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MGC ‘near peers’ provide reassurance, support

Posted by on Wednesday, February 23, 2022 in Uncategorized .

Students in the Vanderbilt University School of Medicine master of genetic counseling program match with peer mentors and mentees to establish a sense of community

By: Lexie Little

As Kelsey Schulz waited to enter their classroom at Vanderbilt University School of Medicine (VUSM) for the first time, they drummed their fingers on the straps of a bag, buzzing with anticipation. That electric feeling intensified as they joined classmates and instructors.

“Every time I have been in a room, whether it’s with prospective genetic counselors, counselors themselves, or people in training programs, it’s always buzzing with the same excitement,” Schulz said. “It’s just so exciting to be in a room where everyone has their own passions.”

Close up of a person outside
Kelsey Schulz

Schulz and classmate Layne Wells felt nervous and eager to begin a new journey in graduate school. With their futures ahead of them, they thought about what challenges would lie ahead. Graduate school requires hard work and dedication, but the process for these students may be made easier by faculty and peer mentors.

The Master of Genetic Counseling (MGC) program at Vanderbilt matches its first-year students with a second-year mentor, or “near peer,” to help them navigate a unique curriculum in an evolving field and life in Nashville, Tennessee, where hospitals, clinics, and outpatient facilities offer ample opportunity to train – not to mention the city’s extracurricular possibilities by way of live music, restaurants, sports, and outdoor attractions.

“When you come to graduate school, you’re meeting new people, you don’t know the city, you don’t even know where to get a cup of coffee,” Schulz said. “You don’t know anything, really.”

That is, until a mentor steps in.

A new beginning

Schulz and Wells arrived at Vanderbilt in August 2021. Prior to their starting the program, they answered a comprehensive set of questions to match them with a current student based on interests, goals, communication preferences, and feedback styles.

Wells, an Illinois native who studied at Scripps College in California, looked forward to connecting with someone who knew the Nashville area. She just needed to come up with five words to make that happen.

Photo of a woman outside with glasses atop her head
Layne Wells

“I am such a wordy individual,” Wells said. “Any time I have a survey or a form like this one that says something like, ‘In five words or less, please describe your ideal style of mentor,’ to this day, I have no idea what I wrote. But the [MGC survey] gave some nice examples like ‘hands-on,’ ‘hands-off,’ ‘supportive,’ ‘teaching,’ ‘more social.’ So, I think I had something to work with. Clearly, it was something delightful because I ended up with Emily.”

Emily Franciskato knew the process all too well, having gone through it herself as a first-year student. She matched with Gianna Petrelli (MGC ’21) who provided the basis for her outlook on mentorship and camaraderie within the MGC program.

With a willingness to meet new students’ needs, Franciskato signed up to take on multiple near peers. Six individuals make up the Class of 2022, while VUSM welcomed eight new MGC students for the Class of 2023. With that fact in mind, she typed answers to a similar survey given to mentors-to-be.

“I learned from my experience with Gianna, and I liked being open to whatever people wanted in terms of mentoring style,” Franciskato said. “Did they want someone they talk to every day? Do they want someone who’s there if they have a question? I think this type of relationship was unique to me because I feel like in my other mentoring relationships before graduate school were structured. Our model here is open and what you want to make it.

A woman sits outside. She's wearing a blue top.
Emily Franciskato

“For me with Gianna, it was a way to get to know Nashville and navigate the transition. Approaching the survey as a second year, I knew that I wanted to be open to whatever people needed. Some people like to figure things out by themselves and text or email if they need to, other people have more detailed questions and interests. Being open to different mentoring styles and structures in MGC is something really unique in my experience.”

Schulz, who spent a number of years between undergraduate studies at Mount Mary University and graduate school working at Planned Parenthood, had never had a formal mentorship connection. Receiving the survey to match, they thought, “These are great questions. I have no clue.” Schulz and Wells appreciated the flexibility and friendliness Franciskato offered.

Navigating initial concerns

The first year of the MGC curriculum focuses on the foundations of genetic counseling through coursework and reading, whereas the second year provides a real-world perspective as students dive into clinical rotations, research, and counseling practice sessions. Being in a new city with new people compounded the potential stressors of the first-year curriculum. As a result, Franciskato wanted to be in tune with Schulz and Wells to offer reassurance and guidance as needed.

“All of the questions they asked me, I had asked Gianna,” Franciskato said. “The first year can be stressful because there’s a lot of information to learn. We hear the phrase over and over: it’s like drinking from a firehose. But I made it through, and I know my near peers will make it through. We’re going to make it together.”

Wells distinctly remembers the first slide show during orientation. The first slide dissolved into the next revealing a single message: “You deserve to be here.”

In a fast-changing field that requires passions for learning, science, and people, students might face imposter syndrome amid talented cohorts.

“Some of us might think that we are the one mistake that the admissions team made,” Wells said. “Second-guessing is easy.”

Schulz echoed the sentiment saying, “The information we’re learning can be so dense sometimes, I think, ‘Oh, am I really supposed to be a genetic counselor? Is this my calling?’ Hearing other people reassure me has been so, so helpful.”

Near peers in the MGC program act as support systems when doubts, both professional and personal, arise. For Franciskato, she aims to normalize her mentees’ feelings and remind them they deserve to be in the program.

Validation remains an important aspect of the mentoring relationship for both Schulz and Wells.

“The validation is invaluable,” Wells said. “It does get to be overwhelming in the beginning and can be really difficult, so having even one person, whether they’re a [teaching assistant] or a mentor, to say, ‘This worked well for our class,’ or ‘We also struggled with this,’ they can provide a framework for how we approach an issue. I also loved learning where to get a cup of coffee, where to go for live music or drinks, just a way to streamline learning a new city when so many of your hours are occupied thinking about graduate school.”

Developing empathy and community

Franciskato, who gained mentorship experience as a teacher in Africa, sees the near peer mentoring structure as a tool for both practice as a future supervisor and a way to train future counselors in their roles. She will have students training with her next year as she takes on the role of a full-time genetic counselor, so working with Wells and Schulz makes for good preparation. But she’s also demonstrating to them how to form empathetic bonds, practice reassurance, and foster open listening skills – all essential skills for a genetic counselor.

As future genetic counselors, MGC students prepare to both provide information based on clinical-grade genetic testing (which evaluates more genetic information than tests commercially available to the public) and work through concerns and emotions patients may encounter when learning about their genetic markers, including what those markers might mean for their overall health and wellness. They will translate complex scientific information into language that patients can understand, helping them to make informed decisions about their health. But that process cannot happen without the ability to relate as a human being, listen to concerns, and reassure the patient’s decisions.

“Something I’ve heard a lot from our instructors is that each counselor takes a different approach,” Schulz said. “We have core aspects of what we do like translating scientific language to terms that the patients can understand and risk assessment and communication, but the one thing I find different about genetic counseling is it’s not just the science piece. We have to individually learn how to be there for a patient or family with empathy, really embracing the ‘counselor’ aspect of our role.

“I feel like sometimes we get nervous about that counselor role because we’re so good at the science. But counseling in a more traditional sense of the word is just as important. I really think that’s what makes our position unique. It’s not just the science communication. We’re there for the person as they are…We’re sometimes not seen as people who are emotionally in tune with our patients, helping them to cope with sometimes complicated feelings…Our work is not the ‘designer baby’ conversation or the ethical issues people often think of. We work through the apprehensions and feelings about genetics and their potential health and wellness impacts, making informed consultations based on the science we know and continue to learn.”

As the phrase goes, practice makes perfect. And the near-peer model allows students to relate on a human level, working through natural concerns about graduate school and rigors of the field to inform difficult conversations they might have with future patients.

Expressing support and care

Recently, students in the first year completed a pre-work task for class that included watching a TED Talk about facilitating difficult conversations. Wells thinks about how hard just describing the field of genetic counseling can be. But she said that challenge to articulate the field in any one concise way seems appropriate because the field constantly changes and evolves based on new discoveries.

Genetic counseling attracts individuals with varied backgrounds and interests as new specialties continue to develop, whether those be in prenatal care, cardio genetics, or an area yet untapped. Franciskato sees the varied passions of her near peers and agrees those differences strengthen the cohorts.

As peers, different interests allow for collaboration and learning from one another. As future counselors, a varied skillset and interests help patients to connect with them. For example, Wells likes to go climbing and offered for Franciskato to join. A future patient might be a climber, allowing Wells to relate and reduce potential tension between practitioner and patient in what can be a misunderstood space.

“That’s what will make you a good genetic counselor,” Franciskato said. “Expect bumps in the road, but know those are normal. Use your village around you, like near peers, to overcome them. It’s a growing field, which is exciting. I think that’s a commonality you can find among most genetic counselors: we like to learn and feel like professional students. We’re learning about genetics faster than we can talk about it. You have to be willing to continue to learn throughout your career. That is a big draw for a lot of us who enjoy research, innovation, and new information.”

They also like to learn about other people, including their peers and instructors. Those foundational relationships allow them to pursue their passions.

When Wells went to her now-thesis adviser’s office to discuss a potential research idea, that mentor held her accountable.

“I feel like something I talk a lot about is when you have mentors and instructors who are also genetic counselors, they know how to ask you the questions that might make you a little uncomfortable,” Wells said. “They are there to help you grow and make decisions. For instance, I was developing a thesis idea that seemed absolutely bonkers. It was something I didn’t think was going to work, but I was really excited about it.

“I remember walking into my now thesis advisor’s office and saying, ‘I am totally prepared to do another project, but I have this idea that I’m really excited about. I have some reservations about doing it justice and finishing it by the time I’m supposed to graduate.’ And she met me with full enthusiasm, knowing that I would get more from the experience with a project backed by my passion. It may not work out, but I just really appreciated having someone who knew what my interests were and was able to have a vision of how the project might play out. I think that probably derived from her counseling background.”

With genuine interests in one another, MGC student-mentors and instructors prepare a new generation of counselors ready to express genuine care for patients.

“We foster a very supportive, very collaborative environment,” Schulz said. “The fact you’re already there means you belong there. You can really be yourself. Like Emily has said, find the thing that makes your heart sing. Find those passions. The fact you’re already pursuing genetic counseling means you’ve already checked those academic and other boxes. Now, you have to figure out what you’re really interested in and what makes you feel alive. Go for it. Let that shine. Let people see it and let people know about it. Engage in that. You have so much freedom to explore your own interests in genetic counseling and forge your own path. Really lean into your strengths. That sense of self makes it easier to relate to peers and patients.”

And each student, mentor and mentee, buzzes with excitement to demonstrate just that.