Author ORCID Identifier

https://orcid.org/0000-0001-5589-7212

Date of Graduation

5-2021

Document Type

Thesis (MS)

Program Affiliation

Genetic Counseling

Degree Name

Masters of Science (MS)

Advisor/Committee Chair

Claire N. Singletary, MS, CGC

Committee Member

Meagan Choates, MS, CGC

Committee Member

Jennifer Czerwinski, MS, CGC

Committee Member

Cherilynn R. Shadding, PhD

Committee Member

Grace Tran, MS, CGC

Committee Member

Chelsea Wagner, MS, CGC

Abstract

Representation for both racial/ethnic and gender identity minorities in genetic counseling (GC) remains the lowest among similar healthcare professions. Barriers that underrepresented minority (URM) individuals face in becoming a competitive GC applicant have not yet been described. Academic capital (AC) is a theoretical framework describing the social processes necessary for individuals to navigate and succeed in higher education. This study aimed to characterize barriers experienced by applicants who self-identify as underrepresented and to explore how AC could identify areas for intervention. Prospective GC applicants for the 2021/2022 cycles were recruited to complete an anonymous online survey in Qualtrics through a multi-pronged snowball recruitment method across social media, email, and websites. In total, 156 eligible participants completed the survey which included background information, application process experiences, and validated Academic Capital Scale (ACS). Responses were analyzed through STATA v14.0 for descriptive statistics and ATLAS.ti for open-ended responses. Top identity aspects in which participants felt underrepresented were race/ethnicity (49%), first-generation college student (37%), socioeconomic status (31%), multicultural background (26%), sexual orientation/LGBTQ+ (26%), and English as a second language (21%). On the ACS, there was a significant difference between participants who identified with one underrepresented group compared to more than one group (p = 0.018) suggesting intersectionality should be studied. Areas for focus based on ACS were concerns about costs, navigation of systems, and college knowledge. Shadowing a genetic counselor, costs, and personal statements were rated as the most challenging application components. The top three factors impacting where to apply were rotations, financial assistance, and cost. The National Institute of Health definition of disadvantaged emerged as a possible proxy to use in holistic admissions. These findings suggest that interventions at the institutional or social network level, such as partnerships with URM institutions or centralized mentorship/shadowing programs, would improve GC-specific AC formation. Financial assistance from training programs or state/national organizations could reduce cost barriers. Overall, creating a successful URM GC pipeline requires interventions targeted to URMs and modifying the definition of a competitive applicant through holistic admissions.

Keywords

genetic counseling, underrepresented minorities, barriers to admission, admissions, diversity, academic capital, career pipeline

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