Graduation Year

2023

Document Type

Thesis

Degree

M.S.P.H.

Degree Name

MS in Public Health (M.S.P.H.)

Degree Granting Department

Public Health

Major Professor

Dr. Deborah Cragun, Ph.D.

Committee Member

Nevena Krstic, MSGC

Committee Member

Kathleen Pope, Ph.D.

Committee Member

Heather Zierhut, Ph.D.

Keywords

communication, genetic counseling, prenatal, skills, strategies

Abstract

Genetic Counseling relies on communication skills to help patients understand and adapt to a genetic disease or risk. However, little is known about which skills are most commonly used or the extent to which genetic counseling sessions vary. A novel process measure titled the "Genetic Counseling Skills Checklist" (GCSC) was developed in a prior pilot study and includes 8 broad categories each consisting of 5-8 skills. This study is the first to apply the final GCSC to characterize 20 mock prenatal sessions conducted by 5 genetic counselors (GCs) for 2 prenatal indications using 3 trained actors as patients. Two experienced GCSC coders independently used the GCSC to document specific communication skills that were used during the recorded sessions and assigned each session an overall subjective rating on a scale from 1 (low quality) to 10 (high quality). Following each session, the 2 coders compared their completed checklists, calculated inter-rater reliability for each skills category, and discussed any areas of disagreement. Together, the coders created a consensus checklist for each session that served as the final agreed upon checklist. Consensus checklists were analyzed using descriptive statistics to unearth trends in skill usage. We found moderate to high inter-rater reliability (Kappa statistics ranging from 0.77 to 0.88) among the 8 categories and a significant positive correlation between average GC quality ratings and overall number of skills used (r=0.88). Our findings indicate that genetic counselors may be assessed more positively by observers if they employ a broader spectrum of communication skills. This study demonstrated that the GCSC can be a valuable and reliable tool to discover and analyze current trends in genetic counseling practice.

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