Genetic Counseling Trainees’ Experience of Cultural Sensitivity Training and Suggested Improvements

The racial demographic of the genetic counseling profession continues to be dominated by White practitioners. Per the 2021 professional status survey of genetic counselors, 90% of the profession is White. This stands in sharp contrast to the increasing racial and ethnic diversity of patients that receive genetic counseling. It is therefore critical that genetic counseling trainees receive education on cultural sensitivity and how to provide high quality care to patients of different racial, ethnic, and cultural background. Often a key step in cultural sensitivity training is to address personal implicit biases. While this process can build awareness of one’s own internalized stereotypes, it can also raise emotional barriers known as “rebound effect” which may limit the trainee's ability to effectively engage in cultural sensitivity training. Little research has been done on the effectiveness of current cultural sensitivity training within genetic counseling programs. Through this exploratory qualitative research study, 21 current and recently graduated genetic counseling trainees from across the country shared their perspectives on the state of cultural sensitivity training today. Five semi-structured focus groups were conducted via the Zoom teleconferencing platform. Transcript data was analyzed via an inductive grounded theory model through two coding cycles. Major findings indicate that GC trainees want more opportunities to learn from medical interpreters and gain insight directly from the minority perspective. Trainees also reported on problematic aspects of current training. This included taking the implicit association test (IAT) without being provided guided debrief after the activity, observing supervisor behavior that did not align with culturally sensitive teachings, and experiencing minority burden. Trainees felt that a critical aspect of cultural sensitivity training was engaging in open discussions on topics related to culture such as current events. Concurrently, trainees emphasized the importance of holding these discussions in a safe space, especially to alleviate minority trainee burden. Participants hypothesized that having a facilitator who is well trained in moderating sensitive conversations, adjusting timing and formatting of discussions, and following up with those negatively impacted by conversation can contribute to fostering a safe space. These findings can inform GC programs’ cultural sensitivity training approach