Student evaluations aren’t just a routine part of fieldwork; they are a powerful tool with the potential to improve teaching and learning in genetic counseling. However, they can be approached with different intentions, depending on the role being served within the process. To understand where these perspectives overlap, informal interviews were conducted with two program directors, three fieldwork supervisors and two recent graduates. After exploring their unique motivations for and approaches to collecting and applying evaluation data, five similarities emerged that support the continuous improvement of the genetic counseling profession:

1. Evaluations should encourage self-directed learning.

Every program and site has its own approach to collecting and applying evaluation data. A common starting point among the fieldwork supervisors interviewed was the emphasis on communication and feedback as a two-way street. To make feedback purposeful and increase its efficacy, initial orientation to a clinic site should include conversations about each student’s learning styles, preferences for receiving feedback and goals for growth. Students should also be encouraged to be self-directed in their learning, taking ownership of the evaluation process.  As one supervisor pointed out, “students don’t need to finish genetic counseling school ‘fully formed.’ We are training to a minimum level of competency that includes the ability and desire to learn and grow for the next 30+ years of their careers.” Evaluations in fieldwork lay the groundwork for this self-reflective practice. 

2. Evaluations should be formative and summative.

Another common theme was that evaluations should not be confined to the middle and end of the rotation. Instead, these conversations should begin during rotation orientation and continue iteratively throughout the rotation experience. By encouraging more routine interactions, supervisors can reduce the likelihood of any surprises during summative evaluations. Additionally, students should have immediate access to their evaluations throughout their training. This allows them more time to reflect on personal strengths and address areas needing improvement.

3. Evaluations among programs should use a shared language.

Programs must champion and support their students, but they also need to support the fieldwork sites. Clear communication with site supervisors about the structure of formal evaluations and expectations for student performance is essential, especially when sites take students from multiple programs. Although supervisors do not typically have access to students’ previous fieldwork evaluations, they can still be informed about the knowledge and skills of their students compared to the expected level of performance at a specific point in training. While the timeframe for acquiring skills can vary among programs, the revised Practice-Based Competencies for Genetic Counselors have clarified the end point: what students should be able to know and do upon graduation from any program. These competencies were written in the context of a developmental framework and provided a shared language for discussing student learning. They have also guided changes to fieldwork evaluation forms that are expected to provide more consistent and reliable assessments between supervisors compared to previous approaches. Ideally, programs would join forces to train supervisors on developmental frameworks as a next step for improving the student evaluation experience.

4. Supervisors should model a growth mindset.

Encouraging students to share their constructive feedback about their rotation experiences with supervisors is crucial to everyone's success. Supervisors can and should continue to learn from their students, while students should feel empowered to have a voice in their experiences. However, this can be challenging due to the inherent power dynamic. The phrase “be careful, the field is small” is not unique to genetic counseling, but it has been said and heard by many in the field. This can create an atmosphere of intimidation and silence, which benefits no one. To break down these barriers, supervisors should work to foster safe environments, model self-assessment, and demonstrate their openness to constructive criticism. These suggestions are not exclusive, and continued efforts towards transparency and supportive communication between all levels of genetic counseling education should continue to be explored.

5. Programs should ensure student feedback is impactful.

Standard C2.5.2 from the Accreditation Council for Genetic Counseling’s Standards of Accreditation for Graduate Programs in Genetics Counseling 2023 Revision requires that students be provided with the opportunity to anonymously evaluate supervisors, with feedback shared in aggregate to maintain confidentiality. However, with small cohorts it can be difficult to accrue sufficient data to protect anonymity in a timely manner. Supervisors may need more support from programs to integrate feedback when it was collected a year or more prior. Programs can help by making delayed feedback relevant to the current situation and working with their students to ensure feedback is clear and constructive. One recent graduate said that “our program director reminded us that a real person is reading the feedback, and we should remain professional in how we word it.”

After considering the multifaceted nature of student evaluations in fieldwork, it has become clear that these assessments are not just a measure of student performance, but a vital tool for fostering growth and development in genetic counseling overall. The collaborative efforts of program directors, fieldwork supervisors and students underscore the importance of a holistic and iterative approach to evaluations. By prioritizing self-directed learning, a shared language, transparency and continuous and relevant feedback, we can create an environment where both students and supervisors thrive.

Acknowledgments 

Special thanks to Peggy Rush, MS, LCGC; Liann Jimmons, MS, LCGC; Josie Minick, MS, CGC; Christina Dailey, MS, CGC; Juliana Vang, MS, CGC; Claire N. Singletary, MS, CGC; and Tahnee Causey, MS, CGC, for sharing their experiences and shaping this article.

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