Embedding simulation in genetic counselor education from the first week of training: Learning outcomes, standardized clients, and students' satisfaction

Health professional educators routinely utilize simulation to prepare students for practice. However, there is little evidence to show whether simulation enhances learning for genetic counseling students. This study aimed to (i) develop simulation learning outcomes and standardized clients for genetic counselor student education and (ii) evaluate students' experiences of learning from face-to-face and virtual simulation in the first week of training in an Australasian master of genetic counseling program. Using the principles of co-design, eight experienced genetic counselors from across Australasia attended an online discussion and one-to-one meetings to develop simulation learning outcomes and build detailed authentic standardized clients. Six learning outcomes were identified: establishing an effective counseling relationship, eliciting information, assessing need, delivering difficult news and helping clients cope with complex emotions, effective communication and facilitating adaptation. Standardized clients were mapped to the learning outcomes and other requirements of the program. Between 2019 and 2022, 106 first year students participated in face-to-face or virtual simulation workshops with two standardized clients on Day 5 of their training. Following the experience, 103 students completed an anonymous survey using a modified version of a validated satisfaction with simulation scale (n = 49 face-to-face in 2019 and 2020 and n = 54 virtual in 2021 and 2022). Responses were analyzed using descriptive statistics and content analysis. Mean satisfaction overall was 95.9% (SD 3.5), 96.2 (SD 4.0) face-to-face, and 95.8 (SD 3.7) virtual. Overall, responses indicated that simulation-based learning and working with standardized clients was a valuable learning experience (100%), developed communication skills and created a sense of reality (99%). For a minority of participants (n = 4), the simulation was too challenging. Key learning related to consolidation of counseling skills, reflective practice, and preparation for clinical placement. In conclusion, exposing novice student genetic counselors to authentic clinical scenarios using standardized clients in face-to-face or virtual classrooms enhanced clinical learning.

Adapting to the challenges of the global pandemic on genetic counselor education: Evaluating students' satisfaction with virtual clinical experiences

Travel restrictions, physical distancing, and limits to clinical placements due to the global pandemic raised enormous challenges for genetic counseling education in 2020. In response, we created authentic virtual clinical experiences in our Master of Genetic Counseling program, mimicking clinical practice: virtual simulation with standardized clients, and virtual clinical placements, including intake calls, triage, consultations, teamwork and time management, and genetic counseling with standardized clients. The virtual clinical experiences involved online pre-brief, simulation, and debrief. We aimed to evaluate students' satisfaction with this learning method. Between April and November 2020, we distributed an anonymous online survey to all participating students using a modified version of a validated satisfaction with simulation scale. We analyzed the combined responses from first- and second-year virtual clinical experiences using descriptive statistics and content analysis. The total number of possible responses was 120. The mean response rate was 68.36% (n = 82.03), with a mean of 16.41 participants responding to each survey from each year group. Of the first-year participants, 53% (n = 10) had not observed a genetic counseling consultation before attending the virtual clinical placement. Overall, 92.5% of responses indicated that students were satisfied with the virtual clinical experiences (SD = 0.05). 100% (n = 82) of responses indicated that working with standardized clients was beneficial to learning, encouraged reflection on clinical ability and was a valuable learning experience overall. However, 37.78% (n = 17) of those who participated in the virtual simulation found that the use of Zoom detracted from their clinical learning. The virtual clinical experiences increased first-year students' confidence about clinical placement and prepared second-year students for telehealth. In conclusion, the adaptation to virtual clinical experiences enhanced learning for most students, prepared them for practice, met the requirements of the accreditation body and enabled all of our final year students to graduate on time.