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 in Technology: A Program to Increase Career Awareness

Most women work to help support themselves and their families. Unfortunately young women are not often encouraged to explore occupational options that offer increased economic mobility. This article describes a program designed to develop awareness of nontraditional technical careers for women, careers that require less than four years of postsecondary education. Attended by guidance counselors and math and science teachers, the conference explored the psychological implications of nontraditional choices as well as provided information about these occupations. The article also discusses funding, program development and design, and evaluation.     

The air gap phenomenon in children's landscape drawings

The “air gap” phenomenon was found to be very common in the free landscape drawings of middle and later childhood. Three experiments are reported in which the contextual cues for such drawings were systematically manipulated. When subjects were supplied with drawing sheets constructed to imply the absence of the air gap, the phenomenon was eliminated in most of their drawings. When supplied with sheets constructed to imply its presence, most subjects produced air gap drawings using contextually provided reference lines. There were no consistent transfer effects across different cuing orders. The susceptibility of the air gap phenomenon to modification by task manipulation suggests that it results from problems of production rather than from defects in the child's internal representation of the world.     

Negative attitudes toward masturbation and pelvic vasocongestion: A thermographic analysis

The present study examined differences in pelvic vasocongestion as a function of negative attitudes toward masturbation. Pelvic vasocongestion was measured thermographically, which is a noninvasive means of detecting and photographing individual heat patterns to indicate physiological condition and functional changes within. The results indicated that women, with positive attitudes toward masturbation, who read an erotic story, experienced the greatest increase in pelvic vasocongestion. This and other findings were discussed in terms of masturbation acting to facilitate the patterning of sexual arousal and orgasmic functioning, especially in regard to creating the capacity for pelvic engorgement.     

Vicarious and operant experiences in the etiology of illness behavior: A replication with healthy individuals

The purpose of the present investigation was to replicate a previous study of diabetic patients on the role of parental modeling in the etiology of illness behavior. A random sample of healthy individuals were assigned to an avoidant model (AM) (i.e. parent reported to have avoided work. chores etc. when ill) or non-avoidant model (NAM) group. Subjects subsequently provided retrospective and current information concerning their illness-behavior experiences. The results indicated that individuals with an AM reported more responsibility avoidance when ill currently and as a child compared to the NAM subjects. Additionally. AM subjects reported receiving more positive reinforcement for current illness compared to NAM subjects. It was concluded that the process by which individuals learn to respond to illness may be similar in healthy and chronically-ill individuals but that positive reinforcement for illness may be more likely to be received by healthy individuals during acute illness than by chronically-ill individuals. The present study provides further preliminary support for the learningtheory model of illness behavior.     

Parental defense style and child competence: A match-mismatch hypothesis

This study sought to explore the possible relationship between parental style of psychological defense and children's social competence in 50 families in which one parent had been hospitalized for a psychiatric disorder. Based upon a formal analysis of the logical transformations inherent in various defense mechanisms, three levels of complexity of defenses were identified, along with a counterpart set of cognitive operations necessary for decoding these defense levels. It was hypothesized that children lacking the requisite cognitive skills to grasp the logical complexities of their disturbed parent's primary mode of psychological defense would be less socially adjusted and judged less competent than children who could understand the defensive transformations of their parent. The results suggested that children who, due to their cognitive immaturity, are potentially     

Sex-role identity and self-esteem in female graduate nursing students

This study investigated masculinity and femininity characteristics and levels of self-esteem of 96 female graduate nursing students between the ages of 20 and 50. The instruments used were incorporated into a questionnaire which was mailed to each student. Self-esteem was measured by a version of Coopersmith's Self-Esteem Inventory which Good and Good modified to adapt to adult standards. To measure femininity and masculinity, a shortened version of the Bem Sex Role Inventory was used: Subjects rated themselves along a 7-point Likert scale for 10 masculine and 10 feminine traits. The categorical method of scoring by Spence, Helmreich, and Stapp was employed. The students were fairly evenly distributed across the following four categories: low masculine-low feminine; low masculine-high feminine; high masculine-low feminine; and high masculinehigh feminine. The students in the high masculine-low feminine and the high masculine-high feminine categories were found to have a statistically higher mean self-esteem than the students in the low masculine-low feminine and low masculne-high feminine categories. Implications were mentioned regarding the development of a high degree of both masculine and feminine characteristics in nurses.     

Men's and women's evaluations of menstrual-related excuses

Based on an attributional analysis of menstrual distress, the present study examined how a woman is evaluated when she attributes an instance of negative social behavior to the approach or onset of menstruation. College men and women were asked to imagine an interaction in which a woman behaves very irritably and then gives one of several excuses for her negative behavior, two of which were menstrual related. Subjects evaluated each excuse in terms of (1) degree of annoyance, (2) blameworthiness, and (3) internality versus externality. The results showed consistent relationships between these evaluations and both sex of subject and general attitudes about menstruation. Males tended to see menstrual-related excuses as less blameworthy and more external than did females. In addition, general attitudes regarding the debilitating effects of menstruation predicted greater tolerance toward the use of menstrual excuses. These results are discussed in terms of their implications for the socialization and continuing reinforcement of menstrual distress.The research reported in this article was supported by grants SOC-7602137 and SOC-7602179 from the National Science Foundation. The authors wish to thank Russ Fazio for his help in collecting the data and Al Rogers and Terry Balaban for their help in analyzing the data. Diane N. Ruble is now at New York University. Ann K. Boggiano is now at the University of Colorado.     

The Waffle Phenomenon: Negative Evaluations of Those Who Shift Attitudinally1

The past two presidential campaigns have been filed with charges that the Democratic nominee “changed his mind” on various issues. The present research explored the possibility that negative evaluations may be produced by attitude change per se. In the first experiment, subjects responded to a stranger whose attitudes remained stable or who changed his attitudes over a period of two months vs. one year. Individuals who changed their attitudes were generally evaluated more negatively than those whose attitudes remained stable; the amount of time over which the change occurred produced no effect. A second expcriment sought to determine if the direction of change (toward increased or decreased similarity with subjects) influenced evaluations of a stranger. Attitude change which resulted in decreased similarity was rated most negatively. Even when a stranger changed his attitudes in the direction of greater similarity with subjects, however, he was still regarded as less decisive, less reliable, and a worse leader than was an individual with stable attitudes. This negative evaluation of attitude change was labeled the “waffle phenomenon”, and the implications for political candidates were discussed.