Association of Genetic Nurses and Counsellors (AGNC)
Genetic Counsellor Training in the UK:
an Information Pack
Claire Dolling
Sue Kenwrick
Rhona Macleod
AGNC Genetic Counsellor Training Panel
Issued October 2015
Contents
Background
Training for Registration
Approved Training Centres
Training Post Holders
Sample job description for training post
Learning contracts
Monitoring and evaluation
2
3
3
3-4
4
4
4
4-5
Appendices:
A: Application form for Validation as a UK Genetic Counsellor Training Centre
6-10
B: Sample Job Description
11-13
C1: The Learning Contract: general information
14-15
C2: Sample Learning Contract
16-20
D: Evaluation Report Forms
21-24
E: Entry Level Criteria
25
Contact details for further information
26
2
Background
The main remit of the Genetic Counsellor Training Panel (GCTP) is:
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to facilitate and monitor posts aimed at training genetic counsellors for Registration in the UK and the Republic of Ireland
to assess and approve Regional Genetics Centres who wish to offer such training.
to provide advice and guidance about genetic counsellor training to trainees, mentors and training centres.
The processes used by the GCTP, and described below, are based closely on those used during the Department of Health (DH)
funded Training Post Scheme, which began in 2005.
Training for Registration
Under the Registration system, practitioners wishing to train as registered genetic counsellors (RGCs) must first satisfy a set of
requirements in one of two potential pathways, henceforth known as entry-level qualifications. Full details of current entry-level
qualifications are available from the website of the Genetic Counsellor Registration Board (www.gcrb.org.uk) and in appendix E.
In order to apply for registration as a genetic counsellor, practitioners must submit a portfolio to the Registration Board. Details of
current portfolio requirements are provided by the GCRB on their website.
Approved Training Centres
Approved Training Centres (ATCs) must provide access to a suitable learning environment including:
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A multidisciplinary approach to patient care
A supervised clinical caseload
Clinical case meetings
A named registered genetic counsellor to act as a training supervisor/mentor.
Established links with departments related to clinical genetics, including laboratories and other related clinical
specialities (e.g. fetal medicine, cancer services and paediatrics)
Clinical and counselling supervision
Opportunities for participation in clinical audit and research
Access to educational opportunities through departmental seminars, study days & journal clubs with clinical application
3
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Learning resources, including appropriate IT facilities and library resources
A minimum of 3 genetic counsellors who are either registered or actively seeking registration.
Centres seeking ATC status must complete and return the “Application form for Validation as a UK Genetic Counsellor Training
Centre” (Appendix A). ATCs should submit an application for revalidation every 5 years.
Training post holders
The primary aim of training posts is to support higher professional training in genetic counselling for new entrants to the specialty,
from a diverse range of backgrounds. Individuals appointed to training posts should satisfy the entry-level qualifications prior to
appointment. Panel members are available for informal advice on whether an applicant’s background meets the aims of a training
post.
Sample job description for training post
For guidance, an example is included in this pack (Appendix B). The job description will reflect the current approach to supervised
practice for new postholders in accordance with the agreed AGNC Career Structure.
Learning contracts
On appointment, the trainee and their mentor will be asked to draw up a personal learning contract which will form the basis for
planned provision of training opportunities. Progress towards fulfilling this contract should be reviewed regularly by the trainee
and mentor, and also by the GCTP. Individual contracts should reflect both the trainee’s previous qualifications and experience,
and their career aims and should take careful note of the current Registration requirements. Further details on Learning Contracts
and a sample contract are included in this pack (Appendices C1, C2).
Monitoring and evaluation of training post
Each Centre will be asked to:
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Notify the GCTP of the appointment of the trainee, together with details of their Mentor, and a copy of the Learning
Contract within one month of the trainee taking up their post.
The Trainee will be asked to:
4
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Submit evaluation reports (see Appendix D) to the GCTP at 6, 12, 18, and 24 months.
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The 12,18 and 24 month reports should contain details of progress towards Registration.
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Update the GCTP following completion of the post on their employment and registration outcomes.
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APPENDIX A
Application form for Validation as a UK Genetic Counsellor Training Centre
(Document updated November 2011)
Is this application being made jointly with another Centre? (please circle)
Yes
No
If yes, please give name of other centre:
…………………………………………………………………………………………………………………………………………………………………………………………………….…………………………………………………….
(NB. Each Centre should complete this form individually)
(A) Details of applying Centre
Centre name:………………………………………………………………………………………………………………………….…………………………………………………………..……………………………………………
Centre address:………………………………………………………….…………………………………………….…………………………………………………………………….…………….…………………………………
……………………………………………………………………………………………….…………………………………………………………..…………………………………………………………………………………………….
Name of Lead Genetic Counsellor:……………………………………………………………….….………………………………………………………………………..………………………………………….………
Contact email address:………………………………………………………………………………………………………………………………………………………………………………………….…………………………
Contact telephone:………………………………………………………………………………….……………………………………………………………………………………………………………………….………………
Clinical Director/Head of Service:………………………………………………………………………………………………………………………………………………………….………………………………………..
UK Registered Genetic Counsellor nominated by Centre as the person with whom the Genetic Counsellor Training Post Panel (GCTPP) will communicate
directly, after the validation process is completed, e.g. with respect to recruitment, appointment and reports on progress etc.)
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….………
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Date of application:………………………………………………………………………………………….………………………………………………………………………………………………......……………………….
(B) Staffing levels
(*FT equivalents)
Population served by Centre:…………………………………………………………………………………………………………………………………………………………………………………………………………….
Number* of Registered Genetic Counsellors:……………………………………………………………………………………………………………………………………………………………………………………
Number* of other genetic counsellors/nurses at band 7 or above (numbers seeking registration):………………….…………………………………………………………………..……
Number* of genetic counsellors at band 6 (e.g. for whom the department has training commitments), and end date of post(s) if fixed term:………………………..
Number* of Consultant Clinical Geneticists:…………………………………………………………………………………………………………………………………………………………………………………….
Number* of Specialist Registrars:…………………………………………………………………………………………………………………………………………………………………………….………………………
Number* of other medical staff: ………………………………………………………………………………………………………………………………………………………………………………………………………
(C) Criteria for selection as a Training Centre
Please indicate how you feel you can meet each of these criteria. Applicants may be asked to expand upon or clarify this evidence.
(i)
The GENETICS SERVICE
CRITERIA
EVIDENCE
Maintaining a high standard of
multidisciplinary care within the
department (e.g. through clinical
case meetings, peer support,
mentoring, case review)
Family follow-up services and/or
genetic registers
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Relationships with relevant
patient groups
Outreach clinics
Established lines of
communication and collaboration
with laboratory services
A multidisciplinary approach to
patient care (e.g.
multidisciplinary meetings,
clinical or educational activities
with professionals from other
disciplines or specialties)
Established links with other
related clinical specialties (e.g.
fetal medicine, cancer services
and paediatrics)
Participation in clinical audit
Involvement in and contribution to
research activities
8
(ii) SUPPORT FOR EDUCATION AND TRAINING
CRITERIA
EVIDENCE
Clinical supervision.
Please give details of:
 proposed UK Registered GC
mentor(s)
 whether mentor(s) will be on
the same site as trainee
genetic counsellor(s)
(If not, please give details)
Counselling supervision
Please give details of
 type of supervision (individual,
group etc.)
 supervisor
 frequency
 source of funding
Journal clubs with clinical
application
Access to educational
opportunities through
departmental seminars and study
days
9
Learning resources including
appropriate IT facilities and
library resources
Access to training in
multidisciplinary teaching
A culture that encourages and
supports continuing professional
development
Ability to establish an appropriate
learning contract with the trainee
e.g. to work towards genetic
counsellor registration
Please complete and return application to the AGNC Genetic Counsellor Training Panel by email to Judy Tocher (judy.tocher@sch.nhs.uk)
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APPENDIX B
Sample Job Description
for trainee genetic counsellor post aimed at completing higher professional training towards registration as genetic counsellor
Job Title:
Trainee Genetic Counsellor
Grade:
Trainee Grade (Agenda for Change Band 6)
Hours:
Full time, fixed term for 24 months (or part time equivalent)
Location:
Named Trust
Reports to:
Named Training Mentor
Accountable to:
Head of Service (or as per local arrangements)
JOB PURPOSE
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To gain the requisite clinical and educational opportunities to enable the postholder to obtain registration as a genetic
counsellor.
To contribute to the provision of a high quality genetic counselling service within (name of Service).
KEY RESPONSIBILITIES (These will vary at different stages of training and according to supervision requirements)
The postholder will:
1.
Participate in drawing up a Learning Contract with their Mentor, within one month of appointment.
2.
Endeavour to meet the learning needs agreed in the Learning Contract, according to the strategies identified, throughout
the tenure of the post.
Participate in 6 monthly reviews of their learning progress with their mentor and through written reports to the Training
Panel.
3.
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4.
See patients and their families in genetic clinics, other clinic settings, and in their own homes.
5.
Take responsibility for his/her own work, subject to the supervision of the named mentor, Genetic Counsellor Manager and
the Consultant Clinical Geneticists.
6.
Participate in clinical and counselling supervision as arranged by their mentor.
7.
Contribute to preparation of consultant led genetic clinics to ensure their effectiveness and efficiency as well as continuity
of care for families referred. This includes pre-clinic contact by telephone/home visiting, preparation of notes, attendance
at clinics and follow-up.
8.
Undertake genetic counselling where the diagnosis has been well established and under the direct supervision of their
mentor or other senior genetic counsellor. In these instances, send summary letters to the patients and their doctors.
9.
Participate in (but not to take primary responsibility for) disease specific clinics/genetic family register service, including
annual review, genetic counselling for the extended family, home visits, organisation of clinics, other follow up and support.
10.
Arrange relevant prenatal diagnostic tests for genetic patients who inform the department of a pregnancy, ensuring
continuity of care through to outcome under the supervision of the mentor.
11.
Confer, where necessary, with their mentor, other senior genetic counsellors, clinical geneticists and laboratory colleagues
to assess the appropriateness and range of clinical contact and investigations to be undertaken.
12.
Endeavour to achieve for all families seen a good understanding of the genetic counselling and the best possible adjustment
to the presence of genetic disease in their family. Towards this aim, interpreting the genetic facts in a way that is
comprehensible to families.
13.
Employ the methods, procedures and approach established within the department but also to aim to improve procedures for
the benefit of patients and the service.
Confer, where necessary, with their mentor, other senior genetic counsellors, clinical geneticists and laboratory colleagues
to assess the appropriateness and range of clinical contact and investigations to be undertaken.
14.
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15.
Undertake an equitable proportion (appropriate to this training post) of the total genetic counsellors’ workload whilst
maintaining an appropriate quality of work.
16.
Maintain a full and accurate record of work undertaken (including pedigrees, telephone and home visit reports,
correspondence and other notes) in both manual and computerised records and preserve their confidentiality.
17.
Ensure that best possible standards of work are maintained.
18.
Facilitate communication between medical, field working, clerical and laboratory staff within the department to ensure the
best possible service to families.
19.
Maintain effective communication with professionals (e.g. medical, nursing, social work) outside the department, both for
the benefit of individual families as well as to promote general awareness of the genetic counselling service.
20.
Assist with departmental research.
21.
Contribute to departmental teaching commitments, as appropriate to level of previous teaching experience.
22.
Attend departmental seminars/teaching sessions, and national meetings.
23.
Collate clinical and educational development opportunities towards the portfolio of evidence required for Genetic
Counsellor registration.
24.
Prioritise work, particularly assessing the urgency of clinical work.
25.
Participate in internal and external audit procedures.
26.
Undertake any other duties, within the context of this job description and appropriate to the grade of the post, necessary
for the changing needs of an effective and efficient patient service.
APPENDIX C1: The Learning Contract: General Information
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What is a Learning Contract?
An individualised plan to facilitate identification of relevant learning strategies for the trainee and enable those strategies to be
assessed.
What is the purpose of the Learning Contract?
A
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Learning Contract (LC) is designed to assist both trainees and mentors to:
identify the trainee’s learning needs
think creatively about ways of addressing those needs
formulate an agreed training plan
agree on means of assessing how and to what extent the training needs have been met.
The LC should be discussed and documented at the start of the training period. At each assessment it is used to review progress
and formulate future training plans.
Where do we start?
The overall focus of the training program is to enable the individual to satisfy the requirements for AGNC registration. As the
registration system is based on a set of competencies, it makes sense to use those as a framework for identifying the needs of the
trainee. It is very likely that an individual who has been appointed to a training post will already have developed some of the
required competencies to a significant extent, but will be able to identify areas where considerable development is still needed.
It is suggested that the trainee and mentor discuss the trainee’s skills in terms of the AGNC competencies to classify competencies
into those where some skill is present but consolidation required and those in which the trainee has little or no competence at
present. Those areas where there is little or no competence will provide the major focus for discussion of educational input
required for this trainee.
What types of educational experience might be appropriate?
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Any appropriate strategy that will enable to trainee to develop competence can be used. It is envisaged that strategies will
include:
 observation of good clinical practice in clinical genetics
 observation of laboratory practice where appropriate to the work of a genetic counsellor (e.g. so a test can be described to a
client or a result interpreted by the counsellor)
 supervised clinical practice with feedback
 informal educational programs (such as journal clubs, case discussion meetings, laboratory/clinical meetings)
 formal unassessed educational programs (such as conferences)
 formal assessed courses ( such as MSC modules, counselling courses)
 observational placements in relevant departments or institutions (such as Fetal Medicine Unit or Breast Cancer screening unit)
 setting the trainee designated learning tasks (such as literature search).
Review and renewal of the Learning Contract (LC)
It is important that the desired outcome for each learning strategy is agreed so that the effectiveness of the plan can be
assessed at the review meeting. As the trainee’s professional development progresses, some learning needs will be satisfied,
others will arise as a result of greater awareness of the role of the genetic counsellor. The LC is a fluid document that should
alter at each 6 monthly review according to need. A sample portion of a LC is included here to assist you. It is not meant to be
prescriptive, but to give you ideas for writing your own contracts. A learning contract template listing all the competencies is
provided for drawing up a tailored contract.
Evaluation reports
To facilitate reporting these are built onto the initial learning contract as illustrated by the sample evaluation forms (Appendix
D2). The competences and initial overall learning needs remain the same. The relevant progress and strategy columns for 6, 12,
18 or 24 month (final) reports can be added to the original learning contract as shown (and those for the previous report
deleted). The reports should be accompanied by mentor and trainee reports that include progress towards registration. Copies
of sequential reports should be kept by the trainee and mentor.
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APPENDIX C2: GC Training Post, Sample Learning Contract
Name of trainee:
Name of mentor:
Training centre:
Commenced post on:
Date:
Competence
Learning needs
1. Establish relationship and elicit
clients’ concerns and expectations
Become competent at
establishing a
professional counselling
relationship
Strategy and Assessment method
0-6 MONTHS
Observe and reflect with mentor on 10 counsellor and at least 5 consultant
consultations.
Undertake and reflect with mentor on at least 10 supervised consultations.
Assist with patient orientation at VHL clinic.
2. Elicit and interpret appropriate
medical, family and psychological
history
Learn to develop family
tree.
Become competent at
eliciting and recording
medical and
psychosocial history.
Become competent at
genetic risk assessment.
Review chapter on drawing family tree.
Clinic observation of practitioners as above.
Review 10 sets of clinical notes.
Discuss use of clinic proformas with mentor.
Review cancer risk assessment with cancer lead. Attend and take cases to
departmental and cancer meetings.
Undertake supervised consultations as above. Attend clinical supervision.
Shadow GCs on call to observe pregnancy procedures.
Accuracy of family tree drawing assessed at mentor meetings
Etc for rest of competencies
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APPENDIX C2: GC Training Post, Learning Contract Template
Name of trainee:
Name of mentor:
Training centre:
Commenced post on:
Date:
Competence
Learning needs
Strategy and Assessment method
0-6 MONTHS
1. Establish relationship and elicit
clients’ concerns and expectations
2. Elicit and interpret appropriate
medical, family and psychological
history
3. Convey clinical and genetic
information to clients appropriate
to their individual needs
4. Explain options available to the
client, including the risks, benefits
and limitations
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5. Acknowledge the implications
of individual and family
experiences, beliefs, values and
culture for the genetic counselling
process
6. Identify and respond to
emerging issues of the client or
family
7. Make a psychosocial assessment
of clients’ needs and resources
and provide support, ensuring
referral to other agencies as
appropriate
8. Use of a range of counselling
skills to facilitate clients’
adjustment and decision- making
9. Document information including
case notes and correspondence in
an appropriate manner
10. Identify, synthesise, organise
and summarise relevant medical
and genetic information for use in
genetic counselling
11. Make appropriate and accurate
genetic risk assessment
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12. Identify and support clients’
access to local, regional and
national resources and services
13. Demonstrate ability to
organise and prioritise a case load
14. Plan, organise and deliver
professional and public education
15. Establish effective working
relationships to function within a
multi-disciplinary team and as part
of the wider health and social care
network
16. Practice in accordance with
the AGNC Code of Ethical Conduct
17. Recognise and maintain
professional boundaries
18. Recognise his or her own
limitations in knowledge and
capabilities and discuss with
colleagues or refer clients when
necessary
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19. Demonstrate reflective skills
within the counselling context and
in personal awareness for the
safety of clients and families by
participation in genetic
counselling supervision
20. Present opportunities for
clients to participate in research
projects in a manner that
facilitates informed choice
21. Demonstrate continuing
professional development as an
individual practitioner and for the
development of the
Profession
22. Develop the necessary skills to
critically analyse research findings
to inform practice development
23. Contribute to the development
and organisation of genetic
services
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APPENDIX D: Genetic Counsellor Training Post
Evaluation report forms
Name of trainee:
Name of mentor:
Training Centre:
Commenced post on:
6 / 12 / 18 month report (delete as appropriate):
Date of report:
APPENDIX D: GC Training Post, Sample Evaluation report forms
Competence
Learning Need
1. Establish relationship and elicit
clients’ concerns and expectations
Become competent at
establishing a
professional counselling
relationship
0-6 Months (or 6-12 or
12-18 as appopriate)
Progress including
obstacles
Completed observation
for 3 counsellors (15
cases) and 2 consultants
(8 cases)including cardiac
clinic. Conducted 15
supervised in general and
cancer clinics
consultations and cocounselled further 10
with consultant in cardiac
clinic. Assisted at 4 VHL
clinics. Reflected on
cases in clinical
supervision. Identified
need to understand more
about bereavement.
21
Strategy and assessment 6-12 Months
(or 12-18 or 18-24)
Continue to develop skills in co-counselling and
unsupervised clinics.
Broaden experience of clinical situations by
observing both GCs and consultant cancer,
endocrine and NF1 clinics.
Attend grief and loss course.
2. Elicit and interpret appropriate
medical, family and psychological
history
Learn to develop family
tree.
Become competent at
eliciting and recording
medical and
psychosocial history.
Become competent at
genetic risk assessment
Reviewed course on
drawing trees. Discussed
strategies used in
observed consultations at
mentor meetings. Drew
family trees and elicited
family and psychosocial
information in 15
supervised consultations.
Conducted risk
assessment, triaged
family history forms with
supervision. Presented
cases at weekly meetings
Continue to develop skills in co-counselling as
well as beginning to see own cases.
Take part in on-call rota to develop skills of
taking relevant history by telephone.
Observe GC and consultants in Fetal medicine
clinic
Process on call pregnancies with supervision.
Etc for other competencies
OR
Final 24 month Report
Progress and assessment including obstacles
Competence
Learning Need
1. Establish relationship and elicit
clients’ concerns and expectations
Become competent at
establishing a
professional counselling
relationship
Experience obtained in counselling in general, prenatal, multidisciplinary and
cancer clinics. Attended advanced communication skills course. Log of all
cases kept and reviewed by mentor
2. Elicit and interpret appropriate
medical, family and psychological
history
Learn to develop family
tree.
Become competent at
eliciting and recording
medical and
psychosocial history.
Become competent at
genetic risk assessment
Competency obtained in variety of clinics as above as well as on-call and
telephone consultations. Feedback obtained from mentor , co-counselling
GCs and consultants.
Etc for other competencies
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(B) Brief statements of progress
(Here the trainee and mentor should each provide a short paragraph summarising progress during the previous 6 months in
implementing the strategies agreed in the learning contract)
Trainee statement:
Signed:
Date:
..............................................................................................
Mentor statement:
Signed:
Date:
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(C) Trainee/mentor contact
Has the trainee and mentor had regular and consistent contact over the period of training since the past report? YES/NO (delete as
appropriate)
If NO, please provide brief explanation of circumstances.
(D) Details of progress towards Genetic Counsellor Registration (12,18 and 24 month reports only).
Mentor signature:
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APPENDIX E: Entry Criteria
Set A
Attainment of a GCRB approved/accredited Master of Science (MSc) degree in Genetic Counselling
Set B
Attainment of a First or Masters degree.
Plus
Attainment of a professional qualification as a registered nurse of midwife and evidence of maintenance of
current professional registration.
Plus
Previous experience as a senior registered practitioner having developed and demonstrated proficiency as an
autonomous professional in a health care setting.
Plus
Completion of training in counselling skills of at least 90 guided learning hours.
Plus
Completion of an academically accredited course on the science of human genetics of no less than 30 guided
learning hours. The applicant must show evidence of having passed a formal assessment/examination as part of
that course.
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For further information, help or advice about Genetic Counsellor Training, please contact a member of the
Training Panel:
Claire Dolling (Birmingham)
Claire.Dolling@bwhct.nhs.uk
Sue Kenwrick (Cambridge)
sue.kenwrick@addenbrookes.nhs.uk
Rhona Macleod (Manchester)
Rhona.Macleod@.nhs.uk
This document is available electronically from Sue Kenwrick
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