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Paneque M, Serra Juhé C, Melegh B, Carreira I, Moog U, Liehr T. Erratum zu: Über die Notwendigkeit der Anerkennung von sog. Kernberufsgruppen innerhalb der genetischen Gesundheitsversorgung in Europa. MED GENET-BERLIN 2022; 34:189-191. [PMID: 38835907 PMCID: PMC11006359 DOI: 10.1515/medgen-2022-2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
[This corrects the article DOI: 10.1515/medgen-2022-2116.].
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Affiliation(s)
- Milena Paneque
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Clara Serra Juhé
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029Madrid, Spain
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Isabel Carreira
- Cytogenetics and Genomics Laboratory, CACC, iCBR/CIMAGO, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ute Moog
- Institut für Humangenetik, Universität Heidelberg, Heidelberg, Germany
| | - Thomas Liehr
- Universitätsklinik Jena, Friedrich Schiller Universität, Institut für Human Genetik, D-07740Jena, Germany
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Paneque M, Liehr T, Serra Juhé C, Moog U, Melegh B, Carreira I. The need for recognition of core professional groups in genetics healthcare services in Europe. Eur J Hum Genet 2022; 30:639-640. [PMID: 35283482 DOI: 10.1038/s41431-022-01080-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Milena Paneque
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. .,IBMC-Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal. .,Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal.
| | - Thomas Liehr
- Jena University Hospital, Friedrich Schiller University, Institute of Human Genetics, Jena, Germany
| | - Clara Serra Juhé
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029, Madrid, Spain
| | - Ute Moog
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Isabel Carreira
- Cytogenetics and Genomics Laboratory, CACC, iCBR/CIMAGO, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Paneque M, Serra Juhé C, Melegh B, Carreira I, Moog U, Liehr T. Über die Notwendigkeit der Anerkennung von sog. Kernberufsgruppen innerhalb der genetischen Gesundheitsversorgung in Europa. MED GENET-BERLIN 2022; 34:81-83. [PMID: 38836018 PMCID: PMC11006253 DOI: 10.1515/medgen-2022-2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Affiliation(s)
- Milena Paneque
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Clara Serra Juhé
- U705 CIBERER, Genetics Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), 28029Madrid, Spain
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Isabel Carreira
- Cytogenetics and Genomics Laboratory, CACC, iCBR/CIMAGO, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ute Moog
- Institut für Humangenetik, Universität Heidelberg, Heidelberg, Germany
| | - Thomas Liehr
- Universitätsklinik Jena, Friedrich Schiller Universität, Institut für Human Genetik, D-07740Jena, Germany
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Schwaninger G, Benjamin C, Rudnik‐Schöneborn S, Zschocke J. The genetic counseling profession in Austria: Stakeholders' perspectives. J Genet Couns 2021; 30:861-871. [PMID: 33797821 PMCID: PMC8251832 DOI: 10.1002/jgc4.1389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 12/22/2022]
Abstract
In contrast to most European countries, genetic counseling in Austria, Germany, and German-speaking Switzerland is exclusively carried out by medical doctors. In this study, we investigate the perspectives of key clinician stakeholders in Austrian genetics services regarding prerequisites, opportunities, and challenges of implementing master's trained genetic counselors. Semi-structured interviews with open-ended questions and thematic analysis were carried out with nine participants, mostly medical geneticists at different hierarchy levels from three Centers for Medical Genetics in Austria. Several Austrian medical geneticists strongly object to the implementation of non-physician genetic counselors, and representatives of 3/6 medical genetic centers declined to be interviewed. Semantic framing was identified as a critical factor: In German medical language, patient consultations carried out by medical geneticists are generally called 'Genetische Beratung' (genetic counseling), and many medical geneticists see themselves primarily as 'Genetische Berater' (genetic counselors). 'Genetic counseling' is specified as an exclusively medical task in Austrian law. There is apprehension that the introduction of non-physician genetic counselors could reduce quality and undermine the position of medical genetics as a clinical specialty. The situation in Austria resembles that in Germany. Our study highlights the need for a clear definition of roles, expertise, and scope of practice of different genetic professionals. The integration of genetic counselors into Austrian genetics services is most likely acceptable in multi-professional teams, closely affiliated with medical genetic services, and under the medico-legal oversight of medical geneticists.
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Affiliation(s)
- Gunda Schwaninger
- Institute of Human GeneticsMedical University of InnsbruckAustria
- Centre for Medical EducationSchool of MedicineCardiff UniversityUK
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Schwaninger G, Heidemann S, Hofmann W, Maurer T, Mayerhanser K, Ronez J, Schüler H, Steinmüller K, Rudnik-Schöneborn S, Zschocke J. Prospects and challenges for the genetic counsellor profession in the German-speaking countries: report of a workshop. MED GENET-BERLIN 2021; 33:35-44. [PMID: 38836206 PMCID: PMC11006327 DOI: 10.1515/medgen-2021-2055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/09/2021] [Indexed: 06/06/2024]
Abstract
The genetic counsellor profession has not yet been established in the German-speaking countries. In 2019 the Medical University of Innsbruck inaugurated the first German-taught Master's degree programme in Genetic and Genomic Counselling. In order to discuss prospects and challenges of the genetic counsellor profession in Germany, Austria and Switzerland (DACH region), the MSc programme team organized a two-day workshop with international speakers and medical geneticists from the DACH region. Day 1 was dedicated to the history, training and international profile of the genetic counsellor profession. Day 2 focused on four specific topics: (i) professional role, (ii) acceptance and job title, (iii) formal requirements and (iv) remuneration concepts for genetic counsellors in the DACH region. The workshop showed that the key factor for the successful implementation of the genetic counsellor profession is acceptance and trust within the medical genetics team. Genetic counsellors complement patient care in aspects that might be underserved considering the increasing demand of counselling in genomic medicine. Successful establishment of the genetic counsellor profession will entail the development of interprofessional teams under medical supervision and in the team of medical geneticists.
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Affiliation(s)
- Gunda Schwaninger
- Institute of Human Genetics, Medical University of Innsbruck, Peter-Mayr-Straße 1, 6020Innsbruck, Austria
| | | | | | - Tamara Maurer
- Institute of Human Genetics, Medical University of Innsbruck, Peter-Mayr-Straße 1, 6020Innsbruck, Austria
| | | | - Joelle Ronez
- Institute of Human Genetics, Medical University Hannover, Hannover, Germany
| | - Herdit Schüler
- Institute of Human Genetics, Universitätsklinikum Aachen, Aachen, Germany
| | | | - Sabine Rudnik-Schöneborn
- Institute of Human Genetics, Medical University of Innsbruck, Peter-Mayr-Straße 1, 6020Innsbruck, Austria
| | - Johannes Zschocke
- Institute of Human Genetics, Medical University of Innsbruck, Peter-Mayr-Straße 1, 6020Innsbruck, Austria
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Unim B, De Vito C, Hagan J, Villari P, Knoppers BM, Zawati M. The Provision of Genetic Testing and Related Services in Quebec, Canada. Front Genet 2020; 11:127. [PMID: 32194621 PMCID: PMC7064617 DOI: 10.3389/fgene.2020.00127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/03/2020] [Indexed: 11/19/2022] Open
Abstract
Background Research in the field of genomics and genetics has evolved in recent years and so has the demand of consumers who are increasingly interested in genomic prediction of diseases and various traits. The aim of this study is to identify genetic service delivery models, policies governing the use of genomics medicine, and measures to evaluate genetic services in the province of Quebec, Canada. Methods An ad hoc questionnaire was designed and administered online in 2017 to healthcare workers with good knowledge or experience in the provision of BReast CAncer genes 1 and 2 (BRCA1/2), Lynch syndrome, familial hypercholesterolemia, inherited thrombophilia genetic tests, engaged in policy planning or evaluation of genetic services. A quali-quantitative analysis of the survey results was performed. Results Thirty professionals participated in the study. The delivery models are classified in five categories according to the leading role of healthcare professionals in patient care pathways: i) the geneticist model; ii) the primary care model; iii) the medical specialist model; iv) the population screening program model; and v) the direct-to-consumer model. Barriers to genetic services are the coverage of genetic tests by the publicly funded healthcare system, the availability of qualified personnel, and the number of genetic centers. Regulatory oversight concerning the provision of genetic services appears to be insufficient. Conclusions Integration between genetics and the overall healthcare system in Quebec is in an early phase. Current models of genetic services require good level of genetic knowledge by all medical specialists, collaboration among different healthcare personnel, and work redistribution. The proper implementation of genomics into healthcare can be achieved through education and training, proper regulatory oversight, genomic policies, and public awareness.
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Affiliation(s)
- Brigid Unim
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Julie Hagan
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Ma'n Zawati
- Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
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Pestoff R, Svensson K, Paneque M, Malmgren CI. Developing a national certification pathway for genetic counselors in Sweden-a short report. J Community Genet 2020; 11:113-117. [PMID: 31154609 PMCID: PMC6962429 DOI: 10.1007/s12687-019-00426-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022] Open
Abstract
There is no Master's level education for genetic counseling in Sweden, meaning that genetic counselor professionals have very different backgrounds. Hence, there is a need to harmonize the quality of genetic counseling and introduce standards for practice. The Swedish Society for Genetic Counselors and the Swedish Society of Medical Genetics and Genomics collaborated to determine professional requirements and a career pathway, defining three vocational levels within the genetic counselor profession. We report here an individual educational pathway leading up to eligibility for certification as a genetic counselor in Sweden.
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Affiliation(s)
- Rebecka Pestoff
- Department of Clinical Genetics, and Department of Clinical and Experimental Medicine, University Hospital, Linköping University, Universitetssjukhuset, 58185 Linköping, Sweden
| | - Karin Svensson
- Division of Laboratory Medicine, Department of Clinical Genetics and Pathology, Region Skåne, Office for Medical services , SE-221 85, Lund, Sweden
| | - Milena Paneque
- i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Charlotta Ingvoldstad Malmgren
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Center for Fetal Medicine, Karolinska University Hospital, 17176 Stockholm, Sweden
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Nembaware V, Mulder N. The African Genomic Medicine Training Initiative (AGMT): Showcasing a Community and Framework Driven Genomic Medicine Training for Nurses in Africa. Front Genet 2019; 10:1209. [PMID: 31921282 PMCID: PMC6934054 DOI: 10.3389/fgene.2019.01209] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/01/2019] [Indexed: 12/25/2022] Open
Abstract
The potential of genomic medicine in improving the quality of healthcare both at population and individual-level is well-recognized globally. However, successful adoption of genetic and genomic evidence into clinical practice depends on training the healthcare workforce and clinical researchers in genomic medicine. Due to limited expertise in the medical genetics and genomics field, widespread uptake largely depends on task-shifting for the implementation of genomic medicine implementation to key healthcare professionals such as nurses. Their knowledge would be developed through courses aimed at professional development. Globally, trainers, and training initiatives in genomic medicine are in early stages of development, but resource limited settings such as the African continent face additional logistical and institutional challenges. The African Genomic Medicine Training (AGMT) Initiative was conceived during a combined conference of the African Society of Human Genetics (AfSHG) and the Human Heredity and Health in Africa Consortium (H3Africa) in 2016, Senegal, in response to the needs for developing knowledge and skills in genomic medicine. AGMT was established to implement a sustainable genomic medicine training initiative primarily for healthcare professionals who are not geneticists but are nurses, doctors, and pharmacists in Africa. This paper reports on the establishment of the AGMT initiative and the strategies developed and piloted by this initiative in designing and implementing an accredited frame-work and community-based blended learning course for nurses across 11 African countries. The global implementation experiences, outcomes and lessons learnt are highlighted. The AGMT initiative strategy takes advantage of existing research consortia and networks to train and create a pool of trainers and has adopted evidence-based approaches to guide curriculum and content development/adaptation. This initiative established the first Africa-wide online blended learning genomic medicine course which forms the basis from which to develop courses for other healthcare professionals and the wider public.
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Affiliation(s)
- Victoria Nembaware
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nicola Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, IDM, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Moldovan R, McGhee KA, Coviello D, Hamang A, Inglis A, Ingvoldstad Malmgren C, Johansson-Soller M, Laurino M, Meiser B, Murphy L, Paneque M, Papsuev O, Pawlak J, Rovira Moreno E, Serra-Juhe C, Shkedi-Rafid S, Laing N, Voelckel MA, Watson M, Austin JC. Psychiatric genetic counseling: A mapping exercise. Am J Med Genet B Neuropsychiatr Genet 2019; 180:523-532. [PMID: 31222934 DOI: 10.1002/ajmg.b.32735] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 03/12/2019] [Accepted: 04/19/2019] [Indexed: 11/08/2022]
Abstract
Psychiatric genetic counseling (PGC) is gradually developing globally, with countries in various stages of development. In some, PGC is established as a service or as part of research projects while in others, it is just emerging as a concept. In this article, we describe the current global landscape of this genetic counseling specialty and this field's professional development. Drawing on information provided by expert representatives from 16 countries, we highlight the following: (a) current understanding of PGC; (b) availability of services for patients; (c) availability of training; (d) healthcare system disparities and cultural differences impacting practice; and (e) anticipated challenges going forward.
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Affiliation(s)
- Ramona Moldovan
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania.,Division of Evolution and Genomic Sciences, School of Biological Science, University of Manchester, Manchester, United Kingdom.,Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Kevin A McGhee
- Faculty of Science and Technology, Bournemouth University, Poole, United Kingdom
| | - Domenico Coviello
- IRCCS Istituto Giannina Gaslini, Research Institute and Children Hospital, Genova, Italy
| | - Anniken Hamang
- Department of Medical Genetics, St. Olavs Hospital, Trondheim University Hospital
| | - Angela Inglis
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charlotta Ingvoldstad Malmgren
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Mercy Laurino
- College of Medicine, Department of Pediatrics, University of the Philippines Manila, Philippine General Hospital, Manila, Philippines
| | - Bettina Meiser
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Lauren Murphy
- University of Texas Genetic Counseling Program, UT MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Milena Paneque
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,CGPP - Centre for Predictive and Preventive Genetics, Institute for Molecular and Cell Biology (IBMC), Universidade do Porto, Porto, Portugal
| | - Oleg Papsuev
- Moscow Research Institute of Psychiatry, Moscow, Russia
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Eulàlia Rovira Moreno
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.,Department of Clinical and Molecular Genetics, Hospital Vall d'Hebron, Barcelona, Spain
| | - Clara Serra-Juhe
- Department of Clinical and Molecular Genetics, Hospital Vall d'Hebron, Barcelona, Spain.,Medicine Genetics, VHIR, Barcelona, Spain
| | - Shiri Shkedi-Rafid
- Department of Genetics and Metabolic Diseases, Hadassah Medical Center, The Faculty of Medicine, The Hebrew University, Jerusalem
| | - Nakita Laing
- Division of Human Genetics, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | | | - Melanie Watson
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Princess Anne Hospital, Southampton, United Kingdom
| | - Jehannine C Austin
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
The highly specialist, hub and spoke model of Clinical Genetics, as described by the Royal College of Physicians in the UK in 1991, is under the spotlight. Whilst this has underpinned the successful delivery of genetics services historically, it may not be able to deliver genomic healthcare on its own, at scale, simply because genomic testing is no longer contained - any clinician can now order a genomic test, irrespective of their discipline. The professional group of genomic counsellors are now questioning whether there is need for an evolution of their roles. Do we persist in being attached to past models, or do we embrace new models of care and take a direct role in 'mainstreaming' the skills of genomic counselling?. We conclude the genomic counsellor profession and the translated skills of genomic counselling have much to offer in shaping the future of medicine as genomic technologies become part of routine clinical practice.
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Dwarte T, Barlow-Stewart K, O’Shea R, Dinger ME, Terrill B. Role and practice evolution for genetic counseling in the genomic era: The experience of Australian and UK genetics practitioners. J Genet Couns 2018; 28:378-387. [DOI: 10.1002/jgc4.1053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/26/2018] [Accepted: 10/20/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Tanya Dwarte
- Discipline of Genetic Medicine, Faculty of Medicine and Health, Northern Clinical School; University of Sydney, St Leonards; NSW Australia
| | - Kristine Barlow-Stewart
- Discipline of Genetic Medicine, Faculty of Medicine and Health, Northern Clinical School; University of Sydney, St Leonards; NSW Australia
| | - Rosie O’Shea
- Discipline of Genetic Medicine, Faculty of Medicine and Health, Northern Clinical School; University of Sydney, St Leonards; NSW Australia
| | - Marcel E. Dinger
- Kinghorn Centre for Clinical Genomics; Garvan Institute of Medical Research; Darlinghurst NSW Australia
- St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney; Kensington NSW Australia
| | - Bronwyn Terrill
- Kinghorn Centre for Clinical Genomics; Garvan Institute of Medical Research; Darlinghurst NSW Australia
- St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney; Kensington NSW Australia
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The European Board of Medical Genetics: development of a professional registration system in Europe. Eur J Hum Genet 2018; 25:S51-S52. [PMID: 29297876 DOI: 10.1038/ejhg.2017.158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Abstract
BACKGROUND Genomic technology can now deliver cost effective, targeted diagnosis and treatment for patients. Genetic counselling is a communication process empowering patients and families to make autonomous decisions and effectively use new genetic information. The skills of genetic counselling and expertise of genetic counsellors are integral to the effective implementation of genomic medicine. SOURCES OF DATA Original papers, reviews, guidelines, policy papers and web-resources. AREAS OF AGREEMENT An international consensus on the definition of genetic counselling. Genetic counselling is necessary for implementation of genomic medicine. AREAS OF CONTROVERSY Models of genetic counselling. GROWING POINTS Genomic medicine is a growing and strategic priority for many health care systems. Genetic counselling is part of this. AREAS TIMELY FOR DEVELOPING RESEARCH An evidence base is necessary, incorporating implementation and outcome research, to enable health care systems, practitioners, patients and families to maximize the utility (medically and psychologically) of the new genomic possibilities.
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Affiliation(s)
- Christine Patch
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, 57 Waterloo Road, London
- Genetic Counselling, Genomics England, Queen Mary University of London, Dawson Hall, London
- Correspondence address. Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, London SE1 8WA. E-mail:
| | - Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Hinxton, UK
- Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge, UK
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14
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Ormond KE, Laurino MY, Barlow-Stewart K, Wessels TM, Macaulay S, Austin J, Middleton A. Genetic counseling globally: Where are we now? AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018; 178:98-107. [PMID: 29575600 PMCID: PMC5947883 DOI: 10.1002/ajmg.c.31607] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 02/16/2018] [Indexed: 11/17/2022]
Abstract
The genetic counseling profession is continuing to develop globally, with countries in various stages of development. In some, the profession has been in existence for decades and is increasingly recognized as an important provider of allied health, while in others it is just beginning. In this article, we describe the current global landscape of the genetic counseling specialty field's professional development. Using examples of the United States, United Kingdom, Canada, Australia, South Africa, and various countries in Asia, we highlight the following: (a) status of genetic counseling training programs, (b) availability of credentialing through government and professional bodies (certification, registration, and licensure), and potential for international reciprocity, (c) scope of clinical practice, and (d) health‐care system disparities and cultural differences impacting on practice. The successful global implementation of precision medicine will require both an increased awareness of the importance of the profession of “genetic counselor” and flexibility in how genetic counselors are incorporated into each country's health‐care market. In turn, this will require more collaboration within and across nations, along with continuing engagement of existing genetic counseling professional societies.
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Affiliation(s)
- Kelly E Ormond
- Department of Genetics and Stanford Center for Biomedical Ethics, Stanford University, Stanford, California
| | - Mercy Ygoña Laurino
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila, Philippines.,Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, Washington
| | | | - Tina-Marié Wessels
- Division Human Genetics, University of Cape Town, Cape Town, South Africa
| | - Shelley Macaulay
- Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand & the National Health Laboratory Service, Johannesburg, South Africa
| | - Jehannine Austin
- Departments of Psychiatry and Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna Middleton
- Society and Ethics Research, Connecting Science, Wellcome Genome Campus, Cambridge, United Kingdom.,Association of Genetic Nurses and Counsellors, United Kingdom and Republic of Ireland.,Faculty of Education, University of Cambridge, Cambridge, United Kingdom
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Szczepura A, Wynn S, Searle B, Khan AJ, Palmer T, Biggerstaff D, Elliott J, Hultén MA. UK families with children with rare chromosome disorders: Changing experiences of diagnosis and counselling (2003-2013). Clin Genet 2018; 93:972-981. [PMID: 29318577 DOI: 10.1111/cge.13207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/05/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022]
Abstract
The latest United Kingdom (UK) strategy for rare diseases emphasises the need to empower affected populations to improve diagnosis, intervention, and coordination of care. Families who have a child with a rare chromosome disorder (RCD) are a challenging group to include. We report the findings of 2 large-scale surveys, undertaken by the UK RCD Support Group Unique, of these families' experiences over a 10-year period. Seven stages of the patient journey were examined. From pre-testing, through diagnosis, genetics consultation, clinical follow-up and peer support. Overall, 1158 families replied; 36.4% response rate (2003) and 53.6% (2013). Analysis of responses identifies significant differences (P < .001) over time with a decrease in results reported face to face (76%-62%), doubling by telephone (12%-22%), improved explanation of chromosome disorder (57%-75%), and increased signposting to peer support group (34%-62%). However, conduct of the consultation raises a number of important questions. Overall, 28 aspects of the patient journey are recognised as requiring improvement; only 12/28 are currently incorporated in UK service specifications. Involvement of RCD families has identified key service improvements. This approach can empower those affected by such extremely rare disorders, and also enable professionals to design improved services in partnership with "expert families." Further surveys are planned.
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Affiliation(s)
- A Szczepura
- Enterprise and Innovation Group, Coventry University, Coventry, UK
| | - S Wynn
- Unique, The Rare Chromosome Disorder Support Group, Surrey, Oxted, UK
| | - B Searle
- Unique, The Rare Chromosome Disorder Support Group, Surrey, Oxted, UK
| | - A J Khan
- Centre for Innovative Research Across the Life Course, Coventry University, Coventry, CV1 5FB, UK
| | - T Palmer
- Department of Mathematics & Statistics, Lancaster University, Lancaster, UK
| | - D Biggerstaff
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Elliott
- Centre for Innovative Research Across the Life Course, Coventry University, Coventry, CV1 5FB, UK
| | - M A Hultén
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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16
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Baty BJ. Genetic counseling: Growth of the profession and the professional. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018. [DOI: 10.1002/ajmg.c.31601] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Bonnie J. Baty
- Department of Pediatrics, SOM 2C454University of Utah Health Sciences CenterSalt Lake City Utah
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17
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Pestoff R, Moldovan R, Cordier C, Serra-Juhé C, Paneque M, Ingvoldstad CM. How practical experiences, educational routes and multidisciplinary teams influence genetic counselors' clinical practice in Europe. Clin Genet 2018; 93:891-898. [PMID: 29251775 DOI: 10.1111/cge.13197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/08/2017] [Accepted: 12/13/2017] [Indexed: 11/29/2022]
Abstract
The main objective of our study was to explore whether, and to what extent, genetic counselors' characteristics impact on their tasks in practice. Specifically, we explored the complementariness between genetic counselors and medical geneticists and therefore looked at the most relevant tasks of genetic counselors, according to genetic counselors themselves and according to the medical geneticists they work with. A total of 104 genetic counselors and 29 medical geneticists from 15 countries completed a purposefully designed questionnaire. Results showed that most genetic counselors in Europe perform similar tasks, irrespective of their backgrounds. When looking at the factors influencing genetic counselors' roles data showed that the type of tasks performed by genetic counselors is associated with the years of experience in the field, not with their background or education. Of particular interest was the consensus between genetic counselors and medical geneticists regarding the genetic counselor's role. Not surprisingly, tasks with more psychosocial implications were seen as genetic counselors' eligibility while tasks with more medical implications were seen as medical geneticists' attribution. Our study shows that most genetic counselors work in tune with international recommendations and seem to be supportive of multidisciplinary teams. Corroborating our data with previous research, we discuss potential implications for practice and training in genetic counseling.
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Affiliation(s)
- R Pestoff
- Department of Clinical Genetics, Linköping University Hospital, Linköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - R Moldovan
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - C Cordier
- Department of Genetics, Synlab Genetics, Lausanne, Switzerland
| | - C Serra-Juhé
- Genetics Unit, Universitat Pompeu Fabra - Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - M Paneque
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Centre for Predictive and Preventive Genetics CGPP- IBMC - Institute for Molecular and Cell Biology Universidade do Porto, Porto, Portugal
| | - C M Ingvoldstad
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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18
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The perceived impact of the European registration system for genetic counsellors and nurses. Eur J Hum Genet 2017; 25:1075-1077. [PMID: 28513617 DOI: 10.1038/ejhg.2017.84] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/29/2017] [Accepted: 04/13/2017] [Indexed: 11/08/2022] Open
Abstract
The aim of the European Board of Medical Genetics has been to develop and promote academic and professional standards necessary in order to provide competent genetic counselling services. The aim of this study was to explore the impact of the European registration system for genetic nurses and counsellors from the perspectives of those professionals who have registered. Registration system was launched in 2013. A cross-sectional, online survey was used to explore the motivations and experiences of those applying for, and the effect of registration on their career. Fifty-five Genetic Nurses and Counsellors are registered till now, from them, thirty-three agreed to participate on this study. The main motivations for registering were for recognition of their work value and competence (30.3%); due to the absence of a registration system in their own country (15.2%) and the possibility of obtaining a European/international certification (27.3%), while 27.3% of respondents registered to support recognition of the genetic counselling profession. Some participants valued the registration process as an educational activity in its own right, while the majority indicated the greatest impact of the registration process was on their clinical practice. The results confirm that registrants value the opportunity to both confirm their own competence and advance the genetic counselling profession in Europe.
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19
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Paneque M, Serra-Juhé C, Pestoff R, Cordier C, Silva J, Moldovan R, Ingvoldstad C. Complementarity between medical geneticists and genetic counsellors: its added value in genetic services in Europe. Eur J Hum Genet 2017; 25:918-923. [PMID: 28513616 DOI: 10.1038/ejhg.2017.76] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/21/2017] [Accepted: 04/05/2017] [Indexed: 11/09/2022] Open
Abstract
Clinical genetic services have progressed significantly the last few decades. This has led to the need for non-medical health-care professionals working as genetic counsellors in Europe and worldwide. However, there is no unified approach to genetic counsellors' role in health-care services in Europe, as in most countries the profession is still emerging and the educational backgrounds diverge noticeably, within and between countries. This qualitative study aims to describe the potential added value of genetic counsellors in clinical genetics teams and to explore their tasks and responsibilities in different European countries. A total of 143 participants providing genetic counselling in Europe at the time of the survey responded. The results show differences in activities of genetic counsellors, although there is a wide range of roles, which are similar. The ability to establish a quality relationship with consultands was frequently mentioned as one of the strengths of genetic counsellors, as well as a patient-centred approach. It is believed that genetic counsellors add a more holistic approach of psychosocial and familial dimensions of genetic concerns to the multidisciplinary teams. This study provides examples of successful integration of genetic counsellors in teams, as complementariness with medical geneticist became clear in several cases. Although the added value of genetic counsellors was manifested, professional recognition of genetic counsellors across Europe is still needed in order to support the quality of patients care and safety of practice.
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Affiliation(s)
- Milena Paneque
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal.,Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Clara Serra-Juhé
- Genetics Unit, Universitat Pompeu Fabra - Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Rebecka Pestoff
- Department of Clinical Genetics, Linköping University Hospital, Linköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - João Silva
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal.,Centre for Predictive and Preventive Genetics (CGPP), Universidade do Porto, Porto, Portugal
| | - Ramona Moldovan
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Charlotta Ingvoldstad
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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20
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Middleton A, Mendes Á, Benjamin CM, Howard HC. Direct-to-consumer genetic testing: where and how does genetic counseling fit? Per Med 2017; 14:249-257. [PMID: 29767582 DOI: 10.2217/pme-2017-0001] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Direct-to-consumer genetic testing for disease ranges from well-validated diagnostic and predictive tests to 'research' results conferring increased risks. While being targeted at public curious about their health, they are also marketed for use in reproductive decision-making or management of disease. By virtue of being 'direct-to-consumer' much of this testing bypasses traditional healthcare systems. We argue that direct-to-consumer genetic testing companies should make genetic counseling available, pre- as well as post-test. While we do not advocate that mandatory genetic counseling should gate-keep access to direct-to-consumer genetic testing, if the testing process has the potential to cause psychological distress, then companies have a responsibility to provide support and should not rely on traditional healthcare systems to pick up the pieces. A video abstract is available for this article via this link .
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Affiliation(s)
- Anna Middleton
- Society & Ethics Research Group, Connecting Science, Wellcome, Genome Campus, Cambridge, UK
| | - Álvaro Mendes
- UnIGENe & Centre for Predictive & Preventive Genetics (CGPP), IBMC - Institute for Molecular & Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
| | - Caroline M Benjamin
- School of Community Health & Midwifery, University of Central Lancashire, Preston, UK.,Liverpool Women's NHS Hospital Trust, Liverpool, UK
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21
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Liehr T, Carreira IM, Aktas D, Bakker E, Rodríguez de Alba M, Coviello DA, Florentin L, Scheffer H, Rincic M. European registration process for Clinical Laboratory Geneticists in genetic healthcare. Eur J Hum Genet 2017; 25:515-519. [PMID: 28272535 PMCID: PMC5437904 DOI: 10.1038/ejhg.2017.25] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/07/2017] [Accepted: 01/31/2017] [Indexed: 01/28/2023] Open
Abstract
Tremendous progress in genetics and genomics led to a wide range of healthcare providers, genetic tests, and more patients who can benefit from these developments. To guarantee and improve the quality of genetic testing, a unified European-based registration for individuals qualified in biomedicine was realized. Therefore a Europe-wide recognition of the profession ‘European registered Clinical Laboratory Geneticist (ErCLG)' based on a syllabus of core competences was established which allows for harmonization in professional education. The ‘European Board of Medical Genetics division − Clinical Laboratory Geneticist' provides now since 3 years the possibility to register as an ErCLG. Applicants may be from all European countries and since this year also from outside of Europe. Five subtitles reflect the exact specialty of each ErCLG, who can reregister every 5 years. A previously not possible statistics based on ~300 individuals from 19 countries as holders of an ErCLG title provides interesting insights into the professionals working in human genetics. It could be substantiated that there are around twice as many females than males and that a PhD title was achieved by 80% of registered ErCLGs. Also most ErCLGs are still trained as generalists (66%), followed by such ErCLGs with focus on molecular genetics (23%); the remaining are concentrated either on clinical (6%), tumor (4%) or biochemical genetics (1%). In conclusion, besides MDs and genetic counselors/nurses an EU-wide recognition system for Clinical Laboratory Geneticist has been established, which strengthens the status of specialists working in human genetic diagnostics in Europe and worldwide.
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Affiliation(s)
- Thomas Liehr
- Jena University Hospital, Friedrich Schiller University, Institute of Human Genetics, Jena, Germany
| | - Isabel M Carreira
- Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Research Centre for Environment, Genetics and Oncobiology, Coimbra, Portugal
| | - Dilek Aktas
- Hacettepe University School of Medicine, Department of Medical Genetics, Sihhiye, Ankara, Turkey
| | - Egbert Bakker
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Lina Florentin
- Alfalab, Molecular Biology and Cytogenetics Center, Leto Maternity Hospital, Athens, Greece
| | - Hans Scheffer
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
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