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Practice-Based Competencies for Genetic Counselors © 2015 Practice-Based Competencies for Genetic Counselors © 2015 Accreditation Council for Genetic Counseling 7918 Jones Branch Drive, Suite 300, McLean, VA 22102 (703) 506-7667 www.gceducation.org Practice-Based Competencies for Genetic Counselors This document defines and describes the twenty two practice-based competencies that an entry-level provider must dem- onstrate to successfully practice as a genetic counselor. It provides guidance for the training of genetic counselors and an assessment for maintenance of competency of practicing genetic counselors. The didactic and experiential components of a genetic counseling training curriculum and maintenance of competency for providers must support the development of competencies categorized in the following domains: (I) Genetics Expertise and Analysis; (II) Interpersonal, Psychosocial and Counseling Skills; (III) Education; and (IV) Professional Development & Practice. These domains describe the minimal skill set of a genetic counselor, which should be applied across practice settings. Some competencies may be relevant to more than one domain. Italicized words are defined in the glossary. Domain I: Genetics Expertise and Analysis 12. Understand how to adapt genetic counseling skills for varied service delivery models. 1. Demonstrate and utilize a depth and breadth of understanding and knowledge of genetics 13. Apply genetic counseling skills in a cultur- and genomics core concepts and principles. ally responsive and respectful manner to all clients. 2. Integrate knowledge of psychosocial aspects of conditions with a genetic component to Domain III: Education promote client well-being. 14. Effectively educate clients about a wide range 3. Construct relevant, targeted and compre- of genetics and genomics information based hensive personal and family histories and on their needs, their characteristics and the pedigrees. circumstances of the encounter. 4. Identify, assess, facilitate, and integrate 15. Write concise and understandable clinical genetic testing options in genetic counseling and scientific information for audiences of practice. varying educational backgrounds. 5. Assess individuals’ and their relatives’ 16. Effectively give a presentation on genetics, probability of conditions with a genetic genomics and genetic counseling issues. component or carrier status based on their pedigree, test result(s), and other pertinent Domain IV: Professional Development & information. Practice 6. Demonstrate the skills necessary to success- fully manage a genetic counseling case. 17. Act in accordance with the ethical, legal and philosophical principles and values of the 7. Critically assess genetic/genomic, medical genetic counseling profession and the policies and social science literature and information. of one’s institution or organization. Domain II: Interpersonal, Psychosocial 18. Demonstrate understanding of the research and Counseling Skills process. 19. Advocate for individuals, families, communi- 8. Establish a mutually agreed upon genetic ties and the genetic counseling profession. counseling agenda with the client. 20. Demonstrate a self-reflective, evidenced- 9. Employ active listening and interviewing based and current approach to genetic skills to identify, assess, and empathically counseling practice. respond to stated and emerging concerns. 21. Understand the methods, roles and responsi- 10. Use a range of genetic counseling skills bilities of the process of clinical supervision and models to facilitate informed decision- of trainees. making and adaptation to genetic risks or conditions. 22. Establish and maintain professional interdisciplinary relationships in both team 11. Promote client-centered, informed, non- and one-on-one settings, and recognize one’s coercive and value-based decision-making. role in the larger healthcare system. © 2015 Accreditation Council for Genetic Counseling 2 Practice-Based Competencies for Genetic Counselors Appendix: Samples of Activities and Skills that may assist in Meeting Practice-Based Competencies These samples may assist in curriculum planning, development, implementation and program and counselor evaluation. They are not intended to be exhaustive nor mandatory, as competencies can be achieved in multiple ways. Domain I: Genetics Expertise and Analysis 1. Demonstrate and utilize a depth and breadth b) Describe common emotional and/or behavioral of understanding and knowledge of genetics responses that may commonly occur in the and genomics core concepts and principles. genetic counseling context. a) Demonstrate knowledge of principles of human, c) Recognize the importance of understanding the medical, and public health genetics and genomics lived experiences of people with various genetic/ and their related sciences. These include: genomic conditions. ▪ Mendelian and non-Mendelian inheritance d) Evaluate the potential impact of psychosocial ▪ Population and quantitative genetics issues on client decision-making and adherence ▪ Human variation and disease susceptibility to medical management. ▪ Family history and pedigree analysis ▪ Normal/abnormal physical & psychological 3. Construct relevant, targeted and compre- development hensive personal and family histories and ▪ Human reproduction pedigrees. ▪ Prenatal genetics a) Demonstrate proficiency in the use of pedigree ▪ Pediatric genetics symbols, standard notation, and nomenclature. ▪ Adult genetics b) Utilize interviewing skills to elicit a family his- ▪ Personalized genomic medicine tory and pursue a relevant path of inquiry. ▪ Cytogenetics ▪ Biochemical genetics c) Use active listening skills to formulate structured questions for the individual case depending on ▪ Molecular genetics the reason for taking the family history and/or ▪ Embryology/Teratology/Developmental potential diagnoses. genetics ▪ Cancer genetics d) Elicit and assess pertinent information relating ▪ Cardiovascular genetics to medical, developmental, pregnancy and psy- ▪ Neurogenetics chosocial histories. ▪ Pharmacogenetics e) Extract pertinent information from available ▪ Psychiatric genetics medical records. b) Apply knowledge of genetic principles and under- 4. Identify, assess, facilitate, and integrate stand how they contribute to etiology, clinical genetic testing options in genetic counseling features and disease expression, natural history, practice. differential diagnoses, genetic testing and test report interpretation, pathophysiology, recur- a) Investigate the availability, analytic validity, rence risk, management and prevention, and clinical validity, and clinical utility of screening, population screening. diagnostic and predictive genetic/genomic tests. b) Evaluate and assess laboratories and select the 2. Integrate knowledge of psychosocial aspects most appropriate laboratory and test based on of conditions with a genetic component to the clinical situation. promote client well-being. c) Identify and discuss the potential benefits, risks, a) Demonstrate an understanding of psychosocial, limitations and costs of genetic testing. ethical, and legal issues related to genetic counseling encounters. 3 © 2015 Accreditation Council for Genetic Counseling Practice-Based Competencies for Genetic Counselors d) Coordinate and facilitate the ordering of appro- b) Assess and modify the case management plan as priate genetic testing for the client. needed to incorporate changes in management e) Interpret the clinical implications of genetic test and surveillance recommendations. reports. c) Document and present the genetic counseling f) Recognize and differentiate specific consider- encounter information clearly and concisely, ations relevant to genetic versus genomic and orally and in writing, in a manner that is under- clinical versus research testing in terms of the standable to the audience and in accordance with informed consent process, results disclosure, professional and institutional guidelines and institutional review board (IRB) guidelines, and standards. clinical decision-making. d) Identify and introduce research options when indicated and requested in compliance with 5. Assess individuals’ and their relatives’ applicable privacy, human subjects, regional and probability of conditions with a genetic institutional standards. component or carrier status based on their pedigree, test result(s), and other pertinent e) Identify, access and present information to clients information. on local, regional, national and international resources, services and support. a) Assess probability of conditions with a genetic component or carrier status using relevant 7. Critically assess genetic/genomic, medical knowledge and data based on pedigree analysis, and social science literature and information. inheritance patterns, genetic epidemiology, quan- a) Plan and execute a thorough search and review of titative genetics principles, and mathematical the literature. calculations. b) Evaluate and critique scientific papers and b) Incorporate the results of screening, diagnostic identify appropriate conclusions by applying and predictive genetic/genomic tests to provide knowledge of relevant research methodologies accurate risk assessment for clients. and statistical analyses. c) Evaluate familial implications of genetic/genomic c) Synthesize information obtained from a lit- test results. erature review to utilize in genetic counseling d) Identify and integrate relevant information about encounters. environmental and lifestyle factors into the risk d) Incorporate medical and scientific literature into assessment.
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