Should I Perform Genetic Testing? A Qualitative Look into the Decision Making Considerations of Religious Israeli Undergraduate Students

Educational tools support informed decision-making for genetic carrier screening in a heterogenic Israeli population

Reproductive genetic carrier screening (RGCS) aims to provide couples with information to make informed decisions. Since 2013, the Israeli Carrier Screening Program has been offered routinely and free of charge to all Israelis of reproductive age, personalized based on religion, ethnicity, and village/tribe where a disorder is frequent. This study evaluated the impact of two educational tools on an informed choice on RGCS uptake and satisfaction with counselling within a heterogeneous population in northern Israel. Participants from diverse sociodemographic population groups were randomly assigned to watch an animated film, read a booklet conveying the same information, or receive no information before counselling for RGCS, and asked to complete pre- and post-counselling questionnaires. A higher informed-decision rate was demonstrated in the film (n=93/141, 66%) and booklet (n=88/131, 67%) groups vs. the non-intervention group (n=62/143, 43%) (P<0.001), assessed by the Multidimensional Measure of Informed Choice. Multivariate logistic regression analysis revealed that allocation to an intervention group, Jewish ethnicity and higher education level, best predicted informed choice. Most participants expressed high levels of satisfaction with the counselling process, regardless of group assignment. While only a minority of participants reported seeking information prior to visiting the clinic, the pre-counselling information interventions were well accepted. Pre-counselling self-learning educational tools should be promoted, easily available, and adjusted linguistically and culturally to targeted populations, to avoid unwanted "automatic" compliance of tested individuals and maximize the potential of informed decision-making. Our study can be applied to other countries where majority and minority ethnic groups access genetic services.

Drama as a Powerful Tool to Enrich Socio-scientific Argumentation

Socio-scientific argumentation (SSA) is increasingly being recognized as a key aspect of scientific literacy. Much of the reason for this is that this skill is crucial for helping students to become active participants in twenty-first-century democratic societies in which the construction of informed and critical views of socio-scientific issues (e.g. climate change, COVID-19 vaccination, genetic testing) plays a fundamental role. The problem is that instructors rarely give students explicit and research-based opportunities to enrich their SSA skills. Therefore, the aim of this study was to provide evidence that drama can be used as a platform to enrich argumentation in genetic testing. The data were derived from the written responses and the audio recordings of seventy-six university students (37 females and 39 males, 16-29 years old) in Colombia during a complete drama-based teaching-learning sequence (TLS) supervised by the same instructor. The outcomes suggest that the sequence can be used to enrich argumentation in genetic testing as it effectively provided participants with explicit opportunities to produce both arguments and counterarguments about the controversy whether the use of genetic tests among people should be encouraged. This study contributes to the literature on SSA in science education by demonstrating that drama is a promising tool to enhance argumentation about science-based social issues.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10763-022-10320-3.

Perspectives on facilitating whole exome sequencing for international patients at Mayo Clinic

Whole exome sequencing (WES) has become a fundamental component of genetic evaluation and diagnosing rare genetic diseases. This test is now offered to patients from a wide variety of cultural backgrounds and in various clinical and research settings. This commentary is a reflection of one group of clinical genetic counselors' experiences in facilitating WES for patients who come from outside the United States for genetic evaluation and pursue WES. This patient population in our clinic primarily consists of individuals from the Middle East and presents recurrent logistical and counseling challenges. We aim to describe our international patient population, illuminate the challenges we have faced and illustrate how we have addressed these challenges.