Education of audiologists to maximize hearing aid outcomesFirst presented as a poster at IHCON 2014

Elaine Saunders 1 Sarah Bellhouse 1 Peter J Blamey 1,2,3,4

1 Blamey and Saunders Hearing Pty Ltd, www.blameysaunders.com.au2 Bionics Institute, www.bionicsinstitute.org3 Department of Audiology and Speech Pathology, The University of Melbourne, www.medoto.unimelb.edu.au 4 Department of Medical Bionics, The University of Melbourne, 384-388 Albert Street, East Melbourne, Victoria 3002, Australia

Abstract:

Aims:

The goal was evaluation of existing variations in postgraduate audiology courses, with a particular focus on hearing aid studies and the combination of this topic with auditory rehabilitation. This research also aimed to evaluate the usefulness of the website based information, as available to prospective audiology students wishing to make an informed decision about university curricula.

Introduction

Hearing aids are the major tool available for rehabilitating people with mild to severe hearing loss. The outcomes achieved depend on many factors, including the severity of hearing loss, the quality of the hearing aid’s sound processing, the adjustment of the hearing aid parameters to the needs and preferences of the user, previous hearing aid experience and user’s attitude. In addition, it is obvious that hearing aids can have no effect if they are not used, as is the case with about 75% of people who would benefit, in developed countries such as Australia and the USA. Evidence supports that many hearing aids in 2014 give improved benefits compared with hearing aids in 2004 [1]. Whilst there is a need for counselling with some clients, this is not true for the majority of people with mild to moderate loss [2]. There is a need for audiologists to evaluate recent developments in hearing aid technologies, pre-fitting and post fitting measures, and rehabilitative techniques.

Methods (1)

University and course selection:Data were collected from universities offering postgraduate (Master’s degree and Professional Doctor of Audiology) courses delivered in English in Australia, Canada, New Zealand (NZ), the United Kingdom (UK) and the United States of America (USA).

Course fees:All course fee information is displayed in USA dollars (currency converted May 2014) and is taken for the 2013-2014 study period. Course fees are listed at domestic student costs, include student fees where possible, and exclude residential costs. Course fees listed are approximations and may vary depending on an individual’s education history and the electives selected.

Methods (2)

Advertised course features:Where available, advertised course features were recorded from course curricula webpages.

Time spent on hearing aid related studies:Modules/units of study listed on curriculum webpages were examined to determine the overall percentage of time dedicated to the study of hearing aids in each course. Where units contained some information about hearing aids, the entire unit value was included in the percentage calculation. The minimum, mean and maximum total percentage of coursework dedicated to hearing aid related studies was then calculated for each of the five surveyed countries.

Method (3)

Hearing aid units including content on auditory rehabilitation:Where available, hearing aid related module/unit descriptions on curricula webpages were examined to determine the advertised content of these units of study. Each module/unit was then recorded as either including content on auditory rehabilitation or as purely focusing on hearing aid technologies. The overall percentage of hearing aid related units that did or did not contain information on auditory rehabilitation was then calculated for each of the five surveyed countries.

Results: Course Duration

Australia Canada New Zealand UK USA0

0.51

1.52

2.53

3.54

4.5

22.7

2

1.2

3.9

Average post graduate audiology course duration (years) per country

Yea

rs

Results: Range of Fees

Australia Canada New Zealand UK USA0

25,000

50,000

75,000

100,000

125,000

150,000

Post graduate audiology course cost range per country in USD

US

Dol

lars

Results (3)

Of the surveyed curricula webpages containing advertised course features, 37% listed clinical practice as the main focus of the course. The second most highly advertised course feature was research (21%), followed by a broad curriculum (15%). No course advertised a focus on hearing aid studies as a feature of the curriculum

Results: Advertised Course Features

Results (4)

On average 11% of coursework was specifically designated to hearing aid related studies across all universities surveyed. Universities in NZ displayed the highest average hearing aid specific coursework, followed in decreasing percentage order by the UK, Australia, Canada and the USA Within most of the surveyed countries there was considerable variation in the amount of total coursework dedicated to hearing aid specific studies between individual universities. The greatest variation was found in universities in the USA where hearing aid specific coursework varied from 2.3% of total coursework at one university to 29.3% of total coursework at another university.

Results (3) CourseworkThe minimum, mean and maximum percentage of total post graduate of audiology coursework, specifically relating to the study of hearing aids in universities in Australia, Canada, New Zealand, the United Kingdom and the United States of America.

Austra

lia

Canad

a

New Zea

land UK

USA0%

10%

20%

30%

Percentage of coursework specifically relating to hearing aids

MinimunMeanMaximum

Per

cent

age

of h

earin

g ai

d re

late

d co

urse

wor

k

Results (4)

Each of the five surveyed countries showed variation in the content of hearing aid related units. While the focus of some units was entirely on hearing aid technology, maintenance and use, other units included rehabilitative information, primarily that of auditory rehabilitation. Of the hearing aid related units advertised on website curricula, Canada and the USA showed the highest percentage of units dedicated entirely to the study of hearing aids. In Australia and NZ the majority of hearing aid related units also include information about auditory rehabilitation, and in the UK 100% of hearing aid related units included information on auditory rehabilitation

Austra lia Canada New Zealand UK USA

27.2

83.3

33.3

0

82.6

72.7

16.6

66.6

100

17.3

Percentage of hearing aid related units including content on auditory rehabilitation

Hearing aids only Auditory rehabilitation/hearing aids

Discussion (1):

The results indicate that there are considerable inconsistencies in many aspects of post graduate audiology training between the five counties surveyed and between individual universities within each of these countries. For students choosing a university to attend there are many factors worthy of their consideration, including the coursework covered, course cost, the length of the course and the relevance of their final qualification in the workplace. The variation seen in both course duration and cost would presumably make it difficult for students to make qualitative comparisons between the courses offered. This is especially confusing given that the outcome of all these courses (combined with national accreditation requirements) allow students to practice as audiologists

Discussion (2)

Where available, students may in part base their university selection upon the advertised features of a course. The most highly advertised course feature was clinical practice , however in all of the five countries surveyed, clinical practice was either a mandatory part of the coursework or was required to be completed after graduation if the student wished to acquire national accreditation. With such structures in place to ensure the compulsory completion of clinic placement, the advertisement of this aspect of study as a ‘feature’ seems redundant. It would seem more advantageous for universities to distinguish themselves by advertising a non-compulsory but highly desirable course feature such as a focus on hearing aid technologies, with a specified goal of understanding emerging technologies

Discussion (3)

This study highlighted the fact that on average a low percentage of coursework is dedicated to hearing aid specific study (Figure 4). Data suggest that most audiologists spend part of their time fitting hearing aids [2] and it would therefore seem beneficial for students to graduate from university with both a sound understanding of current hearing aid technologies and the skills and aptitude required to embrace emergent technologies as they arise. Research for this study also highlighted a lack of readily available online information on university curricula. Many universities listed units by name but gave no further description of the unit content and a small percentage of universities surveyed had no online information available on course content. This lack of transparency on course content would make it difficult for prospective students to identify where the focus of their study would be.

Conclusion and Recommendations

The data suggest that most audiologists spend part of theirtime fitting hearing aids but hearing aid studies make up a relatively small component of most post graduate audiology courses. This is confusing for a prospective student interested in hearing aid technologies or in auditory rehabilitation, from the psychosocial and counselling perspective.

The authors recommend that course curricula have a greater focus on hearing aid technologies, with a specified goal of understanding emerging technologies, and that curricula specify clearly the skills required for auditory rehabilitation, including effective hearing aid fitting to meet the individual needs of hearing aid users.

It is also recommended that universities improve the curriculum information available on their websites. Doing so would both allow students to identify the university most suited to their interests and promote any universities that are taking the lead in providing high quality post graduate audiology education.

References

1. Kochkin, S. (2010). MarkeTrak VIII: Consumer satisfaction with hearing aids is slowly increasing. The Hearing Journal, 63(1), 19-20.

2. Hearing The Need: Audiology and Primary Health Care Reform, Audiology Australia November 2010