Translation, Validation, and Application of Indonesian Genetic Literacy Questionnaires for Medical Students

Background: Increasing relevance of genetics and molecular biology in medicine necessitates greater genetic literacy among healthcare workers. To assess the literacy level, a validated genetic literacy questionnaire is needed. Therefore, a standardised Indonesian-language genetic literacy questionnaire is essential. Aims: We aimed to translate and validate three genetic literacy questionnaires (PUGGS, iGLAS, and UNC-GKS) for use among Indonesian medical students. We then evaluated genetic literacy levels using one of the validated questionnaires. Methods: The PUGGS, iGLAS, and UNC-GKS questionnaires were translated into Indonesian and then reviewed by an expert panel for translational accuracy and conceptual appropriateness. Back-translation was performed to confirm validity. Initial Indonesian versions of the questionnaires underwent cognitive pre-testing with 12 undergraduate medical students. After refinements, the questionnaires were validated among 34 first- to third-year medical students. The Indonesian version of UNC-GKS questionnaire was then used to assess genetic literacy of 486 medical students comprising 228 preclinical medical students, 187 clerkships, and 71 residents. Results: The Indonesian versions of PUGGS (Cronbach's = 0.819) and UNC-GKS ( = 0.809) demonstrated good reliability, while iGLAS showed poor reliability ( = 0.315). Among the 486 students tested, 56% demonstrated moderate overall genetic literacy, and only 15.2% demonstrated good overall literacy. Basic genetic concepts were relatively well-understood with 54.3% having good literacy. On the contrary, gene variant's effects on health were poorly understood with only 9.7% having good literacy. Inheritance concepts were moderately understood with 24.9% having good literacy. Conclusion: The Indonesian translations of PUGGS and UNC-GKS are reliable tools for assessing genetic literacy among medical students. Using UNC-GKS, we observed predominantly moderate genetic literacy levels. Curriculum improvement to better integrate genetics education is essential to support its clinical applications.