Current Practices for Evaluating Clinical Supervisors in North American Genetic Counseling Programs

Clinical supervision is a cornerstone of genetic counseling education, yet there are no standardized methods for evaluating supervisors across North American programs. The Accreditation Council for Genetic Counseling requires that supervisors be evaluated regularly but provides minimal guidance on implementation. This study explored how genetic counseling programs evaluate their clinical supervisors and examined the perceived effectiveness and limitations of these approaches. 16 out of a possible 64 fieldwork directors (FDs) from accredited genetic counseling programs across the United States and Canada completed semi-structured interviews. Participants described their evaluation practices and were asked to share their relevant evaluation tools. Using a constructivist paradigm, we analyzed interview data using inductive content analysis followed by interpretive description. All 16 programs used student evaluations; three used self-assessments; one used peer evaluation; and none used management reviews. The content of the student evaluations as described by FDs addressed aspects of the learning environment including the supervisory relationship, clinical teaching ability, and the clinical site experience. Document analysis indicated broad alignment between the intended purpose of student evaluations and survey content, while also highlighting considerable variability in survey design. Self-assessment and peer evaluation were rarely implemented but were largely considered positive. Challenges to supervisor evaluation included limited resources, relational dynamics within supervision, and concerns about retaliation. While supervisor evaluation is universally practiced, inconsistent implementation and tool design may limit its value for both students and supervisors. These findings demonstrate the need to clarify the specific purpose of student evaluations in order to develop validated tools and ensure alignment between supervisory practice, training, and goals. Improving supervisor evaluation may enhance both the quality of supervision and the learning environment for students.