126
information from their physicians, genetic counselors facilitate that process by
identifying questions patients should ask their doctors and by providing guidance
for speaking with the physician: “It sounds like you will need to be direct and ask
your questions quickly’” (p. 10). The authors further note that given the brief nature
of typical laboratory genetic counselor/client interactions, “genetic counselors must
carefully articulate the questions that are of most immediate importance” (p. 13).
Goodenberger et al. ( 2015 , p. 14) provide examples of questions laboratory
genetic counselors might ask. These include:
- Closed-ended or focused questions to obtain clinical or order-specific infor-
mation, and focus the conversation to ensure relevant information is discussed.
For example, “Has the patient’s father had genetic testing for Lynch syn-
drome?” “Based on the paperwork submitted with the sample, I understand
that this child has asthma. Is there another reason why chromosomes were
ordered?” - Open-ended questions to elicit a patient’s medical and/or social history, under-
stand provider’s concerns, learn what information the person on the other end has
available, and assess the provider’s/lab staff’s understanding of the clinical,
genetic, and technical concepts. For example, “How was this patient first diag-
nosed with Marfan syndrome?” “What information were you given when you
were asked to order this test?” “What is your past experience with microarray
testing in children with autism?”
Burgess et al. ( 2016 ) surveyed genetic counselors about their perceptions of the
similarities and differences between telephone genetic counseling and in person
genetic counseling. With respect to questioning skills, a large majority of their
respondents viewed these question-asking skills as similar: “Tailor questioning for
the individual case.... Assess client emotion and/or behavior [with questions]”
(p. 120). Some participants noted differences that included “...[using] more direct
questioning in telephone genetic counseling than they would typically use in an in
person genetic counseling [session]. One participant illustrated this well by stating:
‘When there is a silence on the end of the line I have no visual cues to guide me as
to why. I have to be more direct and I cannot verify my best guesses with visual
corroboration...’” (p. 121). Some counselors also commented that with respect to
family history and pedigree taking, the lack of visual information required them to
“modify questioning due to the inability to make any kind of visual assessment of
ethnicity. For instance, one participant expressed that “‘Ethnicity can be easier to
determine when you can see the patient/client; you may phrase the ethnicity ques-
tion differently in these cases, such as ‘would you consider yourself to be African
American?’ versus just blatantly asking. It may be more difficult to draw these
conclusions from telephone counseling, so the question may be more pointed’”
(p. 122).
5 Gathering Information: Asking Questions