Author ORCID Identifier
0009-0008-9677-1980
Date of Graduation
5-2025
Document Type
Thesis (MS)
Program Affiliation
Genetic Counseling
Degree Name
Masters of Science (MS)
Advisor/Committee Chair
Aarti Ramdaney, MS, CGC
Committee Member
Syed S. Hashmi, MD, MPH, PhD
Committee Member
Morgan Armstrong, MS, CGC
Committee Member
Morgan Nutter, MS, CGC
Committee Member
Myla Ashfaq, MS, CGC
Abstract
Genetic counseling graduate programs are required to provide didactic coursework and fieldwork experiences to foster development of the practice-based competencies (PBCs) in trainees. Currently, every graduating trainee must log a minimum of 50 participatory encounters to demonstrate readiness for entry-level practice of the PBCs. Previous studies have noted that many trainees exceed the 50-case standard, raising the question of whether this minimum satisfies the training needs of every student. To assess the perceived number of encounters needed for graduates to independently perform the PBCs, a survey was administered to 2023 and 2024 graduates of North American genetic counseling training programs. Descriptive statistics and inductive thematic analysis were used to analyze data for trends and common themes in quantitative and qualitative data, respectively. Ninety-three responses were analyzed, with the majority (62.4%) of respondents having graduated in 2024 and the median number of total cases acquired being 121-130 cases. The median number of cases to reach independence for 21 out of the 22 PBCs fell below 50; however, almost all respondents that achieved independence could be accounted for by 90 and 110 cases. Participants further voiced their support for a higher case number in open-ended questions, stating that 50 encounters were too few to practice independently. Interestingly, while an increase in the minimum number of cases appears to be indicated, almost 50% of participants reported seeing more cases than needed overall, suggesting a careful balancing act between acquiring enough cases to achieve independence and avoiding a point of saturation. Specific PBCs that detail more complex tasks may benefit from supplementary training, including standardized patients or targeted didactic coursework, as they are less commonly encountered in fieldwork training but may require more opportunities to develop independent practice. Participants also noted multiple factors outside case numbers that influenced when they felt they could practice independently, most notably describing how supervisors may promote or impede their development. Future studies are needed to explore trainee and program-driven factors that may influence readiness for practice.
Keywords
genetic counseling, case number, clinical training, trainee independence, accreditation