Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk

Few studies have linked actual genetic counseling content to short-term outcomes. Using the Self-regulation Model, the impact of cognitive and affective content in genetic counseling on short-term outcomes was studied in individuals at elevated risk of familial breast-ovarian cancer. Surveys assessed dependent variables: distress, perceived risk, and 6 knowledge measures (Meaning of Positive Test; Meaning of Negative Test; Personal Behavior; Practitioner Knowledge; Mechanisms of Cancer Inheritance; Frequency of Inherited Cancer) measured at pre- and post-counseling. Proportion of participant cognitive and affective and counselor cognitive and affective content during sessions (using LIWC software) were predictors in regressions. Knowledge increased for 5 measures and decreased for Personal Behavior, Distress and Perceived Risk. Controlling for age and education, results were significant/marginally significant for three measures. More counselor content was associated with decreases in knowledge of Personal Behavior. More participant and less counselor affective content was associated with gains in Practitioner Knowledge. More counselor cognitive, and interaction of counselor cognitive and affective content, were associated with higher perceived risk. Genetic counselors dominate the content of counseling sessions. Therefore, their content is tied more closely to short term outcomes than participant content. A lack of patient communication in sessions may pose problems for understanding of complex concepts.     

Integrating Power to Advance the Study of Connective and Productive Disciplinary Engagement in Mathematics and Science

Abstract

Engle and Conant’s productive disciplinary engagement (PDE) framework has significantly advanced the study of learning in mathematics and science. This artilce revisits PDE through the lens of critical education research. Our analysis synthesizes two themes of power: epistemic diversity, and historicity and identity. We argue that these themes, when integrated into PDE, strengthen it as a tool for design and analysis of disciplinary learning in relation to power and personhood, and describe the broadened framework of connective and productive disciplinary engagement (CPDE). By comparing and contrasting the use of PDE and CPDE in relation to two cases of classroom learning—for science, Warren et al.’s metamorphosis and for mathematics, Godfrey and O’Connor’s measurement—we demonstrate how CPDE surfaces issues of history, power, and culture that may otherwise be overlooked by PDE alone. In particular, we analyze how CPDE makes visible unseen identities and generative resources of disciplinary knowing and doing among minoritized students. We discuss how the revised framework redresses epistemic injustice experienced by minoritized learners held to the narrow rubric of western epistemologies and compels close attention to the diversity of human activity in mathematics and science. Further, we elaborate how it provides a structure for teachers, teacher educators, and researchers to design and analyze learning environments as safeguarding the rightful presence of minoritized learners in STEM classrooms and beyond.