Guidance for COVID-19 Related Changes

ACGC has been closely monitoring the evolving situation related to the COVID-19 pandemic and remains committed to promoting quality in genetic counseling graduate education and supporting programs in their efforts to meet standards as we navigate these unique challenges. ACGC recognizes that compliance with several Standards may be impacted as a result of COVID-19 interruptions. ACGC’s guidance to programs describing temporary Standards adherence policies and recommendations for the 2020-2021 academic year (July 1, 2020 – June 31, 2021) related to documentation of COVID-19 program disruptions (e.g. use of distance learning methods and changes to fieldwork training) is available on the ACGC website.

At this time, ACGC is operating normally without interruptions due to COVID-19, though there may be some delay in responses depending on availability of peer reviewers and COVID-19 interruptions. Please note the change in dates for filing the Report of Current Status, due July 15th instead of June 15th and the option to choose to submit required self-study documents for reaccreditation (for those programs whose documents are due in 2020) on either the traditional date of August 1st, , 2020 or the delayed date of October 1st 2020.

The COVID-19 outbreak is still evolving and the ACGC Executive Office will continue to send updates and guidance as the situation unfolds.

ACGC Guidance Related to Compliance with the ACGC Standards in the Time of COVID-19 (As of June 30, 2020):

As guidance regarding the required safety measures for students in educational settings and interactions with patients in healthcare settings is constantly changing, the guidance offered here will also need continuous updating.  Please check back regularly and feel free to contact the ACGC Executive Office for specific questions related to your genetic counseling program.

ACGC outlines below guidance that includes special allowances for certain Standards most impacted by Covid-19 circumstances.  ACGC expects continued compliance with all Standards not listed below to be as written.

STANDARDS OF ACCREDITATION for GRADUATE PROGRAMS IN GENETIC COUNSELING

https://www.gceducation.org/standards-of-accreditation/

Adopted 02/13/2013

Revisions published 10/01/2019

Compliance start date 06/15/2021

ACGC guidance specific to the extenuating circumstances of COVID-19 pandemic are explained in bolded font throughout this document.  Please pay attention to the noted 2013 Standards B1.2.2 and 2013 B3.2.3 as allowable exceptions throughout the 2020/2021 academic year.

Section A: Administration

Personal safety of students and faculty during COVID-19 ongoing restrictions ties in with our current standards per below.

Standard A1.1.2 Addressing appropriate security and personal safety measures for genetic counseling students, staff, and faculty in all locations were instruction occurs

Standard A3.1.4 Students must be informed about, and have access, to student health and counseling services.

Standard A3.1.5 The health, safety, and privacy of clients, students, faculty, and staff associated with educational activities must be reasonably safeguarded by the institution.

With regards to these Standards, ACGC expects programs to:

1.      Provide all recommended PPE for student curricular requirements whenever such equipment is not otherwise provided to students.

2.      Follow the recommended institutional, public health and state/provincial guidance regarding COVID-19 screening requirements such as monitoring for early disease. symptoms/temperature checks, infection and/or at-risk isolation measures, safe at home advisories, social distancing recommendations, and institutional measures designed to protect students and faculty.

3.      Communicate to students and faculty the institution’s

  •  written, approved, and communicated protocols for physical distancing.
  •  expected protocols for hygiene, PPE use, and community behavior.

4.      Confidentially identify those students and/or faculty at high risk and develop appropriate learning interventions as necessary.

5.      Ensure that students can communicate with mental health services regardless of operating scenario (including distancing and remote environments) and that students have access to mental health services regardless of operating scenario.

6.      Ensure that a member of the institution has been able to reach out to each student on a personal level to assure that the students’ mental health needs are being met.

A2.6 Fieldwork Supervisors

The program must ensure that the students have sufficient access to fieldwork supervision by board-certified genetic counselors who represent a broad range of genetic counseling techniques and styles. Programs must assess and document the credentials and qualifications of those who will be supervising the students’ fieldwork experiences.

The standards below are specific to those supervisors who are involved in the 50 required participatory fieldwork cases (see Standard B3.1). For cases that are not part of the 50 required participatory fieldwork experiences, the participating faculty and staff may also include medical geneticists, social workers, psychologists, non-genetics physicians, and other health professionals with adequate training, experience, and credentials in their respective fields.

 A2.6.1 Qualifications

a. Current genetic counselor certification by ABGC, the Canadian Association of Genetic Counsellors (CAGC), or ABMG[G];

b. At least one year of experience as a clinical genetic counselor; and

c. Documented preparation in fieldwork supervision.

ACGC expects continued compliance related to evaluating and documenting supervisor qualifications.  However, during the 2020-2021 academic year, board certified genetic counselors with less than one year of experience and board-certified medical geneticists will be accepted as individuals capable of supervising students for their required 50 participatory cases (2013 Standard A2.3). Please note, that as stated in the 2013 Standard A2.3, ACGC expects supervisors with less than one year of experience to have a mentorship relationship with a genetic counselor/medical geneticist with supervision experience. Additionally, supervision preparation must be provided for all individuals who will supervise genetic counseling students.

A3.2.5 Length of Training:  All graduate programs in genetic counseling are required to provide training over a minimum of 21 months or two academic years.

ACGC requires notification of institution-mandated or program-related disruption or changes in the expected dates of matriculation or graduation dates for students. 

Section B: Curriculum and Instruction

B1.4 The program must demonstrate educational adequacy and equivalency of course content and/or fieldwork experiences when instruction is:

  • Conducted at geographically separate locations;
  • Provided using different andragogical and instructional methods or techniques for some students; and
  • Provided outside the home department.

Programs that must temporarily change their course instructional delivery method (e.g., hybrid, distance enhanced, or distance learning) for the 2020-2021 academic year because of institutional requirements and for student/faculty/staff safety do not need to submit a substantive change form. No notification is required to ACGC for this temporary accommodation to address increased risk related to COVID-19.  If the Program plans for these instructional delivery changes to become permanent after the 2020-2021 academic year, a substantive change request will need to be submitted to ACGC.

B3 Fieldwork Training

Standard B3.1.2 Must include a minimum of 50 participatory cases; at least 40 cases of the 50 total must be with patients/clients evaluated for risk of or affected by diverse genetic conditions across the life span. (does not include simulated/standardized patients and research participants who are recruited for focus groups, interviews, etc.)

ACGC still expects compliance with Standard B3.1.2.  If a program anticipates that a greater number of standardized patient cases may be required to achieve 50 participatory cases for any individual student or for their overall student cohort, program leadership will need to submit a request for variance notification to ACGC along with rationale for why they cannot comply with Standard B3.1.2.  No fee will be assigned for this specific variance request when directly due to COVID-19 restrictions.

B3.1.3 The 50 required participatory cases described above must be supervised by an experienced ABGC/ABMGG/CAGC certified genetic counselor.

As stated above in relation to supervisor qualifications in Standard A2.6.2, during the 2020-2021 academic year, board certified genetic counselors with less than one year of experience and board-certified medical geneticists will be accepted as individuals capable of supervising students for their required 50 participatory cases (2013 Standard A2.3).  Please note, as stated in the 2013 Standard A2.3, ACGC expects supervisors with less than one year of experience to have a mentorship relationship with a genetic counselor/medical geneticist with supervision experience. Additionally, supervision preparation must be provided for all individuals who will supervise genetic counseling students.  

B3.1.4 Programs must demonstrate that participatory cases and other field experiences are conducted (1) across multiple specialties, including prenatal, pediatric, cancer, and other adult; (2) in a variety of diverse settings that may include clinical, laboratory, research, industry, and/or other environments; and (3) using more than one service delivery mode, such as telephone, group, in-person, and/or telemedicine.

While in-person genetic counseling remains an important service delivery mode for training of genetic counseling students, ACGC recognizes that in-person options may be severely limited or unavailable due to COVID-19’s impact on healthcare delivery.  As such during the 2020-2021 academic year, ACGC will accept telemedicine and/or telephone counseling as the only service delivery models used by students in their fieldwork training.

B3.2 General Description Fieldwork Training: Fieldwork Supervision

B3.2.1 Programs must use a flexible and graduated supervision plan where the level of supervision is commensurate with each student’s documented skills and competencies. A student in the early part of their training must be directly supervised at all times. After the student consistently achieves specific skills, the focus of direct supervision is expected to position the student to develop not-yet achieved or emerging skills. Programs are expected to monitor their supervisory protocols regularly and to protect students from taking on responsibilities they are not yet ready to handle or that are inappropriate for a student. The program is responsible for ensuring clients are not seen independently by a student who has not yet achieved the necessary skills to provide competent genetic counseling. Furthermore, the program must guard against students being used to compensate for inadequate genetic counselor staffing levels at given fieldwork training sites.

ACGC expects full compliance with this Standard whether supervision is in-person or through remote options.

B3.3 Programs must ensure that the number and variety of fieldwork opportunities offer all enrolled students equitable and comparable fieldwork training experiences that provide exposure to the full range of practice settings and full range of PBCs.

ACGC expects that each student’s record will document exposure to and demonstrated competency, for the full range of PBCs prior to graduation.

ACGC guidance for COVID-19 related changes (As of April 8, 2020):

The ACGC Board of Directors would like to take this opportunity to thank the many program leaders who are desperately trying to enable their students to complete this graduate education term. We also want to reassure students that ACGC recognizes the significant challenges that have become the reality for students at this time. ACGC is working to support genetic counseling students and graduate programs during this crisis by providing greater flexibility in coursework delivery modes and in acquisition of fieldwork experiences. The main outcome desired by ACGC for each graduating genetic counseling student has not changed. Programs are expected to ensure that each student has had the opportunity to acquire all practice-based competencies prior to graduation. While this expectation has not changed, ACGC recognizes that the way in which PBCs are acquired will require creative solutions that do not fit the previously recognized service delivery modes, case/specialty types, or patient/client encounters. The following points are offered to provide guidance to program leadership, but do not represent a comprehensive list. Please continue to send in questions and ACGC will continue to post guidance.

Report of Current Status deadline change: Recognizing the additional work programs are having to manage during this period of uncertainty, the ACGC Board of Directors would like to grant an extension to all programs in completing the Report of Current Status (RCS). The due date for all programs will be pushed back one month to July 15, 2020.

Reaccreditation self-study date change: Also in recognition of the heavier workload and added stress for accredited programs, the ACGC Board of Directors will offer two submission dates for the reaccreditation self-study: August 1st, 2020 or October 1st, 2020.

Fall Site visit scheduling: ACGC recognizes that not all Programs will be able to safely host an in-person site visit team this Fall. Site visits may need to be moved to later in the year or even early 2021, especially for those who opt to send in their self-study October 1st. It is important to remember that Programs are accredited through 2021, which means that a delay in the site visit and reaccreditation review will not impact participation in student recruitment or the match process for 2021.

Reaccreditation ACGC peer review: Programs will be reviewed based on all years since their last accreditation review. The past few months in 2020 will be reviewed in light of the restrictions demanded in response to the COVID-19 outbreak.
ACGC may require flexibility on the part of programs in the event that reviewers assigned to a particular program fall ill or are unexpectedly unavailable for review and new reviewers need to be assigned. This could result in a delay in the review by ACGC.

Fieldwork experiences, required and supplementary
1. For 2020 Graduating Students:

a. ACGC is allowing Programs to use the 2019 Revised Standards (B3.1.1, B3.1.2, and B3.1.4) related to what can count toward “core cases” defined in the 2014 Standards, now defined as “participatory cases” in the 2019 Revised Standards. This means that graduating students can obtain cases using telehealth models and Standardized Patient Encounters toward their required 50 cases. These cases can be supervised by both board-certified genetic counselors and geneticists.*
b. ACGC recognizes there may be instances where the Program’s 2020 Graduating Students do not have the required 50 core cases prior to graduation due to COVID-19. In these cases, ACGC expects programs to document this in the student’s record and provide the plan used by the program to ensure the student had other opportunities during the COVID-19 crisis to develop skills related to complete acquisition of the PBCs.
c. ACGC also expects Programs to document that graduating students have successfully met the Program’s curricular requirements and acquisition of the ACGC-PBCs across their training, both prior to and during the COVID-19 crisis.

2. For 2021 Graduating Students:

a. Programs may begin using the 2019 Revised Standards (B3). This means that 2021 graduating students can use telehealth models and Standardized Patient Encounters toward their required 50 participatory cases.
b. Additionally, as delineated in the 2019 Revised Standards, all types of fieldwork placements (clinical, laboratory, research, industry, and/or other environments (B3.1.4; 2019) may be used for an individual student to complete the PBCs enabling the student to be competent and fulfill graduation requirements.
c. Currently, and given that these students have another year of training, ACGC expects that 2021 students will be held to the requirements set forth in the 2019 Revised Standards (B3.1). However, ACGC is also very cognizant of the fluidity of the current national situation due to COVID-19 and will continue to monitor whether additional flexibility will be required.

Supervisors as standardized patients: We recommend that before a supervisor acts as a standardized patient, they receive appropriate training, and that the encounter be fully developed with objectives and outcome measures formulated for each specific student prior to initiating the case experience. These encounters may be used toward the 50 required cases for genetic counseling students. Many programs already use standardized patients for their program and may be willing to assist with case development or training tips. AGCPD has many resources regarding standardized patient scenarios.

Standardized patient training was offered on Thursday, April 9th. For more information about this training and access to the recording, please contact Colleen Dougherty, MS, CGC at cdougherty@baypath.edu, the lead for this project.

Standardized Patient training was performed with the help of:

Janet K. Willhaus, PhD, RN, CHSE, CHSOS
Associate Professor
Coordinator, Graduate Certificate in Healthcare Simulation
Boise State University School of Nursing

Janet Willhaus is a nurse educator and scholar with more than 17 years of healthcare simulation teaching experience. She is certified in both simulation education (CHSE) and operations (CHSOS) and she directs the Graduate Certificate of Healthcare Simulation at Boise State. At the international level, Dr. Willhaus currently serves as the President-elect for the International Nursing Association of Clinical Simulation and Learning (INACSL). Under Willhaus’ leadership, the Boise State Simulation team earned international recognition as the winners of the 2018 INACSL Excellence Award as Frontline Service Champions.

This project is a result of collaboration between multiple GC training programs: Bay Path University, Boise State University, Boston University, Brandeis University, Columbia University, Emory University, Indiana State University, Indiana University, Mt. Sinai School of Medicine, The Ohio State University, Sarah Lawrence College, University of British Columbia, University of Manitoba, and the University of South Carolina

Documenting Changes in the student record related to COVID-19:
ACGC has no specific template and does not plan to require a specific template, as each program will likely have to address the impact of COVID-19 differently depending on their institution and student needs. However, ACGC does suggest that the following minimal information be included for any curricular or fieldwork placement changes related to COVID-19.

  • Fieldwork Placement Changes, please note the following in each student’s record:
    • Date and reason of change for the student placement. (e.g. COVID-19 restrictions required the following change(s) in NAME’s planned fieldwork experiences: and list the changes).
    • Note the student’s field placement plan pre-COVID
    • Note the specific changes made to the student’s remaining work throughout the crisis timeframe (e.g. Student was switched from prenatal placement to cancer placement to participate in telehealth opportunities; student remained in placement but was provided with case preparation assignments related to acquiring skills for the Domain 1: Practice Based Competencies [PBCs]; Students participated in role plays and standardized patient encounters to continue acquisition of skills in the pediatric setting).
    • Document discussions with each student noting the student’s skills and PBCs still outstanding and the program’s plan to have the student acquire those skills and PBCs prior to graduation. It may be prudent to have the student sign off signifying his/her agreement with the changes.
    • Coursework Changes, please note the following in each student’s record:
    • Date and reason for the change in the coursework (e.g. COVID-19 restrictions required cancellation of in-person course content delivery).
    • Note the student’s curriculum plan pre-COVID
    • Note the specific changes in course delivery (e.g. courses transitioned to online delivery; course delivery timing was changed from fall semester to summer semester).
    • Document discussions with students related to these changes.

Using genetic counselors with less than one year of experience to be supervisors:
* ACGC will continue to accept CGC Genetic Counselors as supervisors with less than one-year experience as per Standard A2.3.1 (2014 revision) until compliance with the new Revised 2019 Standard A2.6 is required in 2021. However, ACGC still expects programs to comply with Standard 2.3.1 requirement that “If a clinical supervisor has less than one year of experience, he or she must have a mentorship relationship with a genetic counselor/medical geneticist with supervision experience” and “adequate preparation in clinical supervision.”

Use of remote rotations:
COVID-19 circumstances dictate that remote supervision may be one of the only options for students to acquire cases and practice-based competencies.
There are programs that regularly utilize remote supervision. Much work and planning went into designing this mode of supervision within these programs. After COVID-19 restrictions are lifted, there may be a greater number of programs that look to continue remote fieldwork options; however, any permanent change within a program will require the appropriate curricular changes, implementation of a fully recognized online supervisory format, as well as safeguards for student and patient privacy in ongoing clinical genetic counseling service delivery.

Remote rotations in the summer of 2020
If COVID-19 restrictions continue, then remote fieldwork experiences may be the only option for summer. At this time, we are expecting that first year students will have the option to accrue participatory cases (2019 Revised Standard B3) throughout their second academic year, starting in the Fall 2020.

ACGC Guidance Related to Compliance with the Standards in Time of COVID-19 View Here