Achieving the Practice-Based Competencies: Are More Than 50 Cases Needed?

Farren Elena Lopez, BS (Advisor: Aarti Ramdaney, MS, CGC)

           Genetic counseling graduate programs are required to provide didactic coursework and fieldwork experiences to foster development of the practice-based competencies (PBCs) in trainees. Currently, every graduating trainee must log a minimum of 50 participatory encounters to demonstrate readiness for entry-level practice of the PBCs. Previous studies have noted that many trainees exceed the 50-case standard, raising the question whether this minimum may not satisfy the training needs of every student. To assess the perceived number of encounters needed for graduates to independently perform the PBCs, a survey was administered to 2023 and 2024 graduates of North American genetic counseling training programs. Descriptive statistics and inductive thematic analysis were used to analyze data for trends and common themes in quantitative and qualitative data, respectively. Ninety-three responses were analyzed, with the majority (62.4%) of respondents having graduated in 2024 and the median number of total cases acquired being 121-130 cases. Though the median cases to reach independence for 21 out of the 22 PBCs fell below 50 cases, almost all respondents that achieved independence could be accounted for at ≤90 -110 cases with participants further voicing their support for a higher case number in open-ended questions. Specific PBCs may also benefit from supplementary training, including standardized patients or targeted didactic coursework, as they are less commonly encountered in fieldwork training but may require more opportunities to develop independent practice. Interestingly, while an increase in the minimum number of cases appears to be indicated, almost 50% of participants reported seeing more cases than needed overall, suggesting a careful balancing act between acquiring enough cases to achieve independence and avoiding a point of saturation. Participants also noted multiple factors outside case numbers that influenced when they felt they could practice independently, most notably how supervisors may promote or impede their development. Future studies are needed to explore trainee and program-driven factors that may influence readiness for practice.

Advisory Committee:

• Aarti Ramdaney, MS, CGC, Chair
• Morgan Armstrong, MS, CGC
• Myla Ashfaq, MS, CGC
• Syed Hashmi, MD, MPH, PhD
• Morgan Nutter, MS, CGC

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