Objective: Descriptive three-year comparison of one pre-licensure cohort of baccalaureate nursing students' genomic knowledge, attitude and comfort level. Methods: Two analyses were of interest, utilizing the same survey instrument, Genetics/Genomics Literacy Assessment (GGLA): 1) Comparison of pre vs. post intervention on the sophomore (2nd year) class and 2) Retention of the information through junior (3rd year) and senior year (4th year). Two analyses were of interest: 1) Comparison of pre-class vs. post-class assessment on sophomore [2nd year] students and 2) Retention of the information through junior [3rd year] and senior year [4th year]. Results: For the total score variable [retention of genomic knowledge over time] data was sophomore vs junior vs senior means of 7.1 vs. 6.9 vs. 8.7, p < .001 showing maintenance from sophomore (post-class assessment) to junior year with an increase in the senior year score for the cohort of students. Comparison of pre-class vs. post-class on the sophomore class resulted in statistically significant differences demonstrating higher knowledge after class. Enhancement of confidence, perceptions and attitude regarding genomics was evident with comparison of pre-class vs post-class and overtime after taking foundational course. Overall, data showed that students felt that nurse educators need more confidence in teaching and explaining as well as in patient advocacy. Conclusions: Promoting knowledge and practice integration of universal genomic health requires healthcare professionals, educators and students be knowledgeable and cognizant of their participation to advance client health outcomes.