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).     

Neuropsychological evaluation in the assessment of personal injury

Neuropsychological evaluation offers unique potentials in the assessment of personal injury claims. Strengths and limitations of major approaches to testing are reviewed, and special attention is given to applications in the particular forensic areas of head injury, toxic environments, physical disease, and malpractice. The varieties of cognitive, emotional, and interpersonal damages which may occur with brain injury are described. Suggestions are provided for forensically appropriate neuropsychological assessment, as well as guidelines offered for discerning inappropriate practices. Issues of neurological malingering, credentialing of the expert, and forensic roles of the neuropsychologist in rehabilitation are discussed.     

Circadian factors during sustained performance: Background and methodology

Cornell University Medical College, Westchester Division, The New York Hospital, White Plains, New York It is well established that there is a complex timekeeping mechanism in the human brain. This mechanism is associated with a variety of physiological and psychological rhythms having a period of about a day, and thus referred to as circadian rhythms. The circadian system has recently been modeled in terms of two underlying oscillators, one much more resistant to changes in routine than the other. These oscillators are considered to be endogenous, that is, internal to the organism, and not reliant for their existence upon changes in the person’s environment or general behavior. They thus continue to run even when the sleep/wake cycle is suspended, as in sustained operations. Thus, by their very nature, sustained operations require the individual to override the inputs that are coming from his or her circadian system (especially the indication that sleep is required). The aim of this paper is to provide a background to the area of circadian rhythms research, including a section on the methodology, so that the impact of the circadian system on sustained operations can be better understood.     

Depth of processing: When the principle of congruity fails

Two factors, level of processing (Craik & Lockhart, 1972) and congruity (Schulman, 1974), known to have large effects on the recall of experimenter-provided responses to questions, were examined in a series of five incidental learning experiments using subject-generated responses. The data show that manipulation of level of processing has the same effect on recall of subjectgenerated responses as it does on experimenter-provided responses. However, the effect of congruity is reversed for subject-generated responses. The data suggest that the difficulty of generating unrelated responses (“incongruous“ items) may account, at least in part, for the failure of the “principle of congruity“ with subject-generated responses.     

Acquisition-test interactions between

The effects of changes in context on recognition memory were investigated in two experiments. In Experiment 1 target items were embedded in congruous or incongruous sentence frames and then tested in the original, new congruous, or new incongruous contexts. Experiment 2 included a third encoding condition; targets were also embedded in abstract definitional sentences. Both experiments revealed a reliable crossover interaction between the initial encoding condition and the mode of the changed context. Congruous items were recognized better in new congruous contexts, whereas incongruous items were recognized better in new incongruous contexts. Recognition of definitional items was equally impaired by both context changes. The results suggest the importance of the symmetry between acquisition and test encoding dimensions. These experiments also point out the need to distinguish between different ways in which the concept “integration” is used in current research.     

SEVERE CLASSROOM BEHAVIOR PROBLEMS: TEACHERS OR COUNSELLORS

This experiment was designed to determine the relative effectiveness of teacher and counselling approaches in the reduction of disruptive or inappropriate classroom behavior. Inappropriate classroom behavior frequencies of 12 academically low achieving, seventh-grade, black male students, with a reported high rate of inappropriate classroom behavior, were recorded. Three groups, with nearly equal mean inappropriate behaviors, were randomly assigned to one of three treatment conditions: behavioral counselling, client-centered counselling, or no counselling. Each counselling group received fifteen 30-minute counselling sessions, at a rate of two to three times a week. In addition to counselling, all students subsequently received teacher approval within the classroom. Results indicated that the teacher was able to reduce inappropriate behavior more than any counselling group. There were also indications that behavioral counselling, but not client-centered counselling, was moderately helpful in reducing inappropriate classroom behavior.