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Hart TR, Ahmed S, Byrne R, Sulmonte LAG, Williams LM, McWalter K. Shifts in the genetic counseling workforce highlight a need for laboratory fieldwork experience for genetic counseling trainees. J Genet Couns 2023; 32:1194-1199. [PMID: 37974548 DOI: 10.1002/jgc4.1817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 08/31/2023] [Accepted: 10/04/2023] [Indexed: 11/19/2023]
Abstract
As the genetic counseling workforce experiences an increase in genetic counselors (GCs) in non-direct patient care roles, it is essential that genetic counseling students are trained in these settings. The Accreditation Council for Genetic Counseling (ACGC) standards regarding laboratory exposure have evolved over time, but laboratory fieldwork experience continues to remain a suggestion for a diversified setting. As more trainees seek laboratory exposure and an increasing number of new graduates opt for laboratory positions, learning firsthand from GCs employed in this setting is a valuable experience that should be available to all trainees. Historically, laboratory educational offerings consisted of onsite rotations for students from local training programs focused on understanding diagnostic testing methodologies and shadowing GCs. Through the years, multiple laboratories have expanded their curriculums to expose students to variant interpretation and report writing, research, client services, marketing, and product development. Alongside the growth of laboratory rotation curriculum grew opportunities for remote rotations. Prior to the COVID-19 pandemic, GeneDx offered remote education options including both individualized rotations and a webinar series. These offerings expanded due to the pandemic coupled with increased demand and have positive implications for future trainees. The evolution of the rotation also included conscious efforts to incorporate diversity, equity, and inclusion into the curriculum, as well as to improved accessibility to laboratory rotations. Notably, there are inconsistencies in laboratory rotation curricula and requirements, and a standardized evaluation and definition of competencies are lacking. ACGC guidelines defining common core concepts required from laboratory rotations would help ensure students receive an equitable minimum skill set, regardless of training site. Stakeholders in GC education should collaborate to enhance the experiences of future trainees and provide the skills needed by a workforce shifting to remote work and increasing numbers of non-direct patient-facing laboratory roles. Drawing upon our years of experience, GeneDx aims to actively contribute to discussions around these questions. Alongside other laboratories and training programs, we hope to foster further innovation surrounding the training needs of our future GC colleagues. This educational innovation illustrates an approach to helping genetic counseling students achieve competencies related to lab-based roles.
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2
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Hassel NC, Gilbert AD, Bejjani BA. COVID-19 and the adaptive evolution of genetic counseling. J Genet Couns 2022; 31:832-835. [PMID: 35304788 PMCID: PMC9088315 DOI: 10.1002/jgc4.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/12/2022] [Accepted: 02/27/2022] [Indexed: 11/09/2022]
Abstract
Emerging diseases such as the Coronavirus Disease (COVID-19) have exposed severe weaknesses in the United States and global health. Healthcare systems have struggled and are still severely challenged and strained by this pandemic. It is clear that additional resources are needed to support healthcare providers in managing this and future pandemics. Genetic counselors can play an important supporting role in this fragile ecosystem because their comprehensive and broad training makes them uniquely qualified to meet many of the challenges that arise when healthcare workers and patients are faced with novel diseases. This paper describes the recent involvement of a telegenetic counseling company (Metis Genetics) in communicating and explaining COVID-19 serum antibody results to patients and physicians. This experience demonstrates how genetic counselors may be called upon to play a vital supporting role in the management of infectious disease pandemics. From May 2020 to July 2020, our genetic counseling telegenetics team was asked to provide support to more than 1,580 patients who underwent serum COVID-19 antibody testing and to educate their healthcare providers on the performance properties of this new test. The genetic counselors were able to utilize their expertise to convey test results, information on Center for Disease Control and Prevention (CDC) recommendations, COVID-19 fact-based evidence, to provide psychological support and reassurance to patients, and to respond to providers questions about the test. This experience suggests that the genetic counselors' skillset that has allowed the profession to continuously evolve can also be used in the management of pandemics by communicating directly with the public, supporting other healthcare workers, and assisting individual patients and families navigate the many medical and psychological issues caused by such events.
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Affiliation(s)
| | - Adel D Gilbert
- Metis Genetics, Addison, Texas, USA.,Wake Forest University Graduate School of Arts and Sciences, Winston-Salem, North Carolina, USA
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Wagner NE, Witherington S, Waldman L, Ryan L, Hardy MW. Analysis of the reported use of practice-based competencies by North American genetic counselors during the COVID-19 pandemic. J Genet Couns 2021; 30:1257-1268. [PMID: 34523197 PMCID: PMC8657356 DOI: 10.1002/jgc4.1504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 01/26/2023]
Abstract
Genetic counseling services changed due to the COVID-19 pandemic. Many genetic counselors (GCs) moved from in-person to telehealth services. Others were redeployed by choice or necessity, using their expertise to provide COVID-19 care and education. For some, their employment status changed due to budgetary constraints or decreasing referrals. This study surveyed North American GCs to assess the relative use of genetic counseling Practice-Based Competencies (PBCs) as a proxy for the skills used during the first wave of the pandemic, whether GCs were in their current role or in new or adjusted roles. A secondary aim was to determine whether GCs believe their training should be refocused in view of the workforce shifts posed by the pandemic. The survey comprised closed- and open-ended questions and was completed in full by 97 respondents. The study population was representative of the general genetic counseling workforce in terms of gender, race/ethnicity, age, and practice area when compared to the National Society of Genetic Counselors 2020 Professional Status Survey. Most participants (97.9%) indicated that the COVID-19 pandemic resulted in a change to their work, and 89.7% used at least one PBC at a different frequency than before the pandemic. The most significant change was the adaptation of genetic counseling skills for varied service delivery models: 83.5% of respondents indicated that their roles and responsibilities moved to a remote setting and/or utilized telehealth. The majority of participants felt competent using the PBCs during the pandemic. Major themes that emerged from the qualitative data were as follows: (a) adaptation of service delivery, (b) translation of genetic counseling skills, and (c) provision of psychosocial support. This study highlights practice changes for GCs due to the COVID-19 pandemic as well as the increased use of, and need for focused training in, varied service delivery models.
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Affiliation(s)
- Naomi E. Wagner
- Ocular Genomics Institute, Massachusetts Eye and EarBostonMAUSA
- InvitaeSan FranciscoCAUSA
| | - Sarah Witherington
- Quest Diagnostics, IncSecaucusNJUSA
- BioReference LaboratoriesElmwood ParkNJUSA
| | - Larissa Waldman
- Department of Molecular GeneticsFaculty of MedicineUniversity of TorontoCanada
- Cancer Genetics and High Risk Program, Sunnybrook Odette Cancer CentreCanada
| | | | - Melanie W. Hardy
- Department of Human GeneticsEmory University School of MedicineAtlantaGAUSA
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Higgs E, Dagan-Rosenfeld O, Snyder M. Adapting skills from genetic counseling to wearables technology research during the COVID-19 pandemic: Poised for the pivot. J Genet Couns 2021; 30:1269-1275. [PMID: 34580951 DOI: 10.1002/jgc4.1509] [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: 02/15/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/10/2022]
Abstract
Genetic counselors have shown themselves to be adaptable in an evolving profession, with expansion into new sub-specialties, various non-clinical settings, and research roles. The COVID-19 pandemic caused a sudden and drastic shift in healthcare priorities. In an effort to contribute meaningfully to the COVID-19 crisis, and to adapt to a remote- and essential-only research environment, our workplace and thus our roles pivoted from genomics research to remote COVID-19 research using wearables technologies. With a deep understanding of genomic data, we were quickly able to apply similar concepts to wearables data including considering privacy implications, managing uncertain findings, and acknowledging the lack of ethnic diversity in many datasets. By sharing our own experience as an example, we hope individuals trained in genetic counseling may see opportunities for adaptation of their skills into expanding roles.
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Affiliation(s)
- Emily Higgs
- Department of Genetics, Stanford University, Stanford, CA, USA
| | | | - Michael Snyder
- Department of Genetics, Stanford University, Stanford, CA, USA
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5
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Amendola LM, Golden-Grant K, Scollon S. Scaling Genetic Counseling in the Genomics Era. Annu Rev Genomics Hum Genet 2021; 22:339-355. [PMID: 33722076 DOI: 10.1146/annurev-genom-110320-121752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The development of massively parallel sequencing-based genomic sequencing tests has increased genetic test availability and access. The field and practice of genetic counseling have adapted in response to this paradigm-shifting technology and the subsequent transition to practicing genomic medicine. While the key elements defining genetic counseling remain relevant, genetic counseling service delivery models and practice settings have evolved. Genetic counselors are addressing the challenges of direct-to-consumer and consumer-driven genetic testing, and genetic counseling training programs are responding to the ongoing increased demand for genetic counseling services across a broadening range of contexts. The need to diversify both the patient and participant groups with access to genetic information, as well as the field of genetic counseling, is at the forefront of research and training program initiatives. Genetic counselors are key stakeholders in the genomics era, and their contributions are essential to effectively and equitably deliver precision medicine.
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Affiliation(s)
- Laura M Amendola
- Department of Medicine, Division of Medical Genetics, University of Washington Medical Center, Seattle, Washington 98195, USA; ,
| | - Katie Golden-Grant
- Department of Medicine, Division of Medical Genetics, University of Washington Medical Center, Seattle, Washington 98195, USA; ,
| | - Sarah Scollon
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA;
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Cho MT, Guy C. Evolving Roles of Genetic Counselors in the Clinical Laboratory. Cold Spring Harb Perspect Med 2020; 10:cshperspect.a036574. [PMID: 31570375 DOI: 10.1101/cshperspect.a036574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Genetic counselors (GCs) possess several core competencies that provide direct benefit in the clinical laboratory setting. Communication with clients about complex information such as test methodology or results and the skills of facilitation and translation of complex information were recognized as important skills early in the establishment of GCs in laboratories. The clinical expertise of GCs serves as the background and experience from which they facilitate complex laboratory cases. Early roles for GCs in the laboratory also included result reporting, case management, and test development. The scope of roles has broadened to include management, business development, education, telemedicine, research, and variant interpretation. With increasing value being placed on genetic counseling skills both in and outside of a clinical laboratory, the roles and positions of GCs will likely continue to expand.
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Affiliation(s)
- Megan T Cho
- National Human Genome Research Institute, Bethesda, Maryland 20894, USA
| | - Carrie Guy
- Quest Diagnostics, Secaucus, New Jersey 07094, USA
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Burns K, Swanson A, Hoskovec J, Leonhard J, Hahn S, Stein QP. Genetic counseling job market in the United States and Canada: An analysis of job advertisements 2014–2016. J Genet Couns 2019; 28:869-877. [DOI: 10.1002/jgc4.1129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Kaitlyn Burns
- Department of Genetic Counseling Augustana University Sioux Falls South Dakota
- Sanford Health Sioux Falls South Dakota
| | - Amy Swanson
- Graduate Program in Genetic Counseling Northwestern University Chicago Illinois
| | - Jennifer Hoskovec
- Department of Obstetrics, Gynecology, and Reproductive Sciences McGovern Medical School, UTHealth Houston Texas
| | - Jennifer Leonhard
- Department of Genetic Counseling Augustana University Sioux Falls South Dakota
- Sanford Health Sioux Falls South Dakota
| | | | - Quinn P. Stein
- Department of Genetic Counseling Augustana University Sioux Falls South Dakota
- Sanford Health Sioux Falls South Dakota
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8
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Dwarte T, Barlow-Stewart K, O’Shea R, Dinger ME, Terrill B. Role and practice evolution for genetic counseling in the genomic era: The experience of Australian and UK genetics practitioners. J Genet Couns 2018; 28:378-387. [DOI: 10.1002/jgc4.1053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/26/2018] [Accepted: 10/20/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Tanya Dwarte
- Discipline of Genetic Medicine, Faculty of Medicine and Health, Northern Clinical School; University of Sydney, St Leonards; NSW Australia
| | - Kristine Barlow-Stewart
- Discipline of Genetic Medicine, Faculty of Medicine and Health, Northern Clinical School; University of Sydney, St Leonards; NSW Australia
| | - Rosie O’Shea
- Discipline of Genetic Medicine, Faculty of Medicine and Health, Northern Clinical School; University of Sydney, St Leonards; NSW Australia
| | - Marcel E. Dinger
- Kinghorn Centre for Clinical Genomics; Garvan Institute of Medical Research; Darlinghurst NSW Australia
- St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney; Kensington NSW Australia
| | - Bronwyn Terrill
- Kinghorn Centre for Clinical Genomics; Garvan Institute of Medical Research; Darlinghurst NSW Australia
- St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney; Kensington NSW Australia
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Baty BJ. Genetic counseling: Growth of the profession and the professional. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018. [DOI: 10.1002/ajmg.c.31601] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Bonnie J. Baty
- Department of Pediatrics, SOM 2C454University of Utah Health Sciences CenterSalt Lake City Utah
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10
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Genetic Counsellors and Private Practice: Professional Turbulence and Common Values. J Genet Couns 2017; 27:782-791. [DOI: 10.1007/s10897-017-0201-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 12/17/2017] [Indexed: 02/04/2023]
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11
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Callanan N, Grosse KR. Time Flies: an Examination of Genetic Counselor Professional Development: Introduction to Special Issue on Genetic Counselor Development. J Genet Couns 2016; 25:611-6. [PMID: 27256337 DOI: 10.1007/s10897-016-9972-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/10/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Nancy Callanan
- University of North Carolina at Greensboro, Greensboro, NC, USA.
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