Hollie Williams

Delwin Jacoby

Unexpected

26

Interesting case which includes inclusion of family and maintenance of confidentiality and excellent collaboration

Hollie Williams

Delwin Jacoby

Challenging

26

Nice interesting case with definite unexpected findings. However, references, EBP indications, could further enhance this case.

Hollie Williams

Delwin Jacoby

Collaboration

27

27

Good case, but difficult to manage due to family dynamics and patients work considerations. Nice overall write up. Thanks for your work.

Hollie Williams

Duveen Sturgeon

Unexpected

30

Overall nice case, references would enhance case further with focus on EBP. Thanks for your work.

Hollie Williams

Duveen Sturgeon

Collaboration

31

Very complex case, with multiple layers of family dynamics. Very well handled!

Hollie Williams

Duveen Sturgeon

Challenging

28

very thorough case study. Strong evidence of collaboration with other health care providers.

Hollie Williams

Duveen Sturgeon

Ethical

30

29.75

This was a very challenging case. However, because the applicant was not part of the genetic counseling and testing it was hard to grade. Clearly the applicant did a great job of managing this complex case.

Hollie Williams

Heather Hannon

Challenging

12

This a very thorough and well written case. The applicant is clearly well versed in her speciality.

Hollie Williams

Heather Hannon

Unexpected

25

My impression of the case study is that the genetic counselor did most of the heavy lifting in this case including initial assessment, evaluation and counseling for this client. I struggle with whether the candidate fully understands GINA, EBP, and how this particular genetic finding ties in with the patient's management. I struggle to find examples of how this patient was counseled to overcome his concerns. What brought him to undergo testing? How were family members counseled? How was collaboration facilitated and what team members were included? While the candidate may have a firm understanding of cardiology, I do not get the sense that the candidate has a comprehensive grasp on genomic competencies. The case study is also a rambling train of thought and not what I would expect for an APRN-NP seeking credentialing in genomic nursing.

Hollie Williams

Heather Hannon

Ethical

17

The candidate does an excellent job of identifying family members for cascade testing. This appears to be her main area of focus throughout the attached case studies. I struggle to find evidence of genetic and genomic competency. The VUS finding is a curious finding, considering the patient's personal and family history. So why then was more not done in that moment to investigate this finding in the literature? Additionally, I would have appreciated deeper discussion on what genes can be associated with the clinical picture. There is a possible diagnosis of CMT in this family, what genes are associated with CMT? Are these genes associated with clinical findings this patient displays? Excellent job of cascade testing, but what about follow up, what resources are out there for this patient and affected family members? Lastly, the case is poorly written. It reads like a BSN student wrote it for a reflection assignment, not an APRN-NP for a credentialing portfolio. Part of credentialing is making sure candidates measure up to certain standards. The lack of evidence based discussion and the informal, rambling nature of the case cause concern.

Hollie Williams

Heather Hannon

Collaboration

27

20.25

25.66666667

I wanted to like this case. However, the candidate does not go into the amount of detail I would prefer to see with a complex case. Additionally, there are multiple grammatically errors that cause the note to feel sloppy. It was difficult to tell whether the candidate fully understood implications of this finding for patient and family. Clearly the candidate understood that family members were at risk and the patient was struggling with how to (or whether to) relay this information. But it appears the GC did a lot of the heavy lifting. And for credentialing, I would like to see the candidate outline specific guidelines, discuss implications of testing, and provide more detail about what was shared post test counseling other than the remark that the patient did not care that this was a pathogenic finding. Should he have cared? It looked as if cMRI and EF guided management, so maybe his testing was for family members in the first place? But this is not what is said as the reason why is undergoing testing. It states that he wants to know whether his arrhythmia could be due to an inherited component. I was particularly disappointed with the evaluation component of this case.

Hollie Williams

Delwin Jacoby

Ethical

29

Grammatical errors and informal tone, as well as lack of EBP guidelines throughout case make it more difficult to provide a favorable rating for this case. Overall, it is clear that this candidate has an excellent understanding of cardiology, and it is reassuring to learn that the patient was referred to the appropriate specialist. I would like to see the candidate talk more about these specific genetic findings, what does this mean for prognosis, if anything? What does this mean for medication management, if anything? What does it mean for lifestyle modifications, if anything? This case is submitted for APRN-NP credentialing in genetics / genomics. Thus, I feel the case should tie in the genetic findings and focus on the implications of the findings. I don't see that in this discussion. It reads more like a discussion for management of heart failure that just happens to have a genetic cause. Is identification of at risk family members and cascade testing and curiosity the only reason one does genetic testing in this setting?