Interview Preparation

Do you think one person can make the world a better place? Why or why not?

Absolutely. Just one interaction with a single person can make the world a better place by making that one person's day better.

What is your experience with confidentiality?

As a direct care aide, I maintained the privacy and security of all of my residents' health information in accordance with HIPPA. Also, Alternatives to Violence of the Palouse provides confidential counseling and assistance that would only ever be broken if we needed to make a mandated report in the case of child abuse, vulnerable adult abuse, or lethal harm to oneself or others.

Give me an example of when you had a set of results, and how you interpreted them in the past.

I had to interpret my own genetic test results. Although a genetic counselor educated and supported me, I ultimately made the choice to have an adaptive response which focused on the benefits that knowledge of my BRCA1 mutation gives me.

How well do you handle stress?

I handle stress very well. - High-stress and highly-emotional situations: - Stress from every-day responsibilities: - Coping with stress:

Why are you applying to Stanford's program?

- Clinical immersion from the very beginning of the program, starting with observation and role play in the fall and moving to actual rotations in the winter. The organization of Stanford's coursework to reinforce clinical training will maximize retention of genetic counseling concepts and practices. Variant interpretation rotations that expose students to genetic counselors in industry settings. - The program directors at Stanford took the time to create and host a webinar for interested students. This added a personal touch and helped me get to know the program and program directors so much more than just scrolling through Stanford's web pages, as I had to do for all the other programs I applied to. It can be very difficult to differentiate programs and decide which is the best fit for you looking at their website alone. - Of the programs I applied to, Stanford is the only program that offers elective courses. I like that Stanford allows students to tailor their graduate education to a point. I am very interested in elective courses in cancer biology or biomedical ethics. - I think Stanford's Standardized Patient Training facilities that allow students to work with trained actors will be an invaluable resource for independent learning and critique of my genetic counseling techniques. - One of the best genetic facilities in the country and access to a diverse patient population. - It seems like students have some freedom to help decide their research committee members and that in addition to genetic counselor and individuals with expertise on the topic or methodology, committee members can be from different discipline backgrounds which I think could be very beneficial. - A strong faculty support system comprised of over 50 genetic counselors and 10 MDs/PHDs. - Of the programs I applied to, Stanford is the only one that offers elective courses. I am very interested in taking a course in cancer biology or biomedical ethics. - If I can manage it financially, I am also interested in the possibility of off-site clinical rotations either in Boise or Seattle.

What are the most important qualities for a genetic counselor to possess?

- Effective communication abilities. Genetic counselors need to translate and tailor complex genetic information to clinical and non-clinical audiences. Clinical = other healthcare professionals. Non-clinical = patients of different educational and cultural backgrounds. - Compassion. Because genetic counselors are often relaying information with serious medical implications, the discussions they have with patients can be emotionally loaded. Genetic counselors need to communicate information in a supportive and patient-centered manner so that patients can better cope with their emotions. - Willingness for lifetime learning. The field is rapidly expanding and with new research and technological advances seeming to pop up every day. Genetic counselors should be ready to assimilate new information into their practices for their entire career.

How do you embody these qualities?

- I am an effective communicator. I have spent every day for the past year communicating with individuals whose greatest struggle in life is communication; that is, my clients on the autism spectrum. I have been very successful helping in those individuals learn more effective communication strategies, coping mechanisms for when they're overwhelmed, and socially appropriate behaviors. For example, we use a lot of visual cues to communicate with them because some clients have low tolerance for verbal communication. - My personal experience as a genetic counseling patient gives me an innate feeling of empathy for those at genetic risk. But, aside from that, I have sought out experiences where I provided emotional support to people from backgrounds very different from my own. Working with victims of domestic violence and sexual assault over a hotline, rather than in person, allowed me access to a larger, more diverse population. It is easy to be empathetic to someone similar to you. It's difficult to try and understand someone different from yourself. - My academic record reflects my aptitude for learning, but you can never tell if someone just put in the work or truly enjoyed learning the material. I love to learn and apply new information and I think that quality is reflected in the diversity of my extracurricular activities.

What other schools are you considering? Why?

- I am considering Northwestern University; the University of Texas at Houston; and the University of Utah. My choices were constrained partially by geographic location. I wanted to attend a program on the western half of the US to stay as close as I can to my family. Like Stanford, all of the programs I named have a well-balanced curriculum between the medical and psychosocial issues of genetic counseling, and provide extensive and diverse clinical experiences that can be somewhat tailored to students' preferences (e.g., students choose what specialty clinics they want to participate in). - Specifically, I like that Northwestern's program is only 18 months long. I work well under pressure and think I could thrive in a shorter program. They also offer a psychiatric specialty rotation which I think would be very interesting. - The Texas Medical Center at Houston is the largest in the country and the program is able to offer all incoming students scholarships that qualify them for in-state tuition. - The University of Utah's Huntsman Cancer Institute was a big draw for me. It houses a National Cancer Institute (NCI) and its where my mother went when she was genetically tested. She says she had a really great experience with the genetic counselors there.

What are your research interests?

- I am interested in family communication of genetic risk, specifically I would like to explore the child's perspective in parent-child communication. I think that, today, there is a population out there of individuals like me, young adults whose parents had conversations with them about genetic risk when they were children or teens. Now that they are adults, we can start to gather their perspectives to inform our practices in family communication. - I am interested in adding to the depth of the current research on family communication of genetic risk. I want to start examining the child or young adult's experience in the parent-child conversation about genetic risk.

What about clinical work do you enjoy the most? Least?

- I like that clinical work allows you work one-on-one with someone so that you can see the positive effect your information and support has in that person's life firsthand. - People don't always tell the whole truth when discussing very personal information. I don't enjoy finding out someone bent the truth, especially in regard to their health.

With which faculty member would you most like to work?

- Kerry Kingham, MS, LCGC. - I know that Kerry is the lead genetic counselor in Cancer Genetics and Genomics at the Cancer Center of Stanford Healthcare and that she enjoys educating the community on testing for hereditary cancer syndromes as well as teaching current genetic counseling students and serving as a research mentor. I think she could be a really amazing resource for me considering the area of research I'm interested in (family communication of genetic risk, specifically in genetic cancer syndromes and BRCA1/2) and because I am also interested in providing education to communities about hereditary cancer syndromes.

Did you do an undergraduate honors thesis?

- No. However, I did co-author a poster with a graduate student that was presented at Neuroscience 2015. - As an undergraduate research assistant, I had the opportunity to help design, implement, and evaluate a study that explored whether cognitive factors play a causal role in maintaining upright posture. In our study, subjects sat and played a simple and difficult computer game for five minutes with no motivational instruction, then repeated the task with incentive to focus on either their posture or task performance. 3D motion capture data were collected to analyze the influence of cognitive factors on postural alignment. We found that subjects sat more upright when incentivized to attend to their posture; that instructing subjects to prioritize task performance caused stooped posture only during the difficult task; and that stooped posture was positively correlated with state and trait anxiety and with neck pain. The graduate student conducting this study presented our research at the 45th Annual Meeting of the Society for Neuroscience. Though I was unable to attend due to lack of funding, the experience of collaborating with a graduate student to design a study and critically evaluate the results taught me the standard for graduate-level research and expanded my critical thinking skills.

What are the advantages of you to this program?

- Strong and large support system of genetic counseling staff (50 GC's, 10 MD's, etc.). - Clinical immersion from the start. - Culturally diverse location and clincal rotations in specialty and industry settings. - Access to one of the best genetics facilities in the country.

What worries you about coming to this program?

Affordability is the only apprehension I've had concerning Stanford's program; however, cost is not my first consideration in choosing a program. The quality of my education is far more important to me than the cost, and if I feel Stanford is my perfect fit then I will make it work.

What was the last book you read? What did you learn from it?

All the light we cannot see. A major theme from this book lies around predestination, or how much power human beings have to choose their own destiny. It emphasizes the power of individuals to choose their own path despite the sometimes horrible, war-ridden world around them. Werner chooses to save Marie after the information he hears on her broadcast saves him from being trapped. This broadcast being the very resistance broadcast transmitting information to the Allies that he was hunting down for the Nazis.

With what multicultural or diverse populations have you worked?

As a crisis counselor at Alternatives to Violence of the Palouse I had the opportunity to talk with individuals from many different backgrounds struggling with similar issues. Individuals who identify as LGBTQA+, individuals from different racial/ethnic backgrounds, men and women, varying SES and religious beliefs, the disabled and elderly. It was eye-opening to advocate for individuals with backgrounds so different from my own and help them overcome barriers that I have never had to consider myself. An Arab woman who spoke limited English called in. She had been recently relocated to the United States by her abusive husband and I had to use a third party translation service to communicate effectively with her. Through translation services, I found out that the move isolated her from her family and only support system outside of their marriage. Her traditional Muslim values made her unsure of whether she could or even wanted to leave her husband. She was in despair and concerned about the religious backlash she might experience if her marriage failed. Despite the language and cultural barriers between us, we had a productive conversation. She asked questions about abuse, the forms it can take, and the assistance options available to her in our area; while I asked questions to ascertain what a solution would look like for her in her relationship. I offered additional resources in the event the abuse worsened, including information about professional counselors, legal advocates, and ATVP's women's shelter. Together, we made a safety plan to prepare for the next time her husband escalates.

Tell me more about your work as a direct care aide.

As a direct care aide at Milestone Decisions, I care for five individuals on the autism spectrum with associated mood and attention disorders. Some are mainly non-verbal while others are very high functioning, but all have difficulty with social interaction and connecting with people. The Intermediate Care Facility where I work is referred to as the "behavioral house" within Milestone Decisions because our residents are more prone to self-injurious behavior and aggressive outbursts when they cannot communicate their feelings or needs. I strive to support the residents in learning effective communication strategies, coping mechanisms, and socially appropriate behaviors while ensuring their and fellow staff members' safety. The job is challenging, but witnessing each resident meet new milestones and reduce maladaptive behaviors makes my efforts equally rewarding. One-on-one interaction with each resident has shown me that I am even-tempered in high stress situations, capable of finding creative solutions to complex problems, and a perceptive communicator. These attributes allow me to anticipate the needs of the residents and will contribute invaluably to my capability in directing complex, emotional conversations as a genetic counselor.

What do you believe will be your greatest challenge if accepted into this program?

As a genetic counseling patient and someone who has shadowed several genetic counselors, I know that a genetic counseling session is very time-intensive, requiring a lot of behind-the-scenes work from the genetic counselor. Genetic counselors need to collect accurate family histories, educate themselves on unfamiliar or ill-defined genetic variants, and communicate complex results to diverse audiences. I think initially learning to direct a genetic counseling session and staying on top of all of the work required by a genetic counselor will be very challenging, but I am extremely confident in my ability to do so, especially with practice.

Give me an example of how you have communicated effectively in the past.

As a peer advisor for the Psychology Department, I met with freshmen and sophomore undergraduate students to help them plan coursework for upcoming semesters, identify internships or research assistantships they might be interested in, and connect them with additional campus resources. This experience required effective communication skills and I fulfilled my role very well, advising 30 students in the one year I was a peer advisor. To me, effective communication is about understanding more than just verbal information, but also the emotion and intentions behind the information. It involves engaged listening, making eye contact and paying attention to body language, so that you gain the full meaning of what's being said and make the other person feel heard and understood. I was conveyed information succinctly and clearly and used reflective statements to make sure I understood what the students were saying.

Tell me about an experience working with diverse populations.

As a volunteer advocate at Alternatives to Violence of the Palouse (ATVP), I take our 24-hour emergency hotline after business hours several times a month, serving as a first responder to anyone calling in crisis. My calls have included individuals contemplating suicide, sexual assault victims, and long-time domestic violence victims. While self-care is always necessary, I never feel overly drained discussing these traumatic experiences but invigorated knowing I provide a much-needed service to support and empower people who have experienced violence. During one of my most involved calls, I used translation services to communicate with an Arab woman recently relocated to the United States by her abusive husband. The move isolated the woman from her family and only support system outside of their marriage. Her traditional Muslim values made her uncertain about whether she could or even wanted to leave her husband. She was in despair and concerned about the religious backlash she might experience if her marriage failed. Despite the language and cultural barriers between us, we had a productive conversation. She asked questions about abuse, the forms it can take, and the assistance options available to her in our area; while I asked questions to ascertain what a solution would look like for her in her relationship. She decided she was not prepared to take any definitive action and that talking to someone about the situation was enough for the time being. I provided resources suitable to her circumstances in the event the abuse worsened, including information about professional counselors, legal advocates, and ATVP's women's shelter. Together, we made a safety plan to prepare for the next time her husband escalates.

Define success.

As long as a person is putting effort in to reach their goals, they are succeeding. Success is not an end-all be-all, I've finally reached my ultimate goal, its the continual assessment, adjustment, and pursuit of one's hopes and dreams. Success is defined by trying and failing until you succeed and then trying for the next objective. The only way we can fail is if we quit trying.

How would your professors describe you?

Diligent and engaged. I contribute substantially to in-class and online discussions while listening to and playing off of other students' perspectives. I am thorough in my academic endeavors and have been told by several professors at the end of a semester that I set the standard for high quality responses and work.

Where do you see the field of genetic counseling going?

Disseminating further into industry and education. Genetic counselors are ideal to help pharmaceutical companies reach and market drugs to populations affected by rare disorders, which are often genetically-based. Surveys show that health-care professionals' understanding of genetics and confidence in communicating genetic information to patients is less than it should be, so there's a niche genetic counselors can fill in educating other health care professionals as well as lay-audiences.

When have you managed multiple time commitments at once?

During my entire undergraduate degree, I successfully managed numerous time commitments, but I was most involved during my senior year. I kept up on my academic coursework, maintaining straight A's while studying for the GRE, spending 8-10 hours a week as a research assistant, working part-time (15-20 hours a week) as a direct care aide, volunteering my time as a crisis counselor 2-3 times a month at Alternatives to Violence of the Palouse, and staying actively involved in my sorority's social and philanthropic events.

Genetic testing is a critical decision for any individual, how will you ease their mind and walk them through the process?

Education is paramount, but it needs to be tailored to the patient's wants and needs. If someone isn't ready to hear the information or is in an emotional state that will hinder their ability to comprehend difficult concepts, then telling a patient about a genetic abnormality is next to useless. I plan to address the emotional needs of a client as well as the educational.

What do you have to contribute to us?

High intellectual capacity, a deep work ethic, and commitment to lifetime learning.

What do you do in your spare time? To relax?

I am a very active person so I like to run to de-stress. I also love to read and watch movies in my down time. My favorite social activity is going to concerts.

What are your strengths and weaknesses in working with minorities?

I grew up in a very accepting household and because of that I have always been an open-minded person. In my cultural competency training at Alternatives to Violence of the Palouse we talk about how we all have unconscious biases and that in order to support and empower individuals from different backgrounds we must first recognize and acknowledge our own unconscious biases so we can assess how we treat people from different backgrounds. This is something that's really stuck with me and has made me very conscientious while working with clients from diverse backgrounds and culture, language, customs, beliefs, and values. Weakness: Lack of experience. However, any opportunity I've had to work with diverse populations I have taken; from my work on the hotline to my experiences working with individuals with disabilities to the community action project I did in my women's studies class meant to address a gender-related problem in our community. My group created what we called the "Palouse Rainbow Directory," which is a comprehensive index of LGBTQA+ welcoming and affirming businesses in Moscow, ID and Pullman, WA, which is collectively called the Palouse. To create this index we collaborated with our local PFLAG chapter. The index would allow our community the choice to support LGBTQA affirming businesses. PFLAG is a nonprofit organization whose mission is to uniting people who are lesbian, gay, bisexual, transgender, and queer (LGBTQ) with families, friends, and allies, PFLAG is committed to advancing equality through its mission of support, education, and advocacy.

How do you intend to finance your education?

I have some support from my family and the rest I plan to finance through loans.

Describe any research project you've worked on. What was the purpose of the project and what was your role in the project?

I helped design, implement, and evaluate a study that explored whether cognitive factors play a role in maintaining ergonomically upright posture during an ongoing task. We tested our hypothesis that cognitive factors do play a role by having participants play a simple and difficult computer game for 10 minutes with no motivational instruction, then repeating the task with incentive either to maintain upright posture or win the game. I was one of several research assistants who ran the individual research sessions, collecting personal information from participants, administering self-report surveys, and running complex 3D motion capture equipment that we used to measure posture over time. I also helped analyze the data and create a poster with the graduate student directing the project. He then presented that poster at Neuroscience. Overall, we found that participants stayed upright more when incentivized to attend to their posture. That incentivizing task performance caused stooped posture only during the difficult task. And that stooped posture was positively correlated with neck pain and state and trait anxiety. - A long-held and still popular distinction between "state" and "trait" anxiety allows anxiety to be thought of in two ways: as a temporary emotional state that nearly everyone experiences and as a consistent personality attribute.

How do you see our program fitting in with your career goals?

I hope to work as a clinical genetic counselor in a cancer setting and hope to eventually move close to my family again in Idaho. The continuity of Stanford's coursework and clinical work will reinforce clinical concepts and make me a great clinician. Stanford's program has built-in has relationships with large medical facilities throughout the country which will allow abundant options for job placement.

What would you be doing if you were not pursuing genetic counseling?

I imagine I would be pursuing work as a clinical psychologist. I want to help people with serious problems in a one-on-one setting. I want to contribute to the prevention of distress and disorder, whether that distress has an absolute genetic basis like my BRCA1 gene or is more psychologically-based from an individual's life experiences, traumatic or otherwise.

Why genetic counseling?

I love that genetic counseling lies at the intersection of genomic medicine and psychology. This one career will allow me to pursue my interests in clinical research; to participate in one-on-one counseling relationships where I help patients adapt to and make decisions about complex genetic information and support them in complex emotional states like guilt and grief (you get to see the positive effects of your work in the patients served); and finally I will be a part of a field that is always changing, and therefore I will never stop learning new information. As an avid student, I am excited about a career that will require continuing education.

If you're not accepted to graduate school, what are your plans?

I plan to continue strengthening my resume through further advocacy involvement and will likely seek out a more genetics-based experience since my resume is stronger on the psychological side. And, I will, of course, be reapplying to genetic counseling programs this next year.

Tell me about yourself. How did you become interested in psychology? In genetic counseling?

I started my undergraduate degree as a biology (pre-med) major and I remember feeling very bored and un-challenged in my introductory science classes where we were memorizing simple cell structures and learning introductory principles and applications of chemistry. However, my psychology 101 honors course piqued my attention from the very first day. We discussed how we learn and think, how we experience emotion, differences in personality, social processes. All of these concepts seemed more challenging because even at the introductory level psychology is abstract and more difficult to operationalize. I switched my major to psychology but continued to take the necessary science classes that would allow me to become a genetic counselor. It wasn't until later, in my upper division classes, that I found my love of more difficult science courses, including genetics, biochemistry, molecular biology, and anatomy and physiology. In these classes, I was taught how complex molecular and biochemical processes produce our biological selves and how small changes at the molecular level (e.g., phosphorylating one nucleotide) can have drastic effects on the body's production of protein and overall phenotype.

What are your goals after graduate school? In 5 years? In 10?

I want to work as a full-time genetic counselor in a clinical setting, helping individuals accept and adapt to genetically predisposed cancer syndromes. In five years I hope to have started a family. I think I would eventually like to teach in some capacity; that could be, community outreach to the general population, continuing genetics education for medical professionals, or educating genetic counseling students.

Explain a situation in which you had a conflict and how you resolved it. What would you do differently? Why?

I was a sorority recruitment counselor the summer of my junior year in undergraduate. To become a recruitment counselor applicants go through an application and interview process. Once selected, I was paired with another woman from a sorority different from my own as everyone is and our task was to work together as recruitment counselors in our Panhellenic community to organize and support 30 women assigned to our group as they went through Sorority Recruitment. It was an amazing experience, but my partner and I were very different in our methods of counseling. She was very high-energy, crazy, and silly; while I was more cool, calm, and collected. At first we clashed and disagreed about how we should counsel certain girls, but after working together and learning to understand each other with effective communication, we realized we complimented each other. Hannah could really reach and comfort the highly emotional girls; while I was better at consoling the girls that didn't wear their emotions on their sleeves. Together, we were very successful and all of our girls ended up finding a home in a sorority.

What are your feelings about coming to this state?

I've spent quite a bit of time in Tahoe and love Northern California. The area is very similar to where I'm from in Idaho. I'm excited for more moderate weather however.

Tell me about an assessment instrument with which you feel competent.

In-depth interviews and administering self-report survey methods.

Explain an ethical dilemma that you faced and how you handled it.

Mandated reporting for ATVP.

What was the last movie that you saw?

Miss Sloane.

In college, what courses did you enjoy most? The least? Why?

Most: Physiological psychology and genetics. Complex subjects that are relatable to people in their every day lives. Least: Introductory biology and chemistry courses. Not complex enough for me.

Why should be accept you over equally qualified candidates?

My experience as a genetic counseling patient gives me an unmatched level of empathy and understanding for the patients I would serve as a genetic counselor.

Elevator speech (30 seconds)

My family's history of breast and ovarian cancer introduced me to genetic counseling and gives me a high level of empathy for others affected by genetic syndromes. Over the past four years, I have explored activities related to genetic counseling and through them have fully realized my excitement for this career and potential competence as a genetic counselor. My experiences have made me a compassionate and effective communicator, while my academic record demonstrates my ability to learn complex scientific material.

Describe your greatest accomplishment?

My greatest accomplishment is maintaining a cumulative 4.0 GPA. I have always loved school and while maintaining straight A's for my entire undergraduate degree while fully involved in extracurricular activities was no small task, it was not as difficult for me as you may think, and that is because I enjoyed my education thoroughly. I am fascinated by psychology and genetics so learning the material never felt like just work, but even with the classes I was less interested in, I always found a way to engage myself in the material (e.g., I like to think about how the information can be applied to real-world situations). I think my academic performance is analogous to the complex structures of proteins and their unique functions. My structure (or cognitive interest and ability) was perfectly suited to function exceptionally in the biological and psychological sciences, and especially where they intersect.

What is the most difficult situation you've dealt with in the past, work-related or not?

My work as a direct care aide has by far been my most challenging endeavor, but has made me unshakeable so to speak. My resident's behaviors can be complex and severe. I have listened to someone scream for hours off and on while attempting to be self-injurious or physically aggressive toward me. In that situation, I am an emotionally-unresponsive, but also supportive backboard for them whose sole purpose is to keep the residents' and myself safe while trying to deescalate them with as little physical interaction as possible. This is not an easy task. It requires patience, compassion through understanding that individuals with severe autism do not have as great of control over their emotions or actions as I do, and adaptability in that when the behavior is over and the problem has been fixed, we move on with our day as if nothing happened. To teach the residents better behaviors you have to first build rapport and make sure they trust you, then you can assert yourself respectfully in crisis situations to help that resident de-escalate. I have created such great bonds with the individuals I care for and am really going to miss them when I am gone.

How do you explain to patients that just because they are tested for having a higher chance of developing a certain disease, doesn't necessarily mean you will have that disease?

Our biological processes are the result of not only genetic, but also environmental and lifestyle factors. My BRCA1 mutation gives me a 40-80% lifetime risk for breast cancer and a 20-40% lifetime risk for ovarian cancer, but it does not guarantee that I will develop either. And knowledge of my genetic variant lets me make proactive healthcare decisions that can reduce my risk. (Through screening and preventative surgery at the appropriate age). While my risk is higher than someone without my variant, my results could also be framed as my likelihood of not developing breast cancer, which would be 20-60%.

If you could have dinner with anyone, living or dead, who would it be? Why?

Rosalind Franklin. Her X-Ray diffractions of hydrated DNA elucidated the complex double helix structure that Watson & Crick are famous for. She persevered as a scientist when women could not be scientists and discovered something amazing despite being discounted and objectified by her male contemporaries. She's an inspiration, and she died of ovarian cancer at age 37, which gives me a sense of camaraderie for her since my family is affected by BRCA1.

What would you change about yourself and why?

Sometimes, I have a hard time letting things go. I overthink about my experiences after the fact. For example, "oh, I could've said this in that interview" or "gosh, I could've handled that situation a little better." I can be very critical of myself and rehash my experiences over and over again in my mind when I should probably let it go. This is useful in that I am always reflecting on my actions to make myself better in the future, but I can tend to obsess and its something I am working on. So just being better at letting things go and being less critical of myself.

Why do you think you are a fit for our program?

Stanford's genetic counseling program is held to a very high standard and that is reflected in its production of successful genetic counselors. All of Stanford's genetic counseling students in recent years are passing their boards the first time, graduating on time with a job lined up, and half of them are publishing their student research projects. These statistics are some of, if not, the highest in the country. I also have always been a very high-achieving student, graduating as my high-school valedictorian, maintaining my 4.0 GPA throughout college and graduating summa cum laude, and I would like to continue this trend at a world-renowned institution and genetic counseling program.

Discuss a situation in which you showed leadership ability.

Stepping up to fill empty roles at Milestones. - Shift lead, helping people cover shifts, training new employees, grocery shopping.

What is the clinical relevance of your research?

Stooped posture with the head forward of the torso is associated with multiple health problems, including headaches and neck pain, reduced upper body strength and mobility, and impaired postural control. Neither physiological nor ergonomic factors are sufficient to explain the prevalence (two of three adults aged 65 or older) of stooped posture, so we are investigating the influence of cognitive factors.

What do you think will be your greatest strength as a genetic counselor?

Strength: My ability to provide patient-center advocacy/therapy without becoming too emotionally invested. I am very good at separating my own emotions from the patients, while remaining empathetic to what that individual is experiencing. Weakness: (Over-analyzing sessions after the fact). I am going to struggle with individuals who decline genetic testing likely to benefit them. However, due to my family history, I fully understand that genetic counseling is a complicated decision-making process, informed by medical, familial, psychosocial and cultural factors. Genetic counselors are there to assess family histories and offer resources and guidance to patients, but they are not there to make an individual's decision for them. Providing information while still allowing a person to select their own course of action is a skill I have developed as a volunteer advocate and crisis counselor for Alternatives to Violence of the Palouse. Advocating for a domestic violence victim who chooses to remain in an abusive relationship is a trying task; just as counseling a patient who declines genetic testing likely to benefit them is also challenging. As an advocate or counselor, it is essential to remember that the victim, or patient, knows his or her life circumstances best and should be responsible for making a well-informed, but ultimately self-directed, decision.

What are the challenges you expect to face as a genetic counselor?

The greatest challenge will be delivering bad news, but I am confident in my ability to have difficult conversations in a patient-centered manner that educates, supports, and empowers patients. I am experiences in having difficult and sometimes uncomfortable conversations with victims of domestic violence and sexual assault, and I have become very skilled at listening actively, using reflective statements to make sure I am fully understanding their needs and wants, and offering options, not advice so those individuals can make self-determined decisions. I have also become practiced at acknowledging their trauma and then emphasizing what positive actions we can take now to help them heal. This skill will translate well to genetic counseling where I can emphasize what genetic information allows us to do for prevention in patients and family members.

What variables are of concern to you in working with diverse populations?

The main variable of concern in working with diverse populations is always going to be outreach and overcoming barriers to services. Reaching out to diverse populations so that they are aware of and use genetic counseling services more.

Tell me more about your research experience.

The research I was involved in at the U of I in the Psychology Department's Mind Movement Laboratory explored the cognitive and neural factors underlying control of posture and action. I became practiced working one-one-one with research subjects, asking them personal questions, administering informed consents and other self-report measures, and scoring those measures. The highlight of my research assistantship was co-authoring a poster presented at the Annual Meeting for the Society of Neuroscience. We found that participants sat more upright when incentivized to attend to their posture; that incentivizing task performance caused stooped posture only in the difficult task; and that stooped posture was positively correlated with neck pain and state and trait anxiety.

What can be determined about an applicant at an interview?

Their personal presence; how that applicant holds themselves and displays confidence or lack thereof. Their communication abilities; non-verbal and verbal. Finally, how much they prepared for the interview; did they do their research on their interviewers, do they know about current issues in the field, or are they just winging it?

Explain to me why someone should see a genetic counselor.

To learn more about themselves and use that information to make informed, proactive healthcare decisions. However, just because a person may benefit from certain genetic information, it does not mean that they SHOULD see a genetic counselor. Their own belief system and life circumstances will absolutely contribute to their decision about genetic testing. All we can do is educate our communities about genetic testing and how it can be used to prevent genetic disease.

What is your experience with individual/couples/family/group/inpatient/etc. treatment?

While job shadowing genetic counselors in prenatal, pediatric, and cancer clinical settings, I observed 5 different genetic counselors counsel individuals, couples, and families. I could tell that their communication approaches were tailored to their audiences. As soon as I realized my professional interest in genetic counseling, I reached out to Jennifer Eichmeyer, the genetic counselor I met with as a patient. She graciously provided mentoring, guidance, and the opportunity to job shadow her and her colleagues at St. Luke's Boise Medical Center. A prenatal consultation for abnormal nuchal translucency (NT) is one session I remember acutely. Due to an unusually high NT measurement, the expecting parents chose to undergo chorionic villus sampling, a diagnostic test, so that they could prepare for the possibility of raising a child with a genetic abnormality like Down syndrome. They were highly emotional and expected the worst. Fortunately, the test results showed no signs of Trisomy 21, 18, or 13, and their concern was relieved. Although the couple received good news, discussions leading up to the results were complicated, and the skill and sensitivity with which their genetic counselor navigated the situation were immensely impressive. She was professional, earnest, and expertly communicative. Observation of this case and several like it, involving crisis intervention and personalized education for the patient and family members, solidified my decision to pursue genetic counseling.

What are your strengths and weaknesses? How have you dealt with your shortcomings?

a. Five years ago, when I started my undergraduate degree I would have absolutely, without a doubt classified myself as a Type A Personality: ambitious, competitive, highly organized and aware of time management, as well as impatient, controlling, and unable to tolerate inefficiency. Those last three qualities were and continue to be my greatest weaknesses. However, today, I can say that through my education, advocacy involvement, and work with individuals with autism that I am no longer the person defined by the typical Type A downfalls. As a direct care aide, my patience has increased tenfold, as well as my understanding that it is okay, and mostly beneficial, that people (not just those with disabilities) work at their own pace and learn material in a way that best suits their needs. Working as a part of a research team for three years has made me much more of a collaborator rather than a control freak. I now know that I can hand off a project to a capable counterpart and they will do their best if not better than the work I might've done. While I am still ambitious, highly organized and aware of time management, it is no longer to a fault. Overall, my experiences have made me a more empathetic and adaptable person.