Developing global consensus about core knowledge and skills for genetic counselor education

There are over 130 genetic counselor (GC) training programs documented in more than 30 countries. Some regions also have developed practice-based competencies and guidelines for accrediting GC training, often including lists of required curriculum items (for example: ACGC, CAGC, EBMG, HGSA). However, areas where genetic counseling is emerging or desired may struggle to create training approaches from these often-aspirational knowledge and skill development lists. In a collaborative effort between the Human Genome Organization (HUGO) Education Workgroup and the Transnational Alliance for Genetic Counseling (TAGC), we conducted a global consensus process to assess and deliberate over which knowledge and skills were broadly considered 'core' to the GC educational process. We utilized an online-modified Delphi process to survey a purposive global sample of GC education providers and members of credentialing boards from countries with established GC and medical genetics providers in areas where GC education is newly emerging. We identified a list of 64 potential topics through a literature review and review of relevant curriculum guidelines and professional competencies. We then assessed relevance in a 2-round survey process using the criteria of >80% agreement. Topics that met these criteria, including those that were borderline, were discussed in two online consensus meetings. We present the consensus list of 25 content topics across four major areas of knowledge and skills: counseling and communication, genetics and genomics, medical knowledge, and genetic counseling healthcare professional skills and knowledge that we propose should be included in the GC curriculum for countries where GCs are new or emerging. We also propose 11 additional "Tier 2" topics that could be considered depending on regional needs or as countries evolve the profession.