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Activity 3: Small Versus Big Questions
Provide students one of the following hypothetical scenarios.
- Patient is referred for evaluation of a family history of colon cancer. The patient’s
father, brother, and sister all had colon cancer diagnosed in their 40s. The patient
is 35 years old, recently married, and wants to start a family. - You are seeing a Latino couple whose infant has multiple congenital anomalies.
The baby is in the ICU and is being evaluated for a chromosomal disorder. - A couple is referred for genetic counseling following a positive newborn screen
for cystic fibrosis in their daughter. - Your patient is a 36-year-old African American female referred for genetic coun-
seling during her first pregnancy. She and her husband are newly married. The
pregnancy is unplanned. She is 8 weeks pregnant. She has a brother with
unexplained intellectual disability. Her mother had two miscarriages. Her mater-
nal aunt had a stillborn baby with “multiple birth defects.”
Tell students to imagine they could ask the patient only six questions (excluding
family history questions). What would they ask? Have students write down their six
questions.
Next students exchange papers with one or more classmates and review each
other’s questions.
Estimated time: 20 min.
Process
Ask students to read their six questions, and have a general discussion about the
similarities and differences in questions and whether questions were primarily
open-ended or closed-ended. Finally, refer students to Sarangi et al.’s ( 2004 )
descriptions of six types of reflective frames described in this chapter, and ask them
to identify which of their questions correspond to each of the frames.
As a conclusion to this activity, point out to students that having a framework for
the “big questions” is an important part of case preparation, and it helps them struc-
ture the genetic counseling session.
Estimated time: 50 min.
Activity 4: Constructing Culturally Educated Questions (Dyads or Small Groups)
Introduce this activity with the following information: Charles et al. ( 2006 ) com-
pared culturally tailored genetic counseling versus standard genetic counseling in a
sample of African American women at risk for BRCA 1/2 mutations and found
women who received the culturally tailored counseling reported greater satisfaction
and a greater reduction in their worries than women who received the standard
counseling. Specific to cultural empathy, the culturally tailored approach included
5 Gathering Information: Asking Questions