Bridging the gap: understanding the perspective of healthcare professional students towards precision medicine in a Nigerian tertiary institution (a cross-sectional study) | BMC Medical Education

Study design

This descriptive, cross-sectional survey was conducted between January and March 2024 among healthcare professional students at the University of Nigeria Nsukka.

Study population, sample size, and inclusion criteria

This survey was carried out among 400–600 level healthcare professional students (Medical Laboratory Science, Nursing, Medicine, and Pharmacy) and who were attending the University of Nigeria, Nsukka. While the pharmacy students learn at the Nsukka campus, the other students are based at the Enugu campus of the university. The choice to focus on these three classes was based on the belief that they have been exposed to several medical concepts, including genetic variations and precision medicine, from basic medical sciences through their clinical years. At the time of this study, the university was running both the Bachelor of Pharmacy (BPharm) and the Doctor of Pharmacy (PharmD) programs, with the award of the BPharm degree ending with the students who were at their 500 level and the pioneer PharmD students at their 400 level. Only the medical students were at their 600 level because the Bachelor of Medicine, Bachelor of Surgery (MBBS) degree is a 6-year program. Only students who gave their informed consent to participate were included in the study.

A minimum sample size of 339 for a total population size of 2822 was determined via the Raosoft^® sample size online calculator, with a margin of error set at 5% and a confidence level set at 95%. However, to account for contingencies, a 10% nonresponse rate was added to the minimum sample size to obtain a final sample size of 373.

Study instrument and data collection procedures

A self-administered validated 33-item questionnaire, which was divided into five sections, was used for this study.

Section A of the study instrument collected the sociodemographic details of the respondents, such as their age, gender, department, year of study, place of residence, and religion. Questions concerning awareness of precision medicine, such as “Do you know what precision medicine is?” (yes or no), “If you have heard of precision medicine, where did you hear it from?”, and “If they have interest in a career involving research?” (yes or no), were also added to section A.

Section B comprises four items assessing respondents’ level of comfort with respect to their knowledge of genomic testing concepts, as adopted from a previous study [17]. The items were rated on a four-point Likert scale ranging from ‘not comfortable at all’ to ‘very comfortable’ with their knowledge.

In section C, respondents’ attitudes were evaluated via two of the three subscales from the Evidence-based Practice Attitude Scale Adapting Genome-informed Interventions (EBPAS-GII) [17, 18]. These subscales measured openness to new practices (four items) and the divergence between usual practice and research-based, academically developed genome-informed interventions (four items), with the latter being reverse-scored. Both subscales are rated on a four-point Likert scale ranging from ‘not at all’ to ‘to a very great extent’.

Section D was adopted from a previous study [19] and consisted of six items that assessed respondents’ perceptions of ethical considerations related to precision medicine rated on a four-point Likert scale from ‘not at all’ to ‘to a very great extent’.

The final section of the questionnaire consisted of four items adopted from a previous study [17] and was used to assess respondents’ perception of precision medicine education (PME). The items were equally rated on a four-point Likert scale ranging from ‘not at all’ to ‘to a very great extent’.

Data were collected via a hybrid format in which paper questionnaires were distributed among healthcare professional students who met the inclusion criteria in their classrooms before lectures and via their class WhatsApp groups with a structured online Google form. The students were approached while they were in their respective classes waiting for the next lecture. First, the purpose of the survey was conveyed to them, after which they were asked to declare their informed consent in writing and were subsequently asked to provide their most honest response to the questions with no recourse to external materials or influence. Additionally, the students were assured of the anonymity and confidentiality of their data. The completed questionnaires were collected, bagged, and sealed in a designated envelope. For the students who assessed the questionnaire via the online Google form, a brief description of the study objectives as well as the declaration of their informed consent was provided on the first page of the form, after which they were also asked to answer the questions with the utmost honesty. To enable adherence to the inclusion criteria, the Google form link was set to only a one-time response and sent to the class representatives of the respective classes, who made it available to only the class members in the official class WhatsApp groups. At the end of the study period, the Google form link was deactivated, and the data were downloaded and preserved in an Excel sheet.

Data analysis

All the collected data were coded, entered and cleaned via IBM (SPSS) Statistical Product and Service Solutions version 27. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to summarize all the study variables, whereas Pearson’s chi-square test was used to determine the associations between the sociodemographic characteristics and other outcome variables (level of comfort with knowledge, attitudes, and perception scores).

For comfortability with knowledge of the genomic testing concepts section, scores ranging from 1 (“not at all comfortable”) to 4 (“very comfortable”) were awarded to each response in the section, resulting in a maximum possible score of 16. The total score was computed by adding all the items, and then, a median score was used to categorize the students into high and low level of comfort with knowledge. Likewise, the attitude section was scored from 1 (“not at all”) to 4 (“to a great extent”) for all the items in the section. This gives a maximum possible score of 32. The items in the divergence subscale of this section (items 5 to 8) were all negative statements and were thus reverse scored. The sum of the awarded scores was obtained, and the median score was used to categorize the students into favorable and unfavorable attitudes.

Finally, the responses to the students’ perceptions of ethical considerations related to PM and PME were scored from 1 (“not at all”) to 4 (“to a great extent”) for all the items in both sections, with maximum possible scores of 24 and 16, respectively. The total score was computed, and a median score was used to categorize the students into positive and negative perceptions. All the statistical analyses were performed with the significance level set at p < 0.05.

Ethical approval

Ethical approval was obtained from the Health Research and Ethics Committee, Department of Clinical Pharmacy and Pharmacy Management, with reference number CPPM/HREC/24/UG/0032. Informed consent was sought from each participant, and there was no way of knowing who the respondents were because no personal identifying information was obtained. All information gathered was treated with the utmost confidentiality.