Sudden shift to remote genetic counseling during the COVID‐19 pandemic: Experiences of genetics professionals in Italy

Abstract

The 2020 COVID‐19 pandemic has rendered in‐person provision of genetic counseling impossible for prolonged periods in many countries, mandating a sudden shift to remote delivery. We used qualitative thematic analysis to explore Italian genetics professionals’ experience with remote genetic counseling. Fourteen group and four individual interviews were conducted after participants had delivered one or more remote sessions via videoconference or on the telephone. Data were coded and grouped under themes. Three main themes were identified as follows: (a) technical and logistical issues, (b) communication issues, and (c) clinical content and outcome of the session. The participants acknowledged that not having to travel to the clinic saves consultands time and expense. They also highlighted that not sharing a physical space with consultands and having to rely on technology can negatively impact on effective communication, building trusting relationships, and performing accurate psychosocial assessments. Regarding the clinical content of sessions, remote genetic counseling was perceived to favor greater focus and succinct, to the point communication. However, participants also felt uncomfortable not being able to use visual aids to support the explanation of complex concepts. Moreover, demographics and the socio‐cultural status of consultands emerged as factors influencing the outcome of remote genetic counseling sessions. Finally, participants reported feeling that more experience with this novel approach would improve their confidence and their ability to adapt their counseling skills as appropriate. Based on these findings, we suggest that effective, equitable provision of remote genetic counseling will require an infrastructure that is able to support video counseling, sharing of clinical documents and visual aids, and connect with a wide range of devices. Moreover, the structure of sessions should be tailored to the specific requirements of remote genetic counseling and suitable training efforts should be promoted to enhance professionals’ communication skills.

An examination of psychosocial and professional effects of the COVID‐19 pandemic on genetic counselors

“…Overall, this study recapitulates data regarding changes to professional aspects of genetic counseling practice since the spring of 2020 and elaborates on previously identified non‐professional challenges experienced by genetic counselors (Bergstrom et al, 2021; MacFarlane et al, 2021; Mauer et al, 2021; Mills et al, 2021; Mueller et al, 2021; Pan et al, 2021; Rezich et al, 2021; Shannon et al, 2021; Turchetti et al, 2021; Wessels et al, 2021). As many of the qualitative responses showed, however, the distinction between professional and non‐professional aspects of life for genetic counselors can be ambiguous.…”

“…Initial research regarding the practice of genetic counseling during the pandemic addressed methods for continued out‐patient genetic consultative services via alternative service delivery models (Bergstrom et al, 2021; López‐Fernández et al, 2021; Mauer et al, 2021; Rezich et al, 2021; Shannon et al, 2021; Turchetti et al, 2021). To assess consequences of a large‐scale conversion to telegenetics, Mills et al (2021) surveyed genetic counselors to quantitatively identify aspects of their changed roles.…”

Comparison of willingness and preference for genetic counseling via telemedicine: before vs. during the COVID-19 pandemic

“…It is frequently proposed to improve efficiency of services and patient access (Greenberg et al 2020 ; McDonald et al 2014 ). Increased utilization has never been so rapid, however, as during the COVID-19 pandemic to maintain public health safety while allowing for minimal interruption in care delivery (Greenberg et al 2020 ; Turchetti et al 2021 ). While fewer than half of genetic counselors in the USA reported using telemedicine prior to the pandemic, nearly all used it during the pandemic (National Society of Genetic Counselors 2021 ).…”

An evidence‐based practice guideline of the National Society of Genetic Counselors for telehealth genetic counseling

“…Some genetic counselors feel providing psychosocial support is more difficult over telephone or video and specifically note loss of nonverbal cues and visual aids as a challenge (Mills et al, 2021; Turchetti et al, 2021; Zierhut et al, 2018). The well‐documented success of mental health telehealth provides reassurance that empathic connection is feasible by telehealth (Thomas et al, 2021).…”

“…Genetic counselors often use visual aids during in‐person appointments to demonstrate genetic concepts. Use of visual aids may require more effort in a telehealth setting (Mills et al, 2021; Turchetti et al, 2021). Depending on the platform, video appointments with screen sharing options could increase the ease and flexibility of using visual aids.…”