Date of Award

8-16-2024

Document Type

Open Access Thesis

Department

Genetic Counseling

First Advisor

Jessica Fairey

Abstract

Obstetricians and gynecologists (OBGYNs) are the main providers that order carrier screening on a regular basis, so it is important to understand their knowledge, attitudes, and current practices regarding this screening. There are two primary professional organizations that have established practice guidelines for carrier screening, the American College of Obstetrics and Gynecology (ACOG) and American College of Medical Genetics (ACMG). With the growth of pan-ethnic carrier screening, these guidelines have become remarkably different. This study aimed to assess resident OBGYN’s utilization of pan-ethnic carrier screening, discern any discrepancies between knowledge, attitudes, and current practices, identify possible practice resources that may be beneficial, and assess the need for standardized guidelines. A survey was shared with OBGYN residents across the nation that included topics related to knowledge, attitudes, and current practices about carrier screening. The average knowledge score for our participants (n=23) was 90%. A notable difference existed between the number of participants who believed pre-test counseling was their responsibility (65.2%) and those that felt confident in providing pre-test counseling (43.5%). Additionally, the majority of participants were considering a patient’s ethnicity when selecting a panel (60.9%), and the most popular panel size included four or less conditions.

Findings from this study provided insight into which domains and concepts of carrier screening OBGYN providers may find additional practice resources beneficial. We identified the most significant discrepancies for test selection, points of counseling, and results disclosure. There is significant variability in current practices among OBGYN residents which suggests the need for standardization of guidelines. We recommend that practice resources include recommendations from both ACOG and ACMG and promote pan-ethnic carrier screening. Based on residents’ opinions, these resources should be quick and direct summaries of practice guidelines that outline important topics of discussion. With improved provider knowledge and comfortability with carrier screening, this may improve equitable access of reproductive knowledge for patients.

Rights

© 2024, Aubrey Morgan Surian

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