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1、ORIGINAL RESEARCHA Comparison of Telephone Genetic Counseling and In-PersonGenetic Counseling from the Genetic Counselors PerspectiveKelly R. Burgess1&Erin P. Carmany2&Angela M. Trepanier2Received: 12 November 2014 /Accepted: 18 May 2015#National Society of Genetic Counselors, Inc. 2015Abstract Grow
2、ingdemandforandlimitedgeographicaccessto genetic counseling services is increasing the need for alter-native service delivery models (SDM) like telephone geneticcounseling (TGC). Little research has been done on geneticcounselors perspectives of the practice of TGC. We createdan anonymous online sur
3、vey to assess whether telephone ge-netic counselors believed the tasks identified in the ABGC(American Board of Genetic Counseling) Practice Analysiswere performed similarly or differently in TGC compared toin person genetic counseling (IPGC). Ifthere were differencesnoted, we sought to determine th
4、e nature of the differencesand if additional training might be needed to address them.Eighty eight genetic counselors with experience in TGC com-pleted some or all of the survey. Respondents identified dif-ferences in 13 (14.8 %) of the 88 tasks studied. The tasksidentifiedasmostdifferentinTGCwere:“
5、establishingrapportthrough verbal and nonverbal interactions (60.2 %; 50/83respondents identified the task as different), Brecognizing fac-tors affecting the counseling interaction (47.8 %; 32/67),Bassessing client/family emotions, support, etc. (40.1 %;27/66) and Beducating clients about basic gene
6、tic concepts(35.6 %; 26/73). A slight majority (53.8 %; 35/65) felt addi-tional training was needed to communicate information with-out visual aids and more effectively perform psychosocialassessments. In summary, although a majority of geneticcounseling tasks are performed similarly between TGC and
7、IPGC, TGC counselors recognize that specific training in theTGC model may be needed to address the key differences.Keywords Servicedeliverymodels.Telephonegeneticcounseling.Geneticcounselortraining.GeneticcounselortasksIntroductionWithin the last several years, there have been several impor-tant dev
8、elopments that have led to a potential increase in de-mand for genetic counseling services. The United StatesPreventive Task Force, for example, has recommended genet-ic counseling for women whose family history places them atan increased likelihood to carry a BRCA1 or BRCA2 mutation(Moyer 2014; Uni
9、ted States Preventive Task Force 2005). Asthese recommendations have been classified as a BGrade Brecommendation, they are covered under the Affordable CareAct(U.S.PreventiveServicesTaskForce2014).Additionally,there appears to be a recent trend of insurance companies,including national provider Cign
10、a Corporation, covering thecost of genetic counseling and requiring patients to have ge-netic counseling prior to providing coverage for certain genet-ic tests (Graf et al. 2013; Lee 2013).Another development affecting demand for geneticcounseling services is the expanded use of next generationseque
11、ncing technology in clinical genomic testing. This tech-nology has contributed to the increasing number of genomictests available overall (Genetests 2015). Furthermore, use ofthe technology brings with it potential challenges, especiallyin informed consent and results interpretation, and these arech
12、allenges genetic counselors are specially trained to address(Accreditation Council for Genetic Counseling 2013). The* Erin P. Carmanyecarmanymed.wayne.edu1Rush University Cancer Center, 1725 W. Harrison Ave, Suite 809,Chicago, IL, USA2Center for Molecular Medicine and Genetics, Wayne StateUniversity
13、 School of Medicine, 540 E. Canfield, 2375 Scott Hall,Detroit, MI, USAJ Genet CounselDOI 10.1007/s10897-015-9848-2growing need for genetic counselors in the absence of signif-icant growth in the workforce could limit appointment avail-ability. This could lead to other providers with no specializedtr
14、aining in genetics taking on the responsibility of genetictesting, test interpretation and counseling. Such a situationmay not be ideal since there have been several reports ofadverse patient outcomes when non-genetics providers incor-rectly ordered and interpreted genetic testing results and/orprov
15、ided inadequate genetic counseling (Bensend et al.2013; Bonadies et al. 2014; Brierley et al. 2010, 2012).Additionally, although there is no clear evidence that theexisting genetic counseling workforce cannot meet the de-mand for services even with the increased availability of ge-netic testing, the
16、 geographicdistributionof genetic counselorsis limited, particularly in some rural areas of the country(National Society of Genetic Counselors 2014). As a resultof all of these factors, genetic counselors are increasinglyusing alternative service delivery methods, such as telephonegenetic counseling (TGC), to increase access to services(Cohen et al. 2013).In order toexplore accesstogenetic counseling services, in2009theNationalSocietyofGeneticCounselors(NSGC),theleading professional organization
