.jpeg)
Demystifying Genetics
This is a podcast series called Demystifying Genetics where I, Dr Matt Burgess, Genetic Counsellor interview other genetic counsellors, people working in genetics or people affected by genetic conditions. We chat about human clinical genetics, genetic counselling, ethics, pyschosocial issues and more. To contact me, please reach out at matt at insightgenomica dot au
Sponsored by TrakGene
www.trakgene.com
Demystifying Genetics
Beyond Genes: Can We Truly Measure the Impact of Genetic Counselling? Demystifying Genetics with Marion McAllister
Professor Marion McAllister shares the fascinating journey of developing the Genetic Counselling Outcome Scale, a groundbreaking tool that measures patient empowerment rather than just anxiety reduction. We explore how this simple questionnaire transformed genetic counselling assessment worldwide and evolved to meet changing healthcare needs.
• Creating the first standardised measure for genetic counselling outcomes based on patient-reported benefits
• Translating the scale across cultures and navigating challenging concepts like the English word "condition"
• Developing the shorter Genomics Outcome Scale for economic evaluations and mainstreamed genetic testing
• Evolution of genetic counselling education from traditional face-to-face to blended e-learning formats
• Exploring how AI could complement genetic counselling by handling routine tasks
• Balancing qualitative and quantitative research methods when developing healthcare assessment tools
• Reflecting on research into gender differences in genetic testing for hereditary cancer syndromes
Join me for future episodes of Demystifying Genetics as we continue exploring the human side of genetics and genomics.
Demystifying Genetics is sponsored by TrakGene
https://www.trakgene.com/
G'day. My name is Dr Matt Burgess and I am Founder and Principal Genetic Counselor at Rosalind Genetics, a national genetic counseling and testing service in Australia. On today's Demystifying Genetics podcast, I chat with Professor Marion McAllister. Marion is a genetic counselor based in Cardiff, wales. She's most well known for creating the Genetic Counselling Outcome Scale, which we talk about in a lot of detail. However, we discuss other things, such as her teaching career and various academic interests. Hello, marion, and welcome to Demyifying genetics thank you is this your first podcast?
Marion McAllister:it is indeed oh, how exciting.
Matt Burgess:Um, now, I usually ask guests to uh, if they'd like to provide a photo, and sometimes they say no and I just get one off the internet. Um, you know, like a nice photo, and everybody else who provides a photo, it's a usually like a sort of corporate photo. But you provided a photo that was amazing and it looks like you're trekking somewhere exotic. I'm just wondering, can you tell me about this?
Marion McAllister:So that was. In what month was it? This year, july, I went on a hiking holiday to the Himalayas. Oh, wow. Yeah, it was amazing.
Matt Burgess:Oh, was that the first time you'd been there? Yes, absolutely, and do you live in Cardiff?
Marion McAllister:I live in a little town called Penarth, which is in a different county but it's effectively a suburb of Cardiff.
Matt Burgess:Okay, so I'm guessing the Himalayas is very different from where you live in Wales.
Marion McAllister:Very different and there's no way that you can prepare for climbing in the Himalayas with the small mountains that we have in Wales, and we did have some altitude sickness while we were there, but it didn't ruin the holiday and we had an amazing time.
Matt Burgess:Okay, does that just sort of slow you down or like what happens when you get altitude sickness?
Marion McAllister:Oh, very bad headaches, quite extreme tiredness, and my partner that I was with had a very peculiar experience. He kept nearly falling asleep and starting to dream and then waking up again. Oh yeah, it affects your sleep as well.
Matt Burgess:Okay, sort of sounds like lack of oxygen or.
Marion McAllister:Yeah, but we survived.
Matt Burgess:Oh good, now, when I think of Marion, I think of the genetic counselling outcome scale, and you know, I think we could talk for hours about this. But I'd love to know sort of how that came about.
Marion McAllister:But I'd love to know sort of how that came about.
Marion McAllister:Okay, so I at the time was working as a genetic counsellor in Manchester, which is where I trained, and the clinical director in Manchester had obtained some funding from the Department of Health for one of what were then called genetics knowledge parks, and I was lucky enough to get a halftime post doing some qualitative research in NowGen, the Northwest Genetics Knowledge Park, exploring patient benefits from using clinical genetic services, and this led to development of a model summarizing the patient benefits from using clinical genetic services and genetic counseling, and this was a model of empowerment, and I was then encouraged to apply for some funding to see if we could turn this model into something measurable, because there were a lot of issues with measuring outcomes from clinical genetics and genetic counselling.
Marion McAllister:And I was then lucky enough to get some funding from the Medical Research Council for a fellowship that enabled me to learn some new research skills in psychometrics and scale development and was the the. It was the thing that changed the whole course of my career, because I was able to use that funding to develop this outcome measure, which became known as the genetic enhancing outcome scale.
Matt Burgess:Um, and yes, it just took off from there wow, okay, so you said that there were a lot of issues in measuring sort of empowerment or outcomes. What were those issues?
Marion McAllister:And at the same time that I was doing the qualitative research, she did a systematic review looking at what outcomes had been used to capture benefits or outcomes from clinical genetics.
Marion McAllister:And what they found in this systematic review was that there had been such a wide range of outcome measures used, and I think about half of them were general measures of things like anxiety and depression, which struck us at the time as being, you know, a little bit blunt as instruments to measure outcomes, and also not very positive outcomes, although a reduction in anxiety and depression is always a good thing. And then there were also about half of the measures had been measures that had been developed specifically to capture outcomes from clinical genetics, but most of them had only ever been used once by the people who had developed them, and so there just seemed to be a lot of confusion out there about what was appropriate to capture patient outcomes from clinical genetics, and so that gave us, I suppose, a good rationale for developing something that was grounded in what patients told us were the benefits they had derived from using the services, and that was what led to the empowerment measure in the genetic counselling outcome scale.
Matt Burgess:It'd be interesting sort of working with an outsider from genetics, looking at the outcomes of genetics, because, you know, before we had a scale or something to measure it, I would think that as genetic counsellors we would think that we're doing a good job and you know, we work really closely with families and we do try to empower our clients, but without actually having something to measure it. You know, it's kind of like I guess the question is are we doing our job correctly? Or, you know, does genetic counselling help?
Marion McAllister:Absolutely, yeah, absolutely, and I suppose what's been good about the genetic counselling outcome scale is that, wherever it's been used, it's been shown to improve scores after using genetic services, which does demonstrate that we are doing something that's of benefit to our patients, and it's really nice to have a way to capture that in a positive way.
Matt Burgess:Yeah, I think you know, when I think of different research methods, you know qualitative work is sort of at one end and then sort of the statistics involved in scale sort of development would kind of be at the very other end. Like you said that when you were learning about scale development that it sort of changed your career. Can you tell me a little bit more about what you mean?
Marion McAllister:Well, I had a lot of help from people who knew what they were doing when it came to scale development, because when you get one of these training fellowships from the MRC, you get funding to have advisors to help you, and so I had two really good advisors who had a lot of expertise in psychometric methods and who had done a lot of scale development work in their career, and I would never consider myself to be a psychometrics expert even now because I had so much help from from them. In terms of how it changed my career, I guess you know my academic career has been successful because of the success of the genetic counselling outcome scale, and I'm sure I wouldn't be where I am now had it not been for those opportunities that I had early on yeah, yeah, I know, when I was doing my own research and writing my thesis, um, like, I spoke about different scales in genetic counseling and your name came up and it was lovely to sort of be uh, to include something so specific in genetic counselling in the research.
Matt Burgess:So I think we're all sort of grateful to you for that. One of the things when you're developing a scale is like thinking of statistical things like validity and reliability, and really what that is is is. You know, I'm asking these questions and I'm hoping what I'm asking is actually what I am asking. Maybe I haven't explained that right, or, and what I'm trying to test, is it really testing what I want it to test? How difficult was it to sort of work through those issues when thinking of, like, a genetic counselling appointment?
Marion McAllister:Well, the things that you assess when you're developing a scale are pretty standard, because you've got to look at whether it's measuring what you want it to measure, whether it's doing so reliably and whether it can pick up change over time. So it's not really important what you're measuring, it's the properties of the questionnaire itself that you're assessing, and so validity is about whether it's measuring what you wanted to measure, and reliability is whether, if the thing you're measuring doesn't change over time, do the scores also not change significantly over time. And then you also have to assess whether, if the thing you're measuring does change over time, that the questionnaire actually picks that up. And so it doesn't really matter what you're measuring, as long as the questionnaire itself has those properties. And it often makes me laugh that I spent three years of my life producing one piece of paper.
Matt Burgess:Oh that's funny, oh my dog's babbling Banjo. Oh that's funny, oh my dog's barking banjo. I'll just cut this bit out. Yeah, that is funny that to think that, yeah, it was such important work and then it sort of comes down to 24 sort of important questions that can probably fit onto one page. But you know, it's such a significant piece of research and work at the same time. And I guess another issue in sort of scale development is you know how it translates or how you know there's sort of you know, if we develop it in English, how much of the English culture or the culture of sort of English-speaking countries is included in that. And it's not just necessarily translating it into another language. But does you know, if you translate it into another language, does it capture sort of the important cultural things? Um, I see that, um, the scale has been, uh, you know, is in, uh, available in a number of different languages. How, um, how did that sort of come about?
Marion McAllister:But it usually came about because somebody in another country got in touch with me and said they wanted to translate it into their language for use in their country, and it introduced me to collaborations with lots use, international guidelines on translation and adaptation of questionnaires for use in other countries, for all the reasons that you just said, because you know, the meanings can change across cultures and certain words have proved to be a little bit problematic in some of the translations. So in some languages they don't have a word that is equivalent to our English word condition. And the example I always give when I'm working with internationals is the example of genetic forms of deafness, where people who are deaf wouldn't necessarily consider themselves to have a disease. They have a difference and so they wouldn't necessarily want their condition to be referred to as a disease. And not every language has a word that captures what we would mean by condition, which is sort of non.
Matt Burgess:It's a more sort of non-judgmental word, and so that's that's been a tricky one in some of the translations wow, that that's really interesting and it's it's like a question of philosophy, like yeah, yeah, because condition you're right, like in english it doesn't necessarily have a negative connotation. Um, sometimes I guess it could, but yeah, yeah, that is very interesting.
Marion McAllister:Yeah, and the way we've tried to resolve that is, the international guidelines recommend that you do two independent forward translations by native speakers of the target language, and then those translators and the research team have a meeting together to try and resolve any differences, and then they do two independent back translations by native English speakers and then the whole team, including me, would sit down and talk about whether what's been produced accurately reflects the intended meaning in the original questionnaire. And they've always been quite interesting meetings and we've always managed to reach an agreement that's satisfactory to all people, because we've included the translators in those meetings as well, who have language skills. So, yeah, it's been really interesting.
Matt Burgess:It's been an interesting journey oh, that's fascinating and I guess another like when I was thinking about um, patient reported outcome measures, um, and sort of different scales that we use in health care. A lot of the scales that we use are for what we call patients, and usually a patient is someone who is sick and sort of accessing like a healthcare service, whereas a lot of people in genetics we may not refer to the people that we see as patients and maybe their clients um and um. Sometimes, or a lot of times, the people or our clients in genetics aren't actually sick but they're seeking advice about a risk factor. How does that sort of come or relate to um, your genetic counseling outcome scale?
Marion McAllister:so I think it has to be made clear when we're asking people to complete the genetic counseling outcome scale, that you know. So, for example, if, uh, if parents come with a child and they want to know what the child's condition is or what the risks might be in the next pregnancy, the parents themselves are really the patients, even though the child may be the one who's affected, and it's really about giving clear instructions about who. Who is to complete the questionnaire yeah, yeah, yeah.
Matt Burgess:It's like a interesting thing that we we see sometimes in, or quite often in, genetics. So the scale was published, um in 2011 I think, and it's been used sort of many, many times around the world over many years. Was there any sort of major sort of issues or controversies about it? Or? I guess where I'm going with this question is I'd love to talk to you about the genomics outcome scale. Did that sort of evolve? Because there were issues with the original scale?
Marion McAllister:So you may remember I said I worked with a health economist, catherine Payne, and Catherine was always a bit dissatisfied with the genetic counselling outcome scale because she's very interested in economic evaluations and for an economic evaluation, a 24-it with seven response options, and that's the sort of size of scale that an economist can work with.
Marion McAllister:And so that was one driver. Another driver was the fact that some of the items in the genetic counselling outcome scale refer to why people, whether people understood why they were referred to clinical genetics, and at the time that the questionnaire was developed, the mainstreaming agenda had not really taken off, whereas since then it has. And so there's a lot more genetic testing done outside of clinical genetic services, and so the genetic housing outcome scale was limited in its applicability, and so we wanted to look at whether we could develop a shorter form that could potentially be used in economic evaluations and that also could be applicable outside of the context of clinical genetic services, where maybe a form of genetic testing is done in other specialties. And so, yeah, those were the drivers for developing the shorter form, and I knew that there were methods of doing this because other people had done it with questionnaires in the past, and again. I was just very lucky to be able to find the right people to work with who could make up for my methodological deficiencies.
Matt Burgess:Yeah, I think that that's the great thing about collaborating with people and researchers from all over the world, finding great people to be part of the team and working together and sort of achieving a great outcome, and it really sounds like you were able to do that.
Marion McAllister:Yeah, I was lucky to be able to find the people who could help me.
Matt Burgess:Yeah, it's funny what you say about sort of a health economist. I would think that they would love data and like the more the better. But maybe that's not the case, or you know, the data is better when it's sort of narrower or you can kind of see patterns easier or something. But I guess, as a participant, if I had to fill out a scale, I probably would much rather fill out six questions than 24. Absolutely yeah. Out a scale, I probably would much rather fill out six questions than 24. Absolutely yeah, and I guess you know maybe this question is a bit redundant, but do you find or do you feel that those six questions really do, um, represent the essence of the 2024? Like having you reduced 24 down to six well we were.
Matt Burgess:We were able to demonstrate with methods called item response theory that yes, it does, and that was really good yeah yeah, it's great, it's funny because you know, like, obviously, in genetics, you know, when we sort of have a macro view of genetics, we think about evolution. But then, just in you know, the last few decades of clinical genetics, how we do testing and how we provide genetic counseling has evolved and it's really great that, uh, you know the the measures of our work can evolve with that as well. So, yeah, um, so another thing that I think of when I think of marion mccallister is the genetic counseling course in cardiff. So you have been involved with that course for many years now and I think that you've just recently sort of stepped down as the program director. Is that?
Marion McAllister:right, I have. I have now partially retired as of September. I only work three days a week and Nikki Taberna has taken over as program director and she's doing a great job.
Matt Burgess:Lovely, excellent, okay, so hopefully I trust that you are enjoying your semi-retirement and able to do a bit more travel and relaxing and that sort of thing. Tractate has designed a genetics electronic health record. Here's what it features Pedigrees, demographic data, genetics information, risk tools and sophisticated reporting, all within a clinician-designed workflow. It integrates within other clinical genetics software, databases and hospital information systems to maintain accurate patient records. Trackgene has an experienced team who has been working in the clinical genetics industry for over 15 years. You can request a demo for free. Go to trackgenecom. That's T-R-A-K-G-E-N-E dot com. How has it been, or how was it being program director for those years?
Marion McAllister:Golly, I really enjoyed it. I love working with students and we've just had I think was it last week we had our year two. We run a blended learning program so it's mostly e-learning but the students do come to Cardiff five times over the three years of the program. But the students do come to Cardiff five times over the three years of the programme. And last week we had our second year teaching block, our first second year teaching block, and it's always so nice to do the skills practice with the students when they're in year two because you can really see how they have had their counselling skills have come on so much since they were in year one.
Matt Burgess:um, I mean yeah, we love seeing them in person. Yeah, I really love working with students so I as an outsider, um, when I look at genetic counselling education in england, I thought that there were two universities that taught genetic counselling. But then I found out that there was sort of like a scientist training program where the students sort of enrol and they have some subjects in common, but then you can sort of specialise in genetic counselling and that's sort of separate from the two masters.
Marion McAllister:Have I got that right, or well, in the old days there used to be two programs one in manchester, which is what I trained on um, and then a bit later the one in cardiff, and they were both two-year full-time face-to-face programs. And then back in 2016, um, there was a a lot of money was put into training non-genetics healthcare professionals in genomics because of the mainstreaming agenda but the genetic counselling community, and so that money was partly linked to the 100,000 Genomes Project, and so Health Education England had put a lot of money into what they called MSc in Genomic Medicine courses, which were funded by the Department of Health to train non-genetics healthcare professionals to be able to deliver genomic testing in other specialties. And the genetic counselling community approached a representative from the Department of Health to say, well, what about the people who are already delivering genetic services? And so the plan after that was that genetic counsellors would be trained through what's called the scientist training programme, and in the UK that's a training programme that trains lab scientists, so people who work in NHS laboratories, and so they developed a curriculum for genomic what they call genomic counsellors to be trained through the scientist training programme, and so what that involves is people applying for a job in the NHS as a trainee genomic counsellor. So they work for the NHS and they have a time put aside for the academic component and there was a bidding process then. So we just continued our programme and there was a bidding process for higher education institutions to apply to be the provider of the academic component and we didn't win the bid. The University of Manchester won the bid. So they now deliver the academic component for the scientist training programme in genomics.
Marion McAllister:But because we had discontinued our programme and we couldn't be the STP provider, that was when we decided to develop a new mainly e-learning programme to take advantage of the strengths at Cardiff University in e-learning. So we now run a three-year mainly e-learning programme. And then there was also in the meantime the Glasgow University also started their own two-year face-to-face MSc in genetic and genomic counselling. However, this year they have, for reasons I'm not clear about, they, discontinued their programme. They were mainly training for the Scottish NHS.
Marion McAllister:So now there are two routes in the UK for genetic counsellors. Just to train, there's a scientist training programme and you know we were. We we did wonder whether we would get any students because of course if you work for the NHS through the scientist training programme you're earning a salary while you're training but. But we still get 24-, 25 students joining our program every year and it's because their own personal circumstances better suit one program or another. So we're not really I wouldn't say we're in direct competition necessarily we just I think we have different target populations um, we just I think we have different target populations.
Matt Burgess:Yeah, yeah, I'm involved with uh, teaching in a masters of genetic counseling program in the united states and it's sort of a discussion that we have over there, because the course that I teach in is at a university called bay path university, where it's basically 100% online. The students are expected, maybe once or twice a year, to sort of go to the university, maybe for a couple of days, whereas that's quite different from a lot of the other universities where you need to move and actually be on campus, and I think that it sort of complements each other, because there are people that you know wouldn't be able to move, so then they don't apply for those courses, but you know they are available to do their studies online. So, yeah, it's a very interesting sort of aspect of the education.
Marion McAllister:Yeah, and we've noticed that our student population is now more diverse than it was when we ran the two-year full-time face-to-face programme. When we ran the two-year full-time face-to-face programme, we generally had young graduates joining the programme who were in a position to move lock, stock and barrel to Cardiff for two years, whereas now we have more people who have caring responsibilities or other jobs that they don't want to stop doing. Yeah, so I think it's been good.
Matt Burgess:Yeah, and what about overseas students? Do you have many overseas students that are sort of participating in your program as well?
Marion McAllister:Yeah, we have some. I'm trying to think we have in our year two group at the moment we have a student from Malaysia, one from Singapore and we generally get a few Canadians from time to time. They're mostly UK students. I'd say maybe less than a quarter of our students are overseas, but we do get some. Yeah, okay.
Matt Burgess:I'm surprised when you were listing those countries. They're not European countries. I thought maybe the overseas students would be more from Europe, but no we'd get some from Europe as well.
Marion McAllister:yeah, yeah, but yeah, the odd one from Europe. But there are some training programs in Europe as well. There's one in France and there's one in Romania and there's one in Portugal.
Matt Burgess:Yeah, yeah, excellent. And tell me about your PhD. I know that you did it when you were a genetic counsellor, but was it actually in genetic counselling or were you looking at something different?
Marion McAllister:Well, again, I was very lucky because when I did my MSc in genetic counselling in Manchester, I did my dissertation project interviewing men from breast cancer families.
Marion McAllister:The idea had come from Gareth Evans, who's a consultant clinical geneticist in cancer genetics in Manchester, and he had the impression that sometimes and this is way back in 1995, 1996, he had the impression that some men in breast cancer families weren't really aware that they could transmit a BRCA mutation to their daughters, and so that was what I was looking at and I got very interested in issues of gender and how men and women manage family communication about genetic conditions differently.
Marion McAllister:I just became very interested in it and I was just very lucky that a PhD studentship was advertised at Cambridge University that was looking at predictive testing for Lynch syndrome or what was then known as hereditary nonpolyposis colon cancer Bit of a mouthful and that with a particular focus on gender. And I think, again, I was just very lucky that the topic was so similar to what I had done for my MSc dissertation that I got the studentship. So I did a qualitative study interviewing people from Lynch syndrome families before they had a test, a couple of weeks after they had a test and then six months later to talk about really how they were approaching it and what their thoughts were about risk and how they responded to whatever result they got.
Matt Burgess:Wow, okay, about risk and how they responded to whatever result they got. Wow, Okay, and did you find a significant difference between the two sexes on? You know Lynch syndrome and issues to do with Lynch syndrome?
Marion McAllister:I wouldn't say it was as the differences were as pronounced as they were in the BRCA families, because of course BRCA affects women more than men. So it sort of as with all research, and especially qualitative research, it doesn't always go in the direction you think it will go. So the important findings weren't really to do with gender, although gender did have a little bit of an influence.
Matt Burgess:Okay, excellent, and I saw that a few years ago you were awarded a senior fellowship of the Higher Education Academy. So congratulations, thank you, and I was really curious about that. I guess the Higher Education Academy was something that I wasn't really familiar with, but I've since sort of checked it out a little bit. But yeah, can you tell me about that and how that sort of relates to your research history or background?
Marion McAllister:Okay, it's nothing to do with research. It's a teaching qualification. Okay, it's nothing to do with research, it's a lot through reflecting on my teaching and my approaches to teaching um, because the portfolio that you submit of how to improve and sort of techniques know with myself.
Matt Burgess:On one hand I keep thinking, like I teach introduction to genetic counselling. So I keep thinking, okay, these are new students, that it's their first semester, I need to make sure that it is sort of at the right level. But then sometimes I sort of get surprised when I think that something is common knowledge or I don't think it's that difficult, but then a few students sort of ask me questions and it's like, oh, okay, that mustn't have been clear. So, yeah, I kind of think, oh, I really need to be mindful of, um, yeah, how I teach.
Marion McAllister:Yeah, yeah, and I think you know there's a lot to be said as well for collecting student feedback and reflecting on that and thinking about how to do things better and differently. And the other thing you have to demonstrate in your fellowship application is how you've applied educational theory to your teaching approaches hmm, okay, I guess one of the themes that I could say throughout this conversation is sort of, uh, empowerment and positivity.
Matt Burgess:It sounds like a lot of the things that you have been involved with like you say that you are very lucky and it sort of has like a a positive sort of um, it sort of has like a positive sort of focus. And I see that before you sort of were involved in the world of genetics, you were a change management consultant.
Marion McAllister:That was a long time ago.
Matt Burgess:Yes, Well, we won't talk about years, but was your training or like being a change management consultant, was that sort of where this positivity comes from and like, were they the things that you were able to take from that career into genetics, or is it completely unrelated?
Marion McAllister:I don't think it's completely unrelated. I worked for an organisation called Anderson Consulting which is now known as Accenture, so it's a big global management consulting firm and I have to say it was a very challenging time. I mean, we worked very, very long hours. I've kept time reports from my time at Anderson Consulting and there were some weeks when I was working 90 hour weeks. I worked on a project in Newcastle for a while and a memo went round to all the Anderson consultants at one point to say that core hours on the project were 8am to 10pm Monday to Thursday, 8am to 8pm on Friday and 9am to 5pm on Saturday and Sunday. Oh wow.
Marion McAllister:So it was a very challenging time and, to be honest, looking back, I don't think anybody works at their best when they're working those kind of hours. But that was what was required, and so that was what we did. But that was what was required, and so that was what we did, and so you know, I don't want to say it was an unpleasant experience though, because I was working with lots of very energetic young people and we worked hard and played hard, but I would say that I learned a lot of very transferable skills to do with and just critical analysis and time management, and they were all things that I think have have really helped me in my career since then.
Matt Burgess:Yeah, I guess one thing that would probably help your change management colleagues is artificial intelligence, but I won't ask you about AI with change management people. But how do you think AI is going to affect clinical genetics and how we provide genetic counselling to families?
Marion McAllister:Well, I mean, people are already using chatbots, aren't they? To assess risk and give people information about risks. And you know, I can see a world in which a lot of the routine things that genetic counsellors do the kind of I won't say boring but the repetitive tasks can maybe be done, and there is a shortage of phonetic counsellors there aren't enough of us, you know. So I think it's really good that some tasks can be automated, Perhaps freeing up phonetic counsellors to work sort of the way they described is work at the top of their game, which is really dealing with the emotional and psychosocial issues that our patients come with. So working much more on the relationship, the individual relate, therapeutic relationship we have with our patients, and leaving aside the sort of things that are a bit more routine yeah, I know for myself.
Matt Burgess:You know when I think, think of all of the tasks that we do as a genetic counsellor. You know the time speaking with patients and you know couples and families is what I really enjoy. And one of the things that I probably don't enjoy as much is letter writing, even though it's really important, you know, to document it and to, you know, for the families to have a good summary. And now I see you know the AI that doctors have where it sort of just listens to the consult and then they press one button at the end and there's this beautiful sort of typed up letter and I thought, oh, wow, that's what I need in clinical genetics.
Marion McAllister:Yes, and you know you can instruct chat, gpt or copilot or whatever you're using to say please explain this to me as if I was a five-year-old or please explain this to me as if I was an 11-year-old. And I think that can really help people write better letters for patients because you know, with the best will in the world, you can get lost in your own genetics language sometimes.
Matt Burgess:Yes, yeah, yeah. Yes, it's very interesting and I guess one of the like the controversies that we've been talking about for a number of years and sort of technology taking our jobs. But the more that I think about it and then you know as time goes on, I think you're right. I think that AI and genetic counselors can probably complement each other and it enables us as humans, or as as people, to sort of really do that higher level or to work at the top of our game, where you know a chatbot just really isn't going to do that.
Marion McAllister:Yeah, the other thing that's funny about I like in my teaching slides to have a lot of pictures and it's not always easy to find pictures of genetic counselors that are meaningful. And I have played around with Copilot to try and make it create good pictures of genetic counselors. And I know it's at the moment the worst it will ever be and it will only get better. But I couldn't. I couldn't get it to create genetic. Maybe it's because the prompts I write aren't good enough. I couldn't get it to generate genetic cancers without white coats but also did really peculiar things like creating genetic cancers with DNA on their forehead.
Matt Burgess:Oh, that's hilarious. I would love to see some of your slides. Oh well, Marion, thank you so much for a really interesting conversation. I really enjoyed speaking with you and, yeah, thank you for sharing your time with us today.
Marion McAllister:You're very welcome. I've enjoyed it too.
Matt Burgess:Excellent. Well, I hope that you're able to be a guest on many more podcasts, because I thought you were fabulous today.
Marion McAllister:Thank you so much. Enjoy your weekend.
