Suguitan Mike Darren, McCarthy Veach Patricia, LeRoy Bonnie, Wherley Colleen, Redlinger-Grosse Krista
Medical Genetics, Northwestern Medicine, Winfield, Illinois.
Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, Minnesota.
J Genet Couns. 2019 Jun;28(3):602-615. doi: 10.1002/jgc4.1057. Epub 2019 Feb 23.
Clinical supervision plays a key role in the training of genetic counselor practitioners. The Reciprocal-Engagement Model of Supervision (REM-S) is a recently published model of genetic counseling supervision centered on the supervisor-student relationship. The REM-S comprises five tenets and 16 goals that reciprocally interact to achieve three broad supervision outcomes. Lacking, however, is a comprehensive set of supervisor strategies that correspond to the tenets and goals. This study aimed to elaborate the REM-S by identifying strategies genetic counselor supervisors use to accomplish each REM-S goal when they supervise students in clinical rotations. Nineteen prenatal, pediatric, and cancer genetic counselor supervisors from clinics in a major Midwestern city participated in one of three focus groups. Eleven semistructured questions were asked about strategies they use when attempting to accomplish each REM-S goal. Directed content analysis yielded a total of 14 different strategy domains that vary in their frequency for accomplishing each REM-S goal. Participants identified between nine and 13 strategy domains for each goal. Across all REM-S goals, the most frequent strategy domains are: Assess student; Practice self-reflection to increase supervisor self-awareness; and Establish student goals and expectations. The present findings elaborate the REM-S by identifying supervisor strategies corresponding to the REM-S goals. These strategies can inform training in clinical supervision, and they can be the focus of observational studies designed to identify supervisor behaviors that characterize each strategy.
临床督导在遗传咨询师从业者的培训中起着关键作用。互惠参与督导模式（REM-S）是最近发表的一种以督导-学生关系为核心的遗传咨询督导模式。REM-S包含五个原则和16个目标，它们相互作用以实现三个广泛的督导结果。然而，缺乏一套与这些原则和目标相对应的全面的督导策略。本研究旨在通过确定遗传咨询督导在临床轮转中督导学生时用于实现每个REM-S目标的策略来详细阐述REM-S。来自中西部一个主要城市诊所的19名产前、儿科和癌症遗传咨询督导参加了三个焦点小组之一。针对他们在试图实现每个REM-S目标时所使用的策略提出了11个半结构化问题。定向内容分析共产生了14个不同的策略领域，这些领域在实现每个REM-S目标的频率上有所不同。参与者为每个目标确定了9至13个策略领域。在所有REM-S目标中，最常见的策略领域是：评估学生；进行自我反思以提高督导的自我意识；以及确立学生的目标和期望。本研究结果通过确定与REM-S目标相对应的督导策略，详细阐述了REM-S。这些策略可为临床督导培训提供参考，也可成为旨在识别每种策略所特有的督导行为的观察性研究的重点。
