From classroom to clinic: analyzing the genomics competency gap across undergraduate students, graduate students, and practicing nurses in China

Genomics is increasingly integral to clinical care, spanning areas such as rare diseases, oncology, and pharmacogenomics. Nurses and nursing students play essential roles as frontline providers and educators. However, current evidence suggests a widespread lack of readiness. This study evaluates and compares genomics competency across undergraduate students, graduate students, and practicing nurses in China. A cross-sectional survey was conducted from September to October 2025 among 502 participants (136 undergraduates, 168 graduates, 198 practicing nurses) using the Chinese version of the Genetics and Genomics Nursing Practice Survey (GGNPS-CN). The overall mean genomics knowledge score was 9.51, with no significant differences observed across cohorts. In contrast, self-rated understanding showed notable differences among cohorts. The proportion of “excellent” or “good” ratings was highest among undergraduate students, followed by practicing nurses and then graduate students (p < 0.05). Notably, over one-quarter (25.3%) of respondents reported no formal genomics education in their curriculum. Despite similar knowledge levels, the three nursing cohorts showed a self-assessment bias in genomics. A tiered educational framework is proposed to address stage-specific needs: fostering metacognition in undergraduates, integrating research with practice in graduates, and enhancing ethical decision-making in practicing nurses.