An exploration of cultural competency training and genetic counselors' racial biases

Author:

Quillin John M.1ORCID,Shin Yongyun2ORCID,Shin Dongho2,Carmany Erin3ORCID,Duffy Conor4ORCID,Hagiwara Nao4ORCID

Affiliation:

1. Department of Pediatrics Virginia Commonwealth University Richmond Virginia USA

2. Department of Biostatistics Virginia Commonwealth University Richmond Virginia USA

3. Center for Molecular Medicine and Genetics Wayne State University Detroit Michigan USA

4. Department of Psychology Virginia Commonwealth University Richmond Virginia USA

Abstract

AbstractResearch shows genetic counselors generally have pro‐White implicit biases—both prejudice and stereotyping. Cultural competency training aims to foster equitable beliefs, behaviors, and attitudes in cross‐cultural genetic counseling sessions, including those that are racially discordant (genetic counselors and patients are from different racial backgrounds). Therefore, cultural competency training has the potential to mitigate bias and reduce disparities. Here, we report the prevalence of cultural competency training among genetic counselors and associations between recency of training and counselors' racial biases. We conducted an online survey of genetic counselors and trainees in fall 2021. The survey assessed four types of bias (implicit/explicit prejudice and implicit/explicit stereotyping), time since last cultural competency training, time since last communication skills training, and frequency of clinic sessions with Black patients. Multiple linear regressions modeled associations between cultural competency training and different types of bias, adjusting for communication skills training, frequency of encounters with Black patients, and counselor race (White vs. non‐White). Two hundred fifteen participants (107 genetic counselors and 108 trainees) responded, and 205 reported whether they had prior cultural competency training. Of these, 187 (91%) reported ever having cultural competency training, most (53%) of participants who had training had it within 6 months prior to survey completion. We found no clear pattern of associations between cultural competency training and racial biases (implicit or explicit) in adjusted analyses. Participants who had cultural competency training four or more years prior demonstrated less negative implicit stereotyping toward Black individuals compared with those having more recent training; but no statistically significant effect was found for participants who reported never having cultural competency training, compared with those having training more recently than 4 years prior. Overall, our findings do not support that cultural competency training is negatively associated with, or mitigates, Black/White racial prejudices and stereotypes against Black patients. These findings suggest more effective interventions are needed to reduce racial biases.

Funder

National Institute of Diabetes and Digestive and Kidney Diseases

National Cancer Institute

Publisher

Wiley

Subject

Genetics (clinical)

Reference25 articles.

1. Accreditation Council for Genetic Counseling. (2019).Standards of accreditation for graduate programs in genetic counseling.https://www.gceducation.org/wp‐content/uploads/2022/04/https___www.gceducation.org_wp‐content_uploads_2020_06_Revised‐Standards‐of‐Accreditation_Final_Effective‐10.1.19__6.17.20‐Comp‐Date‐Rev‐5.1‐to‐6.15.pdf

2. Efforts of diversity and inclusion, cultural competency, and equity in the genetic counseling profession: A snapshot and reflection

3. Summary report of the 2019 Diversity and Inclusion Task Force of the National Society of Genetic Counselors

4. The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care

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