A Model of Professional Development for Practicing Genetic Counselors: Adaptation of Communication Skills Training in Oncology

Ongoing professional development for practicing genetic counselors is critical in maintaining best practice. Communication skills training (CST) workshops for doctors in oncology, utilizing trained actors in role plays, have been implemented for many years to improve patient-centred communication. This model was adapted to provide professional development in counseling skills for practicing genetic counselors, already highly trained in counseling skills. Detailed evidence based scenarios were developed. Evaluation of participants’ experience and perceived outcomes on practice included surveys immediately post workshops (2002, 2004, 2005, 2008 (×2); n = 88/97), 2–5 years later (2007; n = 21/38) and a focus group (2007; n = 7). All rated workshops as effective training. Aspects highly valued included facilitator feedback, actors rather than role-playing with peers and being able to stop and try doing things differently. Perceived outcomes included the opportunity to reflect on practice; bring focus to communication; motivation and confidence. The high level of satisfaction is a strong endorsement for ongoing communication skills training in this format as part of professional development.     

Impairments in tactile search following superior parietal damage

The superior parietal cortex is critical for the control of visually guided actions. Research suggests that visual stimuli relevant to actions are preferentially processed when they are in peripersonal space. One recent study demonstrated that visually guided movements towards the body were more impaired in a patient with damage to superior parietal cortex. Whereas past studies have explored disordered movement in optic ataxic patients, there has been less exploration of space perception in terms of search capacity in this population. In addition, there is some debate concerning the relationship between deficits of visuomotor control and impaired attention/perception in optic ataxia. Given that the dorsal stream has been implicated in the spatial processing of stimuli in peripersonal space, and damage to this region is known to cause optic ataxia, we felt that further investigation was warranted. We examined tactile search behavior in the fronto-parallel and radial planes in a patient with right superior parietal damage and optic ataxia. We used a pegboard with removable cylindrical pegs that allowed for the reorganization of targets between trials. To better characterize three-dimensional search behavior, we included both horizontal and vertical search conditions. Results showed that the patient spent more time searching, was more accurate and revisited more targets in right versus left space. Interestingly, the patient spent the majority of her time specifically searching the lower right quadrant of the stimulus array. Further analysis revealed lower target detection rates along the outer borders of the pegboard on all sides. The search pattern observed here is unusual considering that all targets were within arm's reach. The present experiment demonstrates that damage to superior parietal cortex impairs tactile search and biases exploration towards lower right peripersonal space.     

The impact of gender on the assessment of body checking behavior

Body checking includes any behavior aimed at global or specific evaluations of appearance characteristics. Men and women are believed to express these behaviors differently, possibly reflecting different socialization. However, there has been no empirical test of the impact of gender on body checking. A total of 1024 male and female college students completed two measures of body checking, the Body Checking Questionnaire and the Male Body Checking Questionnaire. Using multiple group confirmatory factor analysis, differential item functioning (DIF) was explored in a composite of these measures. Two global latent factors were identified (female and male body checking severity), and there were expected gender differences in these factors even after controlling for DIF. Ten items were found to be unbiased by gender and provide a suitable brief measure of body checking for mixed gender research. Practical applications for body checking assessment and theoretical implications are discussed.     

Aging and the haptic perception of 3D surface shape

Two experiments evaluated the ability of older and younger adults to perceive the three-dimensional (3D) shape of object surfaces from active touch (haptics). The ages of the older adults ranged from 64 to 84 years, while those of the younger adults ranged from 18 to 27 years. In Experiment 1, the participants haptically judged the shape of large (20 cm diameter) surfaces with an entire hand. In contrast, in Experiment 2, the participants explored the shape of small (5 cm diameter) surfaces with a single finger. The haptic surfaces varied in shape index (Koenderink, Solid shape, 1990; Koenderink, Image and Vision Computing, 10, 557-564, 1992) from -1.0 to +1.0 in steps of 0.25. For both types of surfaces (large and small), the participants were able to judge surface shape reliably. The older participants' judgments of surface shape were just as accurate and precise as those of the younger participants. The results of the current study demonstrate that while older adults do possess reductions in tactile sensitivity and acuity, they nevertheless can effectively perceive 3D surface shape from haptic exploration.     

Willing and able to fake emotions: a closer examination of the link between emotional dissonance and employee well-being

Emotional dissonance resulting from an employee's emotional labor is usually considered to lead to negative employee outcomes, such as job dissatisfaction and emotional exhaustion. Drawing on Festinger's (1957) cognitive dissonance theory, we argue that the relationship between service employees' surface acting and job dissatisfaction and emotional exhaustion is moderated by 2 aspects of a service worker's self-concept: the importance of displaying authentic emotions (reflecting the self-concept's self-liking dimension) and the employee's self-efficacy when faking emotions (reflecting the self-competence dimension). A survey of 528 frontline employees from a wide variety of service jobs provides support for the moderating role of both self-concept dimensions, which moderate 3 out of 4 relationships. Theoretical and practical implications are discussed from the perspectives of cognitive dissonance and emotional labor theories.     

Distinguishing norm-based from exemplar-based coding of identity in children: evidence from face identity aftereffects

Children's performance on face identification tests improves dramatically between age 4 and adolescence, yet the source of this improvement is controversial. We used face identity aftereffects to examine whether changes in the organization of face-space during childhood could be a source of this improvement. Specifically we tested whether 7- to 9-year-old children, like adults, show patterns of aftereffects predicted by coding facial identity relative to a norm or the patterns predicted by exemplar-based coding. Consistent with use of norm-based coding children's aftereffects were larger (a) for opposite than non-opposite adapt-test pairs equated for perceptual similarity, and (b) for adaptors far from the average than for adaptors closer to the average. In addition, face identity aftereffects were present by age 5, suggesting adult-like face-space properties by 5, though we did not conduct specific tests to distinguish norm-based from exemplar-based coding in this age group. We conclude that children's poor face identification skills cannot be attributed to a failure to use norm-based coding.     

Context effects on orthographic learning of regular and irregular words

The self-teaching hypothesis proposes that orthographic learning takes place via phonological decoding in meaningful texts, that is, in context. Context is proposed to be important in learning to read, especially when decoding is only partial. However, little research has directly explored this hypothesis. The current study looked at the effect of context on orthographic learning and examined whether there were different effects for novel words given regular and irregular pronunciations. Two experiments were conducted using regular and irregular novel words, respectively. Second-grade children were asked to learn eight novel words either in stories or in a list of words. The results revealed no significant effect of context for the regular items. However, in an orthographic decision task, there was a facilitatory effect of context on irregular novel word learning. The findings support the view that contextual information is important to orthographic learning, but only when the words to be learned contain irregular spelling-sound correspondences.     

Old,New, Borrowed,Blue? The Emergence and Retention of Personal Meaning in Autobiographical Storytelling

Research on narrative identity has traditionally focused on how narrative characteristics are related to personality and well-being in adults. The present pair of studies with college students (Study 1, n= 62; Study 2, n= 68 couples) examined the dynamic conversational processes that might be part of constructing that identity. We examined the characteristics of personal meanings, operationalized as self-event connections, and the retention of those connections about important past events discussed between new romantic partners. Across the 2 studies, self-event connections that were positive and about stable aspects of the self were more likely to occur. Connections that were retained over 1 month were those that were shared by both teller and listener in an independent postconversation assessment. Discussion focuses on the processes that might contribute to the construction of narrative identity and the importance of positivity, stability, and shared connections in developing and maintaining narrative identity.     

Coping skills and exposure therapy in panic disorder and agoraphobia: latest advances and future directions

Although cognitive-behavioral treatments for panic disorder have demonstrated efficacy, a considerable number of patients terminate treatment prematurely or remain symtpomatic. Cognitive and biobehavioral coping skills are taught to improve exposure therapy outcomes but evidence for an additive effect is largely lacking. Current methodologies used to study the augmenting effects of coping skills test the degree to which the delivery of coping skills enhances outcomes. However, they do not assess the degree to which acquisition of coping skills and their application during exposure therapy augment outcomes. We examine the extant evidence on the role of traditional coping skills in augmenting exposure for panic disorder, discuss the limitations of existing research, and offer recommendations for methodological advances.