Portrait of the master genetic counselor: a qualitative investigation of expertise in genetic counseling.

Abstract

This study begins to describe personal and professional characteristics of master genetic counselors—those considered to be experts or among the best-of-the best clinicians in genetic counseling. The focus of the investigation was the person of the master genetic counselor. Fifteen, peer-nominated genetic counselors participated in in-depth, semi- structured telephone interviews exploring their personal qualities, inspirations, motivations, strengths, struggles, and professional development. Analysis using a modified version of Consensual Qualitative Research (Hill, 2012) resulted in four broad themes: 1) Personal Characteristics of Master Genetic Counselors, 2) Relationships with Patients, 3) What Constitutes Success, and 4) Views of the Profession. Findings indicate master genetic counselors: a) have insatiable curiosity, love learning and are life-long learners; b) are reflective, self-aware, confident and recognize their limitations; c) are authentic and genuine, and consider their personality to be their counseling style; c) form collaborative and interactive relationships with patients based on trust; d) have nuanced attunement to the complexity and multiple levels of the counseling process; e) struggle when they cannot connect with patients; f) have deep empathy, are inspired by patients, and derive personal meaning from their work; g) are affected emotionally by their work, but effectively manage the emotional impact; h) view success as patient- centered and based in the patient/genetic counselor relationship; i) view their professional development as ongoing; and j) hold various perspectives on psychosocial aspects of genetic counseling, on the art vs. science nature of the field, and development of the profession. Major findings are discussed in conjunction with theory and previous research. The findings provide strong support for the Reciprocal-Engagement Model of genetic counseling practice (McCarthy Veach, et al., 2007). Study strengths and limitations, implication for training and practice, and research recommendation are discussed.