Loyola University Medical Center, Maywood, Illinois, USA.
Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA.
J Genet Couns. 2024 Feb;33(1):41-53. doi: 10.1002/jgc4.1876. Epub 2024 Feb 15.
Genetic counseling students with minoritized identities have reported experiencing microaggressions throughout graduate training, including from fieldwork supervisors. However, the impacts of these fieldwork experiences have not been thoroughly investigated. As supervision is known to be integral to genetic counseling students' skill development and success, the purpose of this qualitative study was to explore the impact of microaggressions on student training, with a specific focus on the supervisory working alliance. To achieve this goal, we conducted 11 interviews with recent genetic counseling graduates (2019-2021) who reported experiencing at least one microaggression from a fieldwork supervisor during graduate school training. Purposive sampling was used to prioritize interviewees who identified as underrepresented in the field due to race, ethnicity, gender identity, sexual orientation, and/or disability status. All interviewees were initially recruited as part of a larger mixed-methods study investigating the frequency and types of microaggressions genetic counseling students experience from fieldwork supervisors. Interview questions explored the time period before a microaggression event, during the event, and after. Qualitative thematic analysis resulted in four themes, three of which are presented in this paper: (1) Impact of microaggressions, (2) Barriers to reporting microaggressions, and (3) Experience reporting microaggressions. Microaggressions from supervisors were shown to impair the psychological well-being of participants and hinder learning opportunities. These experiences led participants to question their choice of profession and avoid time in clinic, ultimately constraining the development of strong supervisory working alliances. Some participants did not report microaggressions due to fear of negative repercussions, and those who did described defensive responses which harmed students' relationships with program leadership. This study reveals opportunities for supervisors to improve student training conditions by centering students' feelings and experiences, increasing open and honest communication, and extending psychosocial tools to supervision. Additionally, graduate programs are encouraged to establish structured reporting protocols for students and evaluate current shortcomings in equity and inclusion initiatives.
少数族裔身份的遗传咨询学生在研究生培训过程中报告经历过微侵犯，包括来自实地工作督导者。然而，这些实地工作经验的影响尚未得到彻底调查。由于监督被认为是遗传咨询学生技能发展和成功的关键组成部分，本研究的目的是探讨微侵犯对学生培训的影响，重点是监督工作联盟。为了实现这一目标，我们对 11 名最近毕业的遗传咨询师（2019-2021 年）进行了采访，他们在研究生培训期间至少经历过一次来自实地工作督导者的微侵犯。采用目的性抽样优先采访因种族、族裔、性别认同、性取向和/或残疾状况而在该领域代表性不足的受访者。所有受访者最初都是作为一项更大的混合方法研究的一部分被招募的，该研究调查了遗传咨询学生从实地工作督导者那里经历的微侵犯的频率和类型。采访问题探讨了微侵犯事件发生前、发生时和发生后的时间。定性主题分析产生了四个主题，其中三个在本文中呈现：（1）微侵犯的影响，（2）报告微侵犯的障碍，（3）报告微侵犯的经历。督导者的微侵犯被证明会损害参与者的心理健康，并阻碍学习机会。这些经历使参与者质疑自己选择的职业，并避免在诊所工作，最终限制了强大监督工作联盟的发展。一些参与者由于担心负面后果而没有报告微侵犯，而那些报告的人描述了防御性反应，这损害了学生与项目领导层的关系。本研究揭示了督导者通过关注学生的感受和经验、增加开放和诚实的沟通以及将心理社会工具扩展到监督中来改善学生培训条件的机会。此外，鼓励研究生课程为学生建立结构化的报告协议，并评估当前在公平和包容倡议方面的不足。
