From leadership research to district action: Building a genomics-capable cancer workforce: a competency-based framework for education and training in precision oncology

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: review-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Summary Background The Lancet Oncology Commission on cancer genomics and precision oncology identified workforce capability, education, and training as major constraints to equitable implementation. As genomic and multi-omic technologies become integrated into cancer care, structured approaches are needed to define competencies across the multidisciplinary workforce. Methods The Core Competency Framework for Precision Oncology was developed using a narrative review and iterative expert-informed framework development process. Competency frameworks, professional standards, policy guidance, organisational reports, and educational literature relevant to genomic medicine, precision oncology, and workforce development were identified through purposive searches of organisational repositories, peer-reviewed literature, and reference list screening between January 2025 and March 2026. Search terms included combinations of “precision oncology”, “cancer genomics”, “genomic medicine”, “competenc∗”, “education”, “training”, and “workforce”. Competency domains, role functions, progression structures, and implementation concepts were extracted, compared, and synthesised into shared and role-specific competencies mapped across foundational, intermediate, and advanced levels. The framework was refined through iterative multidisciplinary expert consultation involving contributors to the Lancet Oncology Commission. Findings The framework defines three components; shared core competencies applicable across professional groups; role-specific competencies aligned with functions across the precision oncology pathway; and a progression model reflecting increasing interpretive complexity, autonomy, accountability, and leadership. An associated tiered workforce model links competencies to service contexts and levels of practice, supporting distribution of genomic responsibilities while preserving escalation pathways and governance structures. The framework is designed to be adaptable across professions, health systems, and resource settings. Interpretation This framework provides an implementation-oriented structure to support workforce development, curriculum design, continuing professional education, role mapping, competency assessment, and service planning in precision oncology. Its application may support scalable, equitable, and sustainable integration of genomics into routine cancer care. Funding No specific funding was received for this work. Keywords: Precision medicine, Genomics education, Health workforce, Competency framework, Clinical competence, Cancer

Study methods

The Core Competency Framework for Precision Oncology was developed using a targeted narrative review and iterative expert-informed framework development process.28, 29, 30 A narrative approach was selected because the objective was to interpret and synthesise heterogeneous evidence relevant to workforce capability, competency development, and implementation of precision oncology across professional groups, rather than to aggregate homogeneous empirical studies. The evidence base includes substantial grey literature produced by professional bodies, regulators, health systems, and international organisations. Narrative reviews are appropriate where questions are broad, conceptually oriented, and require interpretive synthesis across multiple evidence types.28

Limitations

Several limitations should be acknowledged. The framework was developed through an iterative expert-informed framework development process and has not undergone external validation or prospective evaluation. The professional groupings within the framework are simplified to support global applicability and may not capture all relevant roles, hybrid positions, or country-specific scopes of practice. The framework does not prescribe curriculum content, training duration, assessment tools, credentialing standards, or regulatory requirements; these must be developed within local educational and governance systems. Although the framework is intended to support multi-omic precision oncology, many existing competency sources remain genomics-focused. Periodic refinement will be needed as transcriptomic, proteomic, liquid biopsy, AI-assisted, and computational oncology applications mature to ensure alignment with technological, clinical, and workforce developments. Because the framework was developed through interpretive synthesis, some domains, particularly those relating to multi-omic integration, liquid biopsy, AI-assisted interpretation, computational oncology, and workforce stratification, were constructed by integrating source concepts with expert-informed judgement rather than being directly reproduced from existing competency frameworks. Finally, implementation in resource-constrained settings will depend on infrastructure, specialist support, treatment access, and policy investment beyond the scope of the framework itself.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Amanda Drury; Yosr Hamdi; Nicola Mulder; Jens Rueter; Lindsey Kelley; Kathleen Blazer; Raffaella Casolino; Stacy W Gray. Building a genomics-capable cancer workforce: a competency-based framework for education and training in precision oncology. eClinicalMedicine (2026-08-10). https://doi.org/10.1016/j.eclinm.2026.104142

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.