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- The same young man in scenario 3 refers his sister (the one with the affected son)
for counseling. She has just moved to the USA and has not previously had access
to genetic counseling. She wants to know if her other children will develop
Lesch-Nyhan syndrome and also what are the risks to future pregnancies. - The patient is coming for genetic counseling regarding a history of two sons who
had multiple congenital anomalies and died shortly after birth. No genetic evalu-
ation or testing was completed on either baby. She is now married to a different
partner and seeks information about her chance of having another child with
similar problems. - A 32-year-old man was referred to clinic because his father and paternal grand-
mother both died of a “heart attack” in their early 40s. His brother just had a
heart attack at age 41.
Instructor Note
- Students may need to research one or more conditions in order to complete this
exercise. - One variation is to have students select one or more of the patient scenarios and
write these patients a letter of summary. - These scenarios could be role-played in class, with the student verbally present-
ing risk information to the patient.
Exercise 2: Applying a Decision-Making Model
Observe an actual genetic counseling session, and afterward use the Danish and
D’Augelli decision-making model to describe the patient’s decision-making
process.
Exercise 3: Risk Communication and Cultural Factors
Talk with an individual who is a recognized cultural leader for a specific population
(e.g., Hmong, Native American, Latino/Latina, etc.). Discuss how members of her
or his community typically understand the concept of risk for health problems and
how risk can best be communicated.
Exercise 4: Role Play
Engage in a 30-min role-play of a genetic counseling session with a classmate. The
role-play can be based on a patient you saw in clinic or it can be a made-up patient
situation. During the role-play, focus on providing risk information and assisting the
patient with decision-making. Audio-record the role-play. Next transcribe the role-
play and critique your work. Use the following method for transcribing the session:
7 Providing Information and Facilitating Patient Decision-Making