Examining genetic counselors’ implicit attitudes toward disability

Abstract

Genetic counselors have a unique role in healthcare that requires a balance between being a patient educator and patient advocate when discussing disability. This study aimed to determine genetic counselors’ implicit attitudes toward disability, and identify what factors affect these implicit attitudes. Case scenarios involving disability were used to examine hypothetical estimates of time spent on different topics within a genetic counseling session. Implicit attitudes were measured using the validated Disability Attitudes Implicit Association Test (DA‐IAT), and personal/professional experiences with disability were assessed. Analysis of 382 respondents of the electronic survey revealed that personal experience with individuals with disabilities was not significantly associated with implicit attitudes scores. In addition, results demonstrated that genetic counselors have a stronger bias toward ability (Dmean = 0.62, Dstd = ±0.45) compared to previous participants of the DA‐IAT (p < .005). Practice specialty, length of time in the genetic counseling field, or whether the participant was a practicing counselor or genetic counseling student were not associated with implicit attitudes scores. The bias toward ability observed across practice specialties may be due to shared factors that influence interest in this field, but may also potentially reflect the inability of the DA‐IAT to capture the complexity of genetic counselors’ relationship to individuals with disability. This study emphasizes the importance of incorporating patients’ individual definitions of disability into genetic counseling sessions and building an environment of patient advocacy and education around their personal perspectives and needs.

Diversity training experiences and factors associated with implicit racial bias among recent genetic counselor graduates of accredited programs in the United States and Canada

“…The prevalence of pro-White bias among recent GC graduates was also lower than other reports of bias towards other majority populations among genetic counselors (Gould et al, 2019;Lowe et al, 2020;Nathan et al, 2019)…”

“…A 2014 study of third‐year medical students showed that 65% of respondents demonstrated implicit bias towards people of similar demographic groups as themselves (Gonzalez et al., 2014). The prevalence of pro‐White bias among recent GC graduates was also lower than other reports of bias towards other majority populations among genetic counselors (Gould et al., 2019; Lowe et al., 2020; Nathan et al., 2019). Specifically, Lowe et al reported that 77% of practicing genetic counselors involved in their study demonstrated bias favoring White individuals.…”

“…Evaluations of implicit biases regarding homosexuality and perceived physical disability among genetic counselors and GC students have been published, noting general preference towards heterosexuality and perceived ability (Gould et al., 2019; Nathan et al., 2019). Otherwise, implicit bias specifically among GC students remains understudied.…”

Implicit bias toward people with disability: A systematic review and meta-analysis.

“…Differences in implicit bias between cultural groups were also suggested by findings of studies that investigated racial differences (Coleman et al, 2015; Friedman, 2019; Harder et al, 2019; Jiang et al, 2021; Thomas et al, 2014; VanPuymbrouck et al, 2020); however, such studies compared racial groups within a specified country rather than between countries. Furthermore, samples of healthcare professionals also yielded higher D -scores for general disability (Aaberg, 2012; Archambault et al, 2008; Gould et al, 2019). When comparing implicit attitude results of studies that used Project Implicit data, while all were in the moderate negative implicit attitude range, the subset sample of healthcare professionals had the highest reported D -score (VanPuymbrouck et al, 2020).…”

Reforming Informed Consent: On Disability and Genetic Counseling

“…These include, for example, arguments that the practice of prenatal testing invariably judges certain disabled lives to be not worthy or less worthy of living or that its effect, regardless of questions of judgment, is the prevention of certain people with disabilities from coming into being. 1 Importantly, calls for greater attention to the complexity of disability as well as calls for greater incorporation of the experiential testimony of various disability communities have for many years now also become increasingly common from inside the practice of prenatal genetic counseling (Farrelly et al 2012;Sanborn and Patterson 2014;Madeo et al 2011;Gould et al 2019;Boardman 2020). Whether coming from inside or outside, these calls often assume that genetic counselors' responsibilities to disability communities revolve around dialogue, understanding, and representation.…”