BRIEF RESEARCH REPORT article
Front. Genet.
Sec. ELSI in Science and Genetics
Volume 16 - 2025 | doi: 10.3389/fgene.2025.1692703
Building capability for clinician-led genomic change: insights from use and nonuse of a theory-informed model for change
Provisionally accepted
- 1Melbourne Genomics Health Alliance, Parkville, Australia
- 2Murdoch Children's Research Institute, Parkville, Australia
- 3The University of Melbourne Department of Paediatrics, Parkville, Australia
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Genomics is relevant to the practice of diverse medical specialties. However, integrating genomics into these specialties requires complex interventions to promote adoption by clinicians and organizational (service and hospital) re-design. Clinicians wanting to 'champion' use of genomics rarely have experience in leading complex interventions. A practical evidence-and theory-informed model for change (M4C) designed for clinicians could increase likelihood of success of clinician-led complex practice change interventions. No such model could be identified, so we drew on three existing frameworks which collectively met our selection criteria to develop one. A case study approach was chosen to understand use of the M4C by clinicians leading three clinical change projects across hospitals. Informed by the COM-B system, we provided a toolkit and expert coaching to support use of the M4C. Mixed-methods data was collected: toolkit access; review of expert team notes; evaluation reports; focus groups and interviews. Coaching in all aspects of the M4C was provided, with clinicians particularly valuing coaching in action research and community engagement. Despite theoretical alignment of our strategies to promote adoption of the M4C, only 5/37 team members accessed the toolkit. Although clinicians did not independently engage with the M4C, they did embrace the concepts within it through coaching, with the expert team noting behavior change e.g. in engagement, leading to changes in project implementation. Access to expert support embedded within organizational (hospital) structures is needed to support clinicians to lead the system re-design required to incorporate innovations like genomics in healthcare.
Keywords: Genomics, behavior change, physician, coaching, Qualitative, complex intervention, change
Received: 26 Aug 2025; Accepted: 22 Oct 2025.
Copyright: © 2025 Martyn, Clarke, Do, Dawson-McClaren and Gaff. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Melissa Martyn, melissa.martyn@mcri.edu.au
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