A case-based approach to the development of practice-based competencies for accreditation of and training in graduate programs in genetic counseling

The American Board of Genetic Counseling (ABGC) sponsored a consensus development conference with participation from directors of graduate programs in genetic counseling, board members, and expert consultants. Using a collective, narrative, and case-based approach, 27 competencies were identified as embedded in the practice of genetic counseling. These competencies were organized into four domains of skills: Communication; Critical Thinking; Interpersonal, Counseling, and Psychosocial Assessment; and Professional Ethics and Values. The adoption of a competency framework for accreditation has a variety of implications for curriculum design and implementation. We report here the process by which a set of practice-based genetic counseling competencies have been derived; and in an accompanying article, the competencies themselves are provided. We also discuss the application of the competencies to graduate program accreditation as well as some of the implications competency-based standards may have for education and the genetic counseling profession. These guidelines may also serve as a basis for the continuing education of practicing genetic counselors and a performance evaluation tool in the workplace.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

Women's marital-familial statuses and work histories: Some conceptual considerations

Although vocational psychologists and sociologists have a long history of researching occupational choice, their theoretical postures have almost always been shaped in light of information on males, with little consideration for females. This article is an addition to others which attempt to correct this shortcoming in the literature. The article reviews the dominant conceptual schemes used to study occupational choice, considers potentially female-specific variables, and provides a typology for the analysis of women's marital-familial statuses and work modes.     

Spacing repetitions over 1 week

Does varying the spacing of repetitions over intervals as long as 1 week aftect recall? The answer from three experiments is yes. Subjects incidentally processed words repeated within a single list and words repeated in separate lists at list spacings of up to 1 week. Memory was tested by free recall shortly after the second presentations or after retention intervals of up to 1 week. Recall of the words repeated across separate lists conformed to a proportionality rule. When the retention interval is short relative to the spacing intervals, performance is inversely related to spacing. When the retention interval is a large proportion of the spacing intervals, performance is directly related to spacing. Does varying the spacing of repetitions within a single list affect recall after a retention interval of 2 weeks? The answer depends on the processing used while studying the words. Processing that generated interitem associations resulted in a within-list spacing effect even after a 2-week retention interval. Without the interitem associations, the effect was absent after a 1-day retention interval. Most of these findings were explained by examining the changing relationship between the retrieval context and the context stored during study.     

Incorporating inferences in narrative representations: A study of how and why

Four experiments examined the conceptual organization of narrative passages and the extent to which these representations were explanatory in a variety of experimental tasks. The conceptual representation of a passage consisted of a graph of labeled nodes and labeled, directed arcs which were adopted from the Conceptual Dependency Theory. These representations included both explicitly stated information and inferences which had been empirically extracted by a question-answering procedure. Symbolic procedures for answering how- and why-questions were also delineated. The conceptual representations and the symbolic procedures that operate on these representations together accounted for 91% of the answers generated from question-answering protocols in Experiment 1, and also the rated quality of specific answers to specific questions in Experiment 2. Experiments 3 and 4 supported the hypothesis that structural properties of the representations can predict recall of explicitly stated nodes and verification ratings of inference nodes. The results provide encouraging support for the proposed graphic representations and also for the use of question-answering protocols in uncovering prose inferences.     

Raising the IQ: The Ramey and Haskins study

The Ramey and Haskins intervention experiment succeeded in producing IQ gains at three years of age averaging about one standard deviation in young children who were selected for being at risk for subnormal intellectual development. The study is examined in terms of its consistency with other findings, the heritability of IQ, the g aspect of IQ, the simplex pattern of longitudinal interage mental test score correlations, mother-child IQ correlations, and criteria for establishing educationally and socially significant gains in intelligence defined as g rather than as a score on a particular test. Narrow transfer of training from cognitive intervention techniques to IQ test performance in early childhood, rather than enhancement of the g factor itself, is hypothesized as a cause of the typical fadeout of early IQ gains in later childhood.     

A voice-operated method for administering the MMPI

Paper/pencil psychological tests such as the Minnesota Multiphasic Personality Inventory (MMPI) are difficult to complete independently by patients with limited hand function. This paper describes a voice recognition system developed to allow patients with no hand function to take the MMPI independently. Profiles generated by this system are not statistically different from those generated by standard MMPI booklet format. Limitations and possible extensions of the system as it currently exists are discussed.     

Field-dependence,extraversion, Eysenck and autarky

The research literature was examined with regard to relationships between Field-dependence and Extraversion. Eysenck's contention that the two variables are significantly related to an extent justifying the use of causal hypotheses based on extraversion theory to account for field-dependent behavior was not supported.     

Resolving Ethical Dilemmas in Management: Experimental Investigations of Values, Accountability, and Choice

Hypotheses regarding the effects of personal values and accountability on the resolution of ethical dilemmas in management were formulated and tested experimentally with a sample of 135 M.B.A. students. Personal values were found to be related to how subjects chose to resolve an ethical dilemma presented to them; but, as expected, this relationship did not hold when subjects were made to feel accountable to another for their choices. Accountability, unexpectedly, however, did not have a main effect on choices. This lack of an effect tentatively was attributed to the inexplicitness of the accountability manipulations. In a second and third experiment, support for the importance of explicitness in accountability research was obtained. The theoretical and practical implications of the findings from all three experiments were discussed.     

Respect: Response to shame in health care

Shame is a not uncommon experience of patients in health care settings. Religious assessments often confuse shame with guilt, and therefore respond in ways that may not be appropriate. Illustrated by a case study, this article distinguishes shame from guilt and examines systemic considerations. Then shame is explored in relation to traditional, negotiating, and individualistic belief paradigms, looking at epistemology, causality, response to shame, healing models, and tasks. It concludes with a discussion of the idea of respect as foundational for responding to people experiencing shame in health care.