A Method for Analyzing Videotaped Genetic Counseling Sessions

This study describes the development and evaluation of a multi-item scale for analyzing the genetic counseling process, the Manchester Observation Code (MOC) for genetic counseling. The instrument is specific to the field of genetic counseling and is designed for analysis of the communication between counselor and client. Coding is done directly from videotaped sessions. Because communication is the means by which genetic counseling is accomplished, the method measures four relevant components of communication: (1) grammatical form, (2) purpose, (3) subject, and (4) cue source. The instrument enables an observer to code the counselor's statements into these four components. Three videotaped sessions were used to measure interrater reliability, or the consistency of rating for each of the four communication domains using this method. Three videotaped sessions were also used to measure test-retest reliability, or the consistency of the designed method from one time to another. A total of 21 videotaped sessions were tested using the method. A statistical measure of reliability established consistency of the designed method; Cohen's kappa yielded 0.7 for interrater reliability and 0.79 for test-retest reliability. These findings suggest this instrument may be used to identify important elements of the genetic counseling process.