Change of direction

Though this is slightly off topic from the general focus of this blog I wanted to post this website and get the reactions of the genetic counseling community.

I am not sure if anybody has read the new New York Times article on the company Counsyl but their website is very disturbing to me. It is not disturbing because they offer carrier screening for genetic diagnoses but because they tout phrases such as “Prevent disease before pregnancy” and “A five minute test before pregnancy could save your baby’s life”. Our community knows that offering carrier screening can be helpful when a couple is informed of specificity and sensitivity of the test as well as what options they would have if they decided to conceive on their own or with help of IVF/PGD. Also we know that even with carrier screening we cannot guarantee a child will not be affected by one of the diseases we tested for as well as many others we didn’t or can’t test for. This company is jumping on the bandwagon of other direct-to-consumer genetic testing groups and it seems they forgot to realize that if they want to create something that is helpful to the genetic community maybe they should make sure they don’t market their product in a way that is unethical and unrealistic.

Counsyl website“https://www.counsyl.com/”

How I feel now

It’s hard to begin to describe how I feel about my experience with the ABGC exam. Sometimes I think that it wasn’t my fault that I studied a lot of material that wasn’t on the exam. Also sometimes, I am proud of the fact that I got 75% of the questions correct when I was unsure of the format of the exam and I have not had clinical experience in two years.

But then there are times where I feel disappointed in myself for not accomplishing the goal that I set out to accomplish a couple of months ago. I sometimes question my skills and intelligence as a counselor. Does this exam really mean that I am not able to do my job well? Am I less qualified than those that I work with?

Other counselors might say that is not the case, but it is hard to deny the feeling of worthlessness sometimes.

The prospect of studying for the exam again is overwhelming. Though I did take the exam this past year, I still have no real idea how I should prepare to do better next time. I can only try to do better and hope that the passing score isn’t out of reach for me. I do think that if I do improve my score from this past year and for some reason I still don’t make the cut off then maybe I will say that is the end of my quest of becoming certified. Because I wont know what it means for me other than the state of Massachusetts allowing me to continue to call myself a genetic counselor.

Those of you who have to study again and try again, I am in this with you.

Props to the ABGC

I just wanted to say I think the ABGC did a great job of posting the webcast quickly and making it very easy to access on their website. It was very helpful to be able to listen to the entire meeting even though I was unable to attend the NSGC meeting.

(Here’s a link: ABGC Presentation)

Misunderstandings…

I want to dispel a few misconceptions about this blog and the authors of the blog.  There seems to be some concern and confusion about a few things.  I hope this post helps to clarify.

Concern: “The authors encourage people to send them comments and share content about the exam so that they can review and edit it.”

In fact, we have specifically discouraged any comments/postings that contain specific information about exam content.  Realizing that sharing this type of content is not appropriate or allowed by the ABGC, we asked that those making comments please refrain from including ANY specifics about the content of the exam.

1. skssavage said

   November 9, 2009 at 11:15 am eRemember, we’re talking about what we like or dislike about the review courses and what we’d ideally like to see covered in these courses. Please, no comments on specific questions or specific topics that were included on the exam. (See “Keep in mind…” post.)

We have not solicited any detailed information about the 2009 exam.  Instead, we’ve tried our best to encourage constructive discussion about various aspects of our professional certification, including the exam preparation process/review courses, ideas and ideals about how our certification process could be improved, etc.  Also, it is our hope that this can be a forum in which GCs can express what they do like about the exam process, format, administration, and what they do not like.

We have made posts (Keep in mind and Reminder) explaining that, should we happen to see that someone has made a comment including material that could be considered prohibited by the ABGC, we will do our best to edit that comment appropriately.  Our intent is to avoid any problems with ABGC, protect ourselves, and also protect any commentors (especially because some commentors do include identifying information in their posts).  Overall, we are just trying to be responsible.

Concern: “The authors did not pass the 2009 exam and are personally benefiting from information provided via blog comments.”

It is true that we both took the 2009 exam.  However, if you take a look at the Contributors page, you’ll see that one of us did pass and the other did not.  We were glad to be able to provide two different points of view.  Neither of us is gaining any advantage for future test-taking via these blog discussions because 1) we have specifically requested that no sensitive information be shared and we are intentionally deleting any possibly problematic info that happens to get posted anyway and 2) we have both already seen the 2009 test — we already have the same prior information as any other 2009 test-taker.  The purpose of our editing efforts is not to gather lots of information for ourselves and then prevent other readers from seeing it.  Ideally, nobody will post inappropriate information.

Reminder…

This post is to remind everyone that we should not post specific information about the exam, including the breakdown of exam content and how many questions were in each category.  As a rule of thumb, if it has not been outlined in the ABGC exam bulletin or some other public ABGC communication, we should not share it here.  A few comments have been edited for this reason.  In such cases, the statement below has been included:

Note from blog authors: Edits were made to this comment.  Items were removed or replaced with asterisks in order to protect specific information about exam content.  Because this specific info is not in the ABGC bulletin, we should not share it publicly.

Additionally, some comment have been removed entirely.  We apologize for any confusion that our editing may cause.

Notes from the ABGC meeting

Pasted below are notes from someone who attended the ABGC meeting at the NSGC conference in Atlanta.

ABGC Board Meeting at NSGC AEC 11/15/09

• 428 people took the exam.  331 passed for a 77.3% pass rate.
• Of the 428;  369 were first time test takers.  293 passed for a 79.4% pass rate.
• There was no difference between the pass rate of 2007 and 2008 grads.
• The cost of the exam is increasing to $1365 and can be taken any time between Aug. 16-Sept. 18.
• The certification maintenance fee is increasing to $80.

Comment:  The test was too clinically oriented and should have contained more mundane content.

Answer:  The test focuses more on the clinical aspect as more GCs are clinical.  The practice of GCs will continue to be surveyed.  The test content will change accordingly.  Knowledge was imbedded into the psychosocial questions.

______________________

Comment:  The questions answered incorrectly were not noted on the test report as in previous years.

Answer:  It is too expensive and is not helpful as only the general category was listed.

______________________

Comment:  Why was a clinical supervision question included on the exam when non-certified GCs are not allowed to provide clinical supervision?

Answer:  That was a mistake.

______________________

Comment:  It is hard to test psychosocial in a multiple choice format.

Answer:  This is brought up every year and discussed every year.  Essay format and video vignettes have been entertained, but they are too expensive.  Training programs should focus more on preparing their students for the multiple choice format.

______________________

Comment:  Many questions seemed to have more than one right answer.

Answer:  Typically this means that the test taker read too much into the question.

______________________

Comment:  How was the question labeled into a particular category?

Answer:  Labeling is based on the answer.

______________________

Comment:  5 sample questions with a rationale of why the answer is correct should be provided to help with test preparation.

Answer:  10 questions are being formulated for this purpose.  In the future, it is the hope to have the money to provide an example test.

______________________

Comment:  Will there be a more targeted review course?

Answer:  Review courses are based upon the information released about the exam.  It is felt that more information regarding this exam was provided this year than in previous years.

______________________

Comment:  Will questions be reviewed and kicked out if it was a bad question?

Answer:  Review is based on statistical analysis.  If a question does not perform well (too easy or too hard), it will not be used unless it is revised accordingly.

______________________

Comment:  Is there a way to appeal?

Answer:  It is stated in the bulletin that appealing is not allowed.  Questions with 2 correct answers were dealt with accordingly.

______________________

Comment:  In what areas did people perform the most poorly?

Answer:  That information has not been gathered.

______________________

Comment:  More detailed objectives under the topics should be provided to aid in studying.  The objectives were very vague.

______________________

Comment:  There is controversy over what is considered a minimally competent GC.  It seems that more is important than psychosocial questions such as a GC should be able to read a lab report.

ABGC Meeting at NSGC?

We welcome anyone who attended the ABGC meeting at NSGC to post a summary!

By the by…

If there are any counselors out there who haven’t taken our survey and would like to do so, go for it!  We’ll keep accepting responses and then reanalyze that data once we get to 200 or so.

(Edit:  Here’s the survey link “Click Here to take survey“)

Quick update: At 146 respondents it seems the pass fail rate is creeping closer to 75%/25%…

Questions for the ABGC meeting

The ABGC board meeting is at the end of the NSGC meeting this weekend. Unfortunately I will not be attending but if I was I would like to ask the following questions…

If they used the process they outlined in their score analysis, then they didn’t look at how people did on the exam but instead they scored the exam by deciding the amount of questions a minimally proficient counselor should get right.  (Technically, they scored based on an averaged determination of the percentage of competent GCs who would correctly answer any given question, but this really amounts to the same thing; if you set the average weight of questions at that level, then you set the passing percentage at that level, assuming graduating and practicing counselors are competent.)  If that is so, why is their cut rate set so high? Is this because they felt that a minimally proficient counselor should be able to answer nearly 80% of the questions they created correctly? If so how did they make that decision? And why did they feel this percentage was necessary compared to say 70% or so?

Also, for an exam where it has been said that possibly 100% could pass, and if we truly are not being judged against each other, how did it [seemingly] end up that a perfect 20% failed?  (I base this on our survey results.)  And why was this the set fail percentage when in the past usually only 10% are failed. Why is it higher this year with the new test?

So those are some of mine, what questions do you want answered at the board meeting?

Survey results are in!

General stats:

131 people completed the survey at the time of analysis.  We know this is a small sampling of those who took the exam which may not be perfectly representative of the entire test-taking population.  However, we can take it for what it’s worth.

Question #1 (approximately 50% of respondents were out of school for <2 yrs, approximately 41% have been out 2-3 yrs, of the remaining respondents, years out of school varied between 3-25 yrs.

Question #2 (work experience) (remember, respondents could check more than one…)

prenatal counseling — 52.7%

pediatric counseling — 47.3%

adult genetics — 30.5%

cancer counseling — 42%

research counseling — 15.3%

genetics advocacy — 2.3%

public health — 7.6%

Question #3 (Test outcome — The BIG one!)

Passed — 80.2%

Did not pass — 19.8%

**This percentage holds true when we filter to see the outcome of each version of the exam. Of our respondents who took the 127 exam 80% passed and 20% failed and vice versa.

Question #4 (Test version)

127/170 — 51.1%

131/170 — 48.9%

Question #5 (Relevance to practice)

Strongly agree — 3.8% (100% passed the exam — 5 respondents)

Somewhat agree — 26.7% (97% passed the exam — 34/35 respondents)

Neutral — 9.9% (92% passed the exam — 12/13 respondents)

Somewhat disagree — 30.5% (80% passed the exam — 32/40 respondents)

Strongly disagree — 29% (58% passed the exam — 22/38 respondents)

Comments section: 89 respondents provided comments, which we need some time to read more closely.  We’ll plan to share some excerpts soon.

Quick note — after reading through the ABGC’s explanation of their scoring system and then viewing the data from our survey, we think the findings from Question #3 are the most interesting.  Obviously, this is a quick analysis of our survey results.  Feel free to leave comments and provide input on other things you’d like to see regarding the data.