Episode 13: Embedding Genomics Into Everyday Care — Part 2 with A/Prof Amy Nisselle

Episode SummaryGenomics is ready. But are our health systems, clinical teams, and education frameworks ready to support it at scale? In this second episode with A/Prof Amy Nisselle, host Alison Archibald explores what it actually takes to embed genomics into routine clinical practice — from the evolving role of genetic counsellors to AI-powered tools that are changing the way patients and clinicians learn.GuestA/Prof Amy Nisselle is a genomics education, research, and evaluation expert across Murdoch Children's Research Institute, the University of Melbourne, and the University of Queensland. With over 20 years in the field, Amy is one of Australia's leading thinkers on translating genomic science into clinical practice.What We CoverThe genetic counsellor as systems glue — Genetic counsellors aren't just patient-facing. They play critical roles as lab liaisons, result interpreters, educator-clinician bridges, and confidence builders for mainstream practitioners who need a trusted expert to call.The lab liaison role — A genetic counsellor embedded between the referring doctor and the laboratory can uplift poor referrals, triage test complexity, and ensure results are understood and acted on correctly. There aren't enough of them — but evidence shows they're highly cost-effective.The confidence ladder — Research shows doctors need to cross a confidence dip before genomics becomes routine. The solution isn't more lectures. It's foundational knowledge paired with real clinical exposure — workplace learning that makes genomics relevant right now, to this patient, today.Just start the conversation — A concept from SMA Australia advocate Julie Sini that resonated strongly with both Amy and Ali: GPs don't need to know everything. They just need to start the conversation and know who to call. That alone builds confidence over time.The clinician personas — Amy's PhD student Alice identified six types of mainstream clinician attitudes toward genomics: from the self-directed champion to the skeptical pragmatist. Understanding which type you're talking to changes how you design education entirely.AI in the genomics workflow — AI has a clear and growing role: summarising patient information, guiding decision-making through tools like Genetics Advisor, generating personalised education videos before consultations, and creating safe simulations for clinicians to practice genomic conversations. The key insight: AI handles the standardised content so humans can focus on the emotional and complex.What good genomic care looks like — Amy's answer is elegant: every clinician and every patient has the competence and confidence to engage with genomics as relevant to their role. Not uniform mastery — contextual capability. The rural GP who can order a test and know who to call. The patient who feels informed and comfortable with the choices they're making.Key Quote"Good genomic care is everyone being informed and making an informed decision — the clinician and the patient. I want them to have the competence and confidence to do genomics in the context relevant to them."