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).     

Violent behavior in adolescents and young adults: A person and environment model

We explore a model that examines how personal and environmental variables explain violent behavior by adolescents. Repeated interviews with youths from 1984–1992 from 10 cities across the United States provided the data. These interviews first occurred with 2,787 youths when they were adolescents (1984–85 and 1986–87) and the interviews were repeated on a subsample of 602 youths when they were young adults (1989–90 and 1991–92). Longitudinal multivariate analyses showed that almost a third of the variance in adolescent violent behaviors was predicted by a combination of personal variables (gender, substance misuse) and environmental variables (history of child abuse, stressful events, traumatic events, and city rates of unemployment). Further, almost a third of the variance in change in violent behaviors from year to year was predicted by prior violent behavior and a combination of personal variables (gender, suicidality, and substance misuse) and environmental variables (stressful events).     

Evidence that blocking is due to associative deficit: Blocking history affects the degree of subsequent associative competition

Rats were trained on an appetitive discriminated operant procedure according to a blocking design, in which training with a compound stimulus (A + B) was given with or without prior training with A alone. Stimulus B was then presented in compound with a new stimulus (B + C compound). The ability of Stimulus B to block acquisition of control by Stimulus C was decreased by B having itself been blocked by A during the prior training. The results imply that the mechanism of blocking during the initial blocking procedure was a reduced association between Stimulus B and the reinforcer, and not a performance deficit such as that postulated by comparator models of learning.     

Varieties of positive and negative priming

Numerous recent investigations have focused on a particular relation between the roles a stimulus plays in successive displays: when a stimulus ignored by a subject on one occasion is to be attended on a succeeding occasion, reaction time to that stimulus is slowed relative to a control condition. But this is but one possible case ofnegative priming. There are other ways in which negative priming might occur, and there are several varieties of positive priming as well. All these possibilities were explored in the present experiment.     

Touch dominates haptic estimates of discordant visual-haptic size

Observers (72 college students) estimated the size of plastic squares that they held in their fingers and simultaneously viewed through a reducing lens that halved the squares’ visual size. The squares were grasped from below through a cloth that prevented direct sight of the hand. Each estimate was a match selected later, either haptically or visually, from a set of comparison squares. Vision dominated the visual estimates and touch dominated the haptic estimates, whether or not the observers knew in advance which type of estimate they would be asked to make. Neither modality inherently dominates perceived size.     

Fetal brain tissue transplants reduce visual deficits in adult rats with bilateral lesions of the occipital cortex

Fetal brain tissue from the occipital or the frontal cortex was implanted into the damaged occipital cortex of adult rats. The animals receiving grafts of embryonic frontal cortex showed partial restoration of brightness discrimination while recipients given homologous implants of occipital cortex were as impaired as those animals with lesions alone. Neither frontal nor occipital grafts aided in the performance of a pattern discrimination problem; both groups of brain-damaged animals were unable to learn the task. Nonetheless, both groups of animals had viable and enlarged grafts with similar neuronal and glial profiles.     

An empirical investigation of Shneidman's formulations regarding suicide

This study of suicide notes involved the deduction of 50 protocol sentences that reflected important aspects of Shneidman's formulations regarding suicide. Independent judges noted the incidence of contents corresponding to the protocol sentences in 33 genuine and 33 simulated notes. Statements that were found significantly and more frequently in genuine notes included the following: the experience of adult trauma such as a calamitous relationship; a rejection; the withdrawal of a significant person resulting in despair; perceiving another as dooming one to the suicide; expressions of ambivalence; feelings of love, hate and other emotions; feelings of helplessness, pessimism and emotional confusion; appearing to be intoxicated by one's overpowering emotions and constricted perceptions; and the communications appearing to have unconscious implications. Statements of "egression" and more logical reasoning were more characteristic of the simulated notes. A frequency count in the genuine notes indicated that many protocol sentences were also very predictive of the content. Implications of the results are discussed.     

Calibration of probability assessments by professional blackjack dealers, statistical experts, and lay people

The question addressed in this study is whether experts are better calibrated than lay people. We investigated how well people are calibrated when they assess the probabilities of card combinations in the game of blackjack. Three groups of subjects were used: professional dealers, statistical experts, and control subjects. The results showed that experience and statistical expertise do not make people better calibrated in this task. It is argued that the concept of calibration is not wholly appropriate to describe the obtained deviations from the normatively correct responses. This is illustrated by a discriminant analysis performed on the signed deviation scores, which resulted in an almost perfect separation of the three groups, although they were overlapping with respect to calibration.     

Organizational factors and work involvement

The aim of this paper is to describe a study which investigated the influence of organizational factors on job involvement and specialization involvement. It was hypothesized that rank, self-expression, participation in decision making, and career factors affect job and specialization involvement. The independent variables were chosen by considering an extension of Schein's (1971, Journal of Applied Behavioral Science, 7, 401–426) “career cone” concept. The hypotheses were tested using a sample of Australian Army officers (N = 384) in a questionnaire survey. The results showed that job involvement is associated primarily with self-expression, although the latter is influenced in turn by participation in decision making, and that specialization involvement is associated with both self-expression and career factors. Rank does not affect either involvement variable. It was concluded that Schein's concept is a useful guide to theory and research on career attitudes. The results support the proposition that job and specialization involvement are distinct constructs. Implications for organizations are discussed.