This thesis presents a qualitative study of genetic counselling. Using a combination of semi-structured interviews and conversation analysis, it focuses on the role, function and structure of genetic counselling and on its status as medical or counselling work. Semi-structured interviews are used to ascertain genetic counsellors' accounts or perceptions of the nature of their role, their views on client expectations, and genetic counselling clients' perceptions and expectations of the same. Conversation analytic study of recorded genetic counselling consultations is used to identify whether or not they possess an overall shape and whether they appear conversationally as a counselling or a medical interaction. Rose's (1998, 1999) sociological work on the growth of the therapeutic community and the techne of 'psy' provides a framework for a discussion on the strength of the genetic counselling profession's association with a Rogerian counselling philosophy and on the potential difficulties this may bring. The questions are raised; does genetic counselling have many similarities to "personal, emotional or psychological" 'counselling' at all? And is this alliance with the counselling community either fair or possible for the professionals involved? The results were as follows. First, that the genetic counselling consultations in this corpus do not present with one unique overall shape that can encompass all interactions. Second, that the accounts of the genetic counsellors and clients in this sample, and the conversation analytic study of the recorded consultations, suggest that genetic counselling is primarily a medical-based activity and that this is what clients want. Third, that genetic counselling has a number of dissimilarities to psychotherapeutic counselling that suggest it is not so much 'counselling' as using counselling skills, and finally, that the tensions incurred in fulfilling medical-type tasks within what is ostensibly a 'counselling' role are neither fair nor practical for the professionals involved.

Clinical facilitators facilitate the clinical training of students in the hospitals at which students are placed for the practical component of their studies. Clinical facilitators’ success depends on their ability to facilitate students effectively. Students who have been effectively facilitated have the potential to become competent bedside nurses to their patients. This is sure to lead to better patient outcomes and will therefore have a direct impact on the quality of nursing care. The clinical facilitators who are appointed to facilitate students in the clinical learning environment are, however, not necessarily empowered and skilled to teach their students effectively. If their own mentoring needs are addressed, clinical facilitators may be assisted to become more effective in their transition from clinician to clinical facilitator. A qualitative study was conducted with the purpose to explore and describe the mentoring needs of clinical facilitators with a view to proposing a mentoring programme for effective clinical facilitation. Data were collected by means of focus groups with clinical facilitators working in a private hospital group. The findings of this study confirmed the need for mentoring. Mentoring of clinical facilitators contributes to their skills and understanding of clinical facilitation. As an outcome of the study, an outline of a mentoring programme was drawn up which could be used in the orientation and mentoring of novice clinical facilitators. / Health Studies / M.A. (Health Studies)