From graduate to seasoned practitioner: a qualitative investigation of genetic counselor professional development.

Abstract

Research on professional development processes can contribute to individuals' anticipation and normalization of developmental processes, to improved training and supervision, and to the creation of a wider breadth and depth of professional development opportunities and support in the field. Presently, no comprehensive studies of genetic counselor professional development have been conducted. In the present study 34 post-degree genetic counselors from all six National Society of Genetic Counselors practice regions in the United States and Canada participated in a semi-structured telephone interview about their professional development experiences. Five major research questions were investigated: (1) What constitutes professional development for genetic counselors? (2) How do these professional development processes occur for genetic counselors? (3) What facilitates and/or impedes professional development? 4) How does genetic counselor professional development vary as a function of experience level? and 5) How does genetic counselor professional development compare/contrast to psychotherapist development described by Skovholt and Ronnestad (1992a)/Ronnestad and Skovholt (2003) and Orlinsky et al. (2005)? Participants were purposefully sampled from three levels of post-degree genetic counseling experience: novice (0-5 years), experienced (6-14 years), and seasoned (> 15 years). Using a modified version of Consensual Qualitative Research (Hill et al., 2005; 1997), three themes, 12 domains, and 47 categories were extracted from data. The themes are: 1) Being a clinician: Genetic counselors' evolving perceptions of and relationships to their clinical work; 2) The field itself: Genetic counselors' evolving perceptions of and relationships to the field of genetic counseling; and 3) Being a clinician in the field: Genetic counselors' evolving perceptions of and relationships to their role as a genetic counselor A preliminary model of genetic counselor professional development is proposed. The model suggests development processes occur throughout the professional lifespan, each component of professional development mutually influences the others, and there are both positive and negative avenues of development. For instance, personal life and professional life mutually influence each in important ways. Participants rated 15 influences on their professional development (adapted from Orlinsky et al., 2005). Within and across experience levels, and consistent with Orlinsky et al.'s (2005) findings, sources of interpersonal influence ("experiences in genetic counseling with patients" and "working with genetic counseling colleagues") were rated as highly important. The findings also were largely consistent with Skovholt & Ronnestad's (1992a / 2003) therapist model (anxiety in early practice dissipating over time, personal life affecting professional development, etc.), with a few notable differences (including unique challenges of frequently delivering "bad news" to patients, and the parallel process between individual counselors' professional development experiences and genetic counseling's development as a relatively young field. Major findings, study strengths and limitations, and practice, training, and research implications are discussed.