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Schwartz L, Mackall MS, Arjunan A, Goodenberger M, Mills R, Ham C, Witherington S. Graduate training, credentialing, and continuing education to prepare genetic counselors for laboratory roles-Results of a national survey. J Genet Couns 2024. [PMID: 38339832 DOI: 10.1002/jgc4.1883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
Opportunities for genetic counselors to work in a variety of practice settings have greatly expanded, particularly in the laboratory. This study aimed to assess attitudes of genetic counselors working both within and outside of the laboratory setting regarding (1) the re-wording and/or expansion of key measures of genetic counselors' competency, including practice-based competencies (PBCs) and board examination, to include laboratory roles, (2) preparation and transferability of competencies developed in master's in genetic counseling (MGC) programs to different roles, (3) need of additional training for genetic counselors to practice in laboratory settings, and (4) preferred methods to obtain that training. An e-blast was sent to ABGC diplomats (N = 5458) with a link to a 29-item survey with 12 demographic questions to compare respondents to 2021 NSGC Professional Status Survey (PSS) respondents. Statistical comparisons were made between respondents working in the laboratory versus other settings. Among 399 responses received, there was an oversampling of respondents working in the laboratory (52% vs. 20% in PSS) and in non-direct patient care positions (47% vs. 25% in PSS). Most respondents agreed the PBCs were transferable to their work yet favored making the PBCs less direct patient care-focused, expanding PBCs to align with laboratory roles, adding laboratory-focused questions to the ABGC exam, and adding laboratory-focused training in MGC programs. Most agreed requiring post-MGC training would limit genetic counselors' ability to change jobs. Genetic counselors working in the laboratory reported being significantly less prepared by their MGC program for some roles (p < 0.001) or how the PBCs applied to non-direct patient care positions (p < 0.001). Only 53% of all respondents agreed that NSGC supports their professional needs and others in their practice area, and genetic counselors working in the laboratory were significantly less likely to agree (p = 0.002). These sentiments should be further explored.
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Affiliation(s)
- Lisa Schwartz
- Department of Biomedical Laboratory Sciences, The George Washington University, Ashburn, Virginia, USA
| | - Mia S Mackall
- Clinical Genetic Services, Natera, Inc., Austin, Texas, USA
| | - Aishwarya Arjunan
- Department of Medical Affairs, GRAIL, LLC., Menlo Park, California, USA
| | - McKinsey Goodenberger
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, Minnesota, USA
| | - Rachel Mills
- MS Genetic Counseling Program, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Chloe Ham
- MD Program, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sarah Witherington
- Oncology Genetic Services, BioReference Health, LLC, Elmwood Park, New Jersey, USA
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Cragun DL, Hunt PP, Dean M, Zierhut H, Kaphingst K, Resnicow K. Creation and beta testing of a "choose your own adventure" digital simulation to reinforce motivational interviewing skills in genetic counseling. J Genet Couns 2024; 33:15-27. [PMID: 37950577 DOI: 10.1002/jgc4.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
Standardized patients and/or role-playing are commonly used for practicing genetic counseling (GC) skills. Use of digital simulation, incorporating gamification elements, would require fewer resources to sustain than standardized patients. This manuscript reports steps taken and the lessons learned from creating a digital "Choose your own adventure" simulation in which students select preferred dialog for a genetic counselor who is seeing an adult patient to discuss genetic testing for the known pathogenic variant that caused familial adenomatous polyposis (FAP) in their father. The case has three endings, one of which is attained by selecting options that are mostly consistent with motivational interviewing counseling techniques. We conducted a preliminary evaluation of our beta version among nine GC students and one educator using a survey to assess acceptability and appropriateness as well as to elicit open-ended feedback. All participants agreed or strongly agreed with statements indicating the case was acceptable, appropriate, and fun. Users particularly appreciated the immediate feedback given throughout the case simulation. Many users wanted more options to select from and listed various other recommendations, including several which would require substantial resources to implement.
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Affiliation(s)
- Deborah L Cragun
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | | | - Marleah Dean
- Department of Communication, University of South Florida, Tampa, Florida, USA
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA
| | - Kimberly Kaphingst
- Department of Communication, University of Utah, Salt Lake City, Utah, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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Epstein R, Fuerstman L, Heidlebaugh A, Schiller J, Zayhowski K. Experiences of genetic counseling students with disabilities and chronic illnesses: A qualitative study. J Genet Couns 2023; 32:1161-1173. [PMID: 37194122 DOI: 10.1002/jgc4.1726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/21/2022] [Accepted: 04/18/2023] [Indexed: 05/18/2023]
Abstract
While many patients with disabilities or chronic illnesses are served by genetic counselors, little effort has been made to promote the inclusion of individuals with disabilities and chronic illnesses as professionals in the genetic counseling field. Genetic counselors with disabilities and chronic illnesses have reported insufficient support from their colleagues throughout all stages of their professional journeys, but there is a lack of research exploring these challenges. To gain an understanding of the experiences of this community during graduate training, we conducted semi-structured interviews with 13 recent graduates of genetic counseling programs who identify as having a disability or chronic illness. Questions explored various aspects of the graduate school experience including challenges, strengths, relationships, disclosure, and accommodations. Qualitative thematic analysis of interview transcripts resulted in six themes: (1) decisions around disclosure are complex, (2) interactions with others contribute to feeling misunderstood, (3) the high-performance culture in graduate programs makes it challenging to meet personal needs, (4) interpersonal relationships provide support, (5) the accommodation process is often disappointing, and (6) lived experiences are valuable to patients. This study reveals opportunities to better support genetic counseling students with disabilities and chronic illnesses through strengthening inclusion efforts, shifting away from ableist ideologies, and promoting more flexible training options.
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Affiliation(s)
- Rachel Epstein
- Department of Graduate Medical Sciences, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | | | - Alexis Heidlebaugh
- Autism & Developmental Medicine Institute, Geisinger, Danville, Pennsylvania, USA
| | - Julia Schiller
- Department of Graduate Medical Sciences, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Kimberly Zayhowski
- Department of Obstetrics and Gynecology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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Spencer-Hintze M, Wusik K, Yager G, He H, Caldwell S, Atzinger C. Creation and initial validation of a genetic counseling supervisory self-efficacy scale. J Genet Couns 2023; 32:1018-1031. [PMID: 37138448 DOI: 10.1002/jgc4.1709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 02/28/2023] [Accepted: 03/12/2023] [Indexed: 05/05/2023]
Abstract
Fieldwork supervision is the "signature pedagogy" for training genetic counseling students, ensuring that students have the experience necessary to become minimally competent genetic counselors. According to the National Society of Genetic Counselors 2022 Professional Status Survey, roughly 40% of genetic counselors serve as supervisors for genetic counseling graduate students. Despite fieldwork supervision being essential for training, there are currently no validated supervision skill assessment tools for genetic counseling fieldwork supervisors to use for professional development. While a self-efficacy scale for genetic counselors currently exists, a comprehensive self-efficacy scale for genetic counseling supervision skills does not. The purpose of the study was to develop and validate a genetic counseling supervisory self-efficacy scale (GCSSES). This study was comparative, quantitative, and cross-sectional, with data collected via an online questionnaire which assessed supervision self-efficacy (95 items), derived from 154 published GC supervision competencies, demographics (5), experience (9), and supervisory development (18), using the Psychotherapy Supervisory Development Scale (PSDS). A total of 119 board-certified genetic counselors completed the survey. Factor analysis eliminated 40 items due to insufficient factor loading, and item-item correlation eliminated one item with elevated inter-item correlation, leaving 54 items on the finalized GCSSES. Exploratory factor analysis derived four GCSSES factors, which accounted for 65% of the variance in the scale: (a) Goal Setting, Feedback, and Evaluation; (b) Complex Aspects of Supervision; (c) Conflict Resolution; and (d) Working Alliance. Preliminary analyses show the GCSSES has high reliability and internal consistency (Cronbach's alpha = 0.99). Positive correlations between experience variables and supervisory self-efficacy were identified. A 54 item GCSSES was developed by this study. The GCSSES may serve as a tool for genetic counseling supervisors and graduate programs to assess skills, monitor professional development, and target training. A genetic counseling supervisory self-efficacy scale can also be used in future studies regarding training of genetic counseling supervisors.
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Affiliation(s)
- MacKenzie Spencer-Hintze
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Katie Wusik
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Geoffrey Yager
- College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, Ohio, USA
| | - Hua He
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sarah Caldwell
- Genetics, Baptist Health System-Lexington, Lexington, Kentucky, USA
| | - Carrie Atzinger
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Keller H, Wusik K, He H, Yager G, Atzinger C. Further validation of the Genetic Counseling Self‐Efficacy Scale (GCSES): Its relationship with personality characteristics. J Genet Couns 2019; 29:748-758. [DOI: 10.1002/jgc4.1202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Haley Keller
- Division of Human Genetics Cincinnati Children’s Hospital Medical Center Cincinnati OH USA
- University of Cincinnati Cincinnati OH USA
| | - Katie Wusik
- Division of Human Genetics Cincinnati Children’s Hospital Medical Center Cincinnati OH USA
| | - Hua He
- Division of Human Genetics Cincinnati Children’s Hospital Medical Center Cincinnati OH USA
| | | | - Carrie Atzinger
- Division of Human Genetics Cincinnati Children’s Hospital Medical Center Cincinnati OH USA
- Department of Pediatrics College of Medicine University of Cincinnati Cincinnati OH USA
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