Mary Dunn, MSN, RN, NP-C, OCN, on the role of APPs in genetic testing

In this video, Mary Dunn, MSN, RN, NP-C, OCN, of the University of North Carolina, Chapel Hill, discusses the role of advanced practice providers (APPs) in germline and somatic genetic testing, including patient counseling, test ordering, result communication, and follow-up.

Dunn explains that the role of APPs in genetic testing can vary based on the practice setting and their responsibilities within the care team. However, she views APPs as valuable resources for initiating conversations about genetic testing, explaining the differences between germline and somatic testing, discussing why testing is recommended, reviewing the testing process, and ordering tests when appropriate. APPs can also help identify when patients would benefit from additional expertise from genetic counselors or other genetics specialists.

She emphasizes that genetic testing can provide important information for both treatment planning and familial cancer risk assessment.

“We should definitely be offering germline and somatic testing to patients in order to make informed discussions around their prognosis and treatment options,” Dunn says, highlighting the broader role of testing beyond simply identifying potential therapeutic targets.

She also discusses strategies for communicating genetic testing results, noting that positive results warrant particular care because they may cause anxiety and have implications for family members. She supplements conversations with written educational materials that patients can review after the visit and prefers to communicate positive results by telephone or during an in-person visit rather than solely through an electronic health record portal. This approach, she says, allows for a more nuanced discussion and gives patients an opportunity to ask questions and better understand the meaning of their results.