1. Closing Remarks Cross-Cultural Issues and TAGC Jon Weil University of California San Francisco

2.   With its international membership, TAGC provides the opportunity to investigate cross- cultural issues from an international perspective.   Although this was not explicitly addressed at the 2011 conference, the topics that were discussed include cross- cultural issues that provide opportunities for future discussion and research.

3.   What follows are some thoughts about this for each of the presentations made at the 2011 conference.

4. Narrative Genetic Counseling The presenters discussed the fact that   Reflective writing by genetic counselors and students is limited, due to loss of the tradition of writing in the electronic/internet age.   The use of a narrative approach with patients involves a learning process and is constrained by the need to convey information.

5. Narrative Genetic Counseling, cont. Are there communities and cultures in which the tradition of writing or of oral history remains strong? Might these communities or cultures contribute to, or serve as models for, the further development of narrative genetic counseling?

6. Supervision   The relationship between supervisor and supervisee, and how supervision contributes to the broader educational and training process, will be affected by many educational and cultural factors.   These involve social expectations and norms of behavior for interactions between student and supervisor such as:

7. Supervision, cont. The role of the supervisor in providing constructive criticism, and of the student in responding The appropriateness of students sharing relevant personal information with the supervisor Guidelines and trust concerning confidentiality Guidelines, social expectations and trust concerning the role that the supervisor’s evaluation has in the overall evaluation and progress of the student The acceptance and use of an ombudsman to provide independent evaluation and intervention in cases of dissatisfaction or disagreement between supervisor and supervisee

8. International Credentialing   The presentation stressed that similarities in education and practice in different countries support international credentialing. ! ! What social, medical, health care system and legal issues might there be that would create difficulties when transferring the education, training and clinical experience obtained in one country to practice in another country? ! ! How can these be explored and addressed?

9. LexiGene   This very valuable project raises interesting issues concerning language and usage within and across national borders:

10. LexiGene, cont. ! ! How do terms and concepts differ among regions within countries and among different countries that use the same language? e.g., Spanish as used in the different Spanish speaking countries of North, Central and South America and in Spain ! ! Are there historical/social/racial issues underlying the use of different languages within the same country and/or the same language among different countries that influence the meaning and emotional impact of terms and concepts?

11. Collaborations with community and advocacy groups ! ! How do social attitudes and available resources in different countries or regions affect such collaborations? ! ! How do social attitudes and norms regarding the role of public interest groups, including advocacy, affect such collaborations?