a concern that becomes more pressing when compared to the education provided to other healthcare professionals. While physicians often receive more comprehensive training in genomics, nursing education lags behind, limiting nurses’ ability to engage with genomic healthcare effectively. This disparity raises important questions about how genomics is being introduced in our country and underscores the urgent need for curricular reform in nursing education. Additionally, the growing role of genetic counselors, who are essential for interpreting genetic tests and guiding patients, highlights the need for interdisciplinary collaboration (Costa et al. 2024; Guimaraes et al. 2024; Paneque et al. 2022, 2023). In Portugal, a master’s degree in genetic counseling is already available, reflecting a recognition of the importance of specialized training in this field. This program includes courses such as Genetic Counseling Principles and Techniques, Clinical Molecular Genetics and Bioethics and Genetics, which provide extensive training in both clinical and psychosocial genomics. In contrast, nursing programs have not yet fully integrated such comprehensive genomic education. To ensure that nurses can work effectively alongside other healthcare professionals and contribute to genomic healthcare, it is crucial to revise nursing curricula to include both foundational genomics and its clinical applications. Such reform will better equip nurses to actively participate in interdisciplinary care teams and improve patient outcomes in an era increasingly driven by personalized healthcare. Interprofessional collaboration has the potential to improve patient care, reduce costs, and enhance the overall quality of service, particularly when integrating emerging fields like genomics into clinical practice (Ersig et al. 2025). Collaboration among healthcare professionals becomes a key component not only in clinical settings but also within educational programs that prepare healthcare workers (Costa et al. 2024). To foster effective collaboration, educational strategies could include joint curricula that allow students from different disciplines, such as nursing, genetic counselling, and medicine, to learn together (Clary-Muronda and Smith 2024). These curricula could focus on core genomic concepts and their application in diverse clinical scenarios, helping students to understand both the theoretical and practical aspects of genomics. Furthermore, interprofessional workshops or simulation exercises could be employed to provide students with hands-on experience working together in teams (Zureigat et al. 2022). These workshops would enable future healthcare providers to collaborate in real-time, simulating situations where genomic knowledge and interprofessional teamwork are required. Additionally, implementing these strategies throughout the education process will not only build a foundation of genomic knowledge across disciplines but also ensure that healthcare professionals are well-prepared to apply this knowledge in patient care. By promoting interprofessional collaboration both in education and clinical practice, we can create healthcare teams capable of delivering more integrated and personalized care (Limoges et al. 2024).

Although the importance of genomics in nursing practice is well recognized, there remains a lack of comprehensive research in Portugal, particularly regarding its integration into nursing curricula. National studies addressing these gaps are notably absent, which presents a significant barrier to advancing nursing education in this critical area. In the context of precision healthcare, it is imperative to invest in targeted research and curricular enhancements to equip nurses with the competencies needed for genomics-informed, patient-centered care. By fostering a robust understanding of both the theoretical and practical aspects of genomics, future nurses will be better prepared to meet the evolving demands of clinical practice and contribute effectively to interdisciplinary healthcare teams.

This study provides a valuable overview of the current state of genomic content integration in Portuguese nursing curricula, highlighting significant gaps that warrant attention. In the context of precision healthcare, these findings underscore the need for ongoing evaluation of how genomics is incorporated into nursing education to ensure that future nurses are adequately prepared to meet evolving clinical demands.

Several limitations of this study must be acknowledged. The analysis relied on publicly available course descriptions, which may not fully capture the depth or scope of the genomic content delivered in nursing programs. Detailed learning materials, instructional methods, and actual teaching practices were beyond the scope of this research, which limits the ability to draw conclusions about the extent of genomic education provided. Additionally, the study did not consider clinical learning environments where students might apply genomic knowledge, potentially take advantage of essential experiential learning opportunities, such as genetic counselling or family history collection. Future research could address these limitations by incorporating qualitative methods such as interviews with faculty and focus groups with curriculum developers. These approaches would provide deeper insights into the rationale behind curricular choices and the extent to which genomic content is intentionally integrated into nursing education. Additionally, further investigation is needed to explore the perspectives of nurses working in genetic healthcare settings regarding the additional education they feel would enhance their practice. Understanding these educational needs could inform the development of targeted educational strategies that bridge existing gaps in genomics nursing education. Moreover, the findings are specific to nursing programs in Portugal, which may limit their generalizability to other educational contexts.

Further recommendations arise from the findings of this study. To address the identified gaps, nursing programs should prioritize the integration of comprehensive genomic content throughout the curriculum. This includes ensuring that core courses, particularly those in nursing practice, psychosocial care, and ethics, incorporate relevant genomic principles. Developing standardized guidelines for the inclusion of genomic content could help reduce variability across programs and ensure consistency in nursing education. Moreover, nursing regulatory bodies, higher education institutions, and professional organizations in Portugal could collaborate to establish policies supporting the integration of genomics into nursing curricula. One potential strategy could be the development of a genomic knowledge matrix that defines the minimum required genomic content for nursing programs, ensuring consistency across institutions. In addition, these bodies could collaborate to create accreditation standards that include genomic education as part of nursing program requirements.

Greater collaboration with genetic specialists and interdisciplinary teams can enhance the quality of education, providing nursing students with access to updated resources and expertise in genomics. In parallel with defining the genomic content that should be integrated into nursing curricula, it is equally important to establish and regulate the competencies that nurses must acquire in genomics. This process should leverage existing frameworks and guidelines developed in Europe, ensuring alignment with international standards and promoting consistency in the professional qualifications of nurses across different contexts. Nurses should also remain current with technological innovations in genomics, ensuring they are equipped to apply the latest advancements in clinical practice and deliver high-quality, genomics-informed care.