Audiology Practice Research Articles

9 Upsetting Dilemmas

9 Upsetting Dilemmas

Can You Handle Being the Boss?

Can You Handle Being the Boss?

Reflection and Reflective Practice: Creating Knowledge through Experience

Reflection and reflective practice are popular concepts in the health professions that have yet to be rigorously addressed in audiology literature. In this article, a select summary of the theoretical bases of reflection and reflective practice are presented, highlighted with practical examples. The potential for reflection and reflective practice to benefit audiology education and practice is discussed. A nondichotomous approach to including a reflective epistemology of practice in audiology is recommended. Also highlighted are the centrality of experience to knowledge development and attention to reflection-in-action as a way of being professional practitioners. Also, critical reflection is identified as crucial to uncovering assumptions that underlie our practices and challenging oppressive discourses and systems, toward moving the profession forward in a spirit of optimized patient/client care. Although this article is conceptually focused and not a broad literature review, some early research in audiology related to this topic is reviewed briefly and practical approaches to fostering reflective practice also are considered. Reflection and reflective practice offer generative possibilities for the rigorous development of knowledge based in practice and experience, crucial to balancing other practice approaches such as evidence-based practice.

The Education and Socialization of Audiology Students and Novices

This article is the fifth in a series of five articles explaining the findings of a constructivist grounded theory study. The theory is named RESPoND: Reflection in the Education and Socialization of Practitioners: Novice Development. Participants in the study included a cohort of audiology students, clinical faculty, and preceptors. This particular article focuses on the third of three facets that together explain the role of reflection in novice development, in the context of the RESPoND theory. The facet of focus in this article explains reflection as a developing behavior. This article also explores the overall RESPoND theory as a whole, as a process through which audiology students and novices develop and socialize into the profession, as understood through reflective processes. Audiology is a relatively young health profession with emerging literature on professional identity, professional socialization, and professional development. Rigorous research focused on understanding and representing the complex processes of becoming an audiologist and being an audiologist engaged in lifelong learning may be helpful in moving the profession forward as an autonomous and constantly improving profession. This article provides insight into the evolutionary journey form audiology student to novice audiologist, the development of reflective behavior within this process, and the intertwined processes of reflective development and professional development as audiologists are educated and socialized toward professional practice. These findings are presented as theory that is grounded in one cohort's experience. Yet, although contextually tied, the theoretical implications may extend to others involved in audiology education and practice.

Re-envisioning Collaboration, Hierarchy, and Transparency in Audiology Education, Practice, and Research

In this article five audiologists reflect individually and as a group on three perceived key challenges for their “cohort” of audiology clinicians, educators, and researchers. These three challenges were chosen based on practice, teaching and preceptoring, and research experiences and were inspired by related literature outside the young field of audiology. Audiology has the opportunity to look to older health professions that have faced similar challenges. The three challenges chosen for discussion were: collaboration, hierarchy, and transparency. A reflective dialogue ensued in which the group did not always come to an agreement. Yet the presentation of both our distinct and similar perspectives demonstrates the potentially generative and critical insights that can arise when we question the status quo and imagine what could be . This article is neither a research paper nor a literature review by any means. Rather, it serves as an invitation to ourselves and our colleagues to ask difficult questions about the way we are and to try to see ourselves through the eyes of others . In this way, as a new cohort, we may be able to continue to advance the field that has been built by audiology clinicians, educators, and researchers who came before us. And we strive to do this alongside the existing leaders who continue to work hard for audiology during challenging and changing times. Perhaps a critically reflective dialogue drawing from multiple perspectives can help us continue to improve, as a collective field, in a challenging economic climate.

The effect of head movement and head positioning on sound field audiometry

Objective: Positioning and maintaining the subject's head at the calibration point (CP) of the sound field (SF) during SF assessment remains a challenge. The purpose of this study was to investigate the sound pressure level (SPL) at head positions likely to be encountered in routine audiological practice. Design: Eight National Health Service SF clinics were used to obtain SPL measurements. Part 1 of the study investigated SPL variability at positions around the CP (0.15 m and 0.30 m). Parts 2 and 3 of the study, investigated the SPL at two typical head heights of the infant population. Study sample: Only sound field measures were obtained. Results: Part 1: 32% and 40% of measurements of SPL around the CP were >2 dB different from the SPL at the CP (0.15 m and 0.30 m). Parts 2 and 3: 55% and 38% of measurements of SPL, at the two infant head heights, were >2 dB from the SPL at the CP. Conclusions: Variability in SPL, due to head movement, is to be expected when performing SF audiometry. Furthermore, the typical head heights of infants will introduce additional variability, unless the position of the CP is chosen carefully.

Multidimensional Student Assessment

Multidimensional Student Assessment

Survey of Audiological Immittance Practices

The purpose of this study was to examine current immittance practices and trends over time, reasons why multifrequency (MF) and multicomponent (MC) tympanometry have been underused, and the prevalence of negative patient reactions to acoustic reflex (AR) testing. Two audiological practice surveys were conducted regarding tympanometry (2008, n = 156) and AR (2009, n = 90). Most respondents conduct tympanometry and AR threshold (ART) testing. MF and MC tympanometry were rarely reported, generally due to a lack of equipment and training. ART testing was reported most often using both ipsilateral and contralateral presentation. Contralateral testing has decreased over time. Patient complaints of discomfort following AR testing were common. Complaints of tinnitus or hearing loss were present, although rare. Tympanometry and ART tests have remained popular for the past 30 years, whereas acoustic reflex decay (ARD) testing has decreased in popularity. MF and MC tympanometry are conducted infrequently. AR is frequently associated with discomfort but rarely associated with other symptoms. However, one respondent reported that AR testing had caused permanent tinnitus and hearing loss.

Fostering Reflective Skills in Audiology Practice and Education

Reflection is considered a deliberate process of learning from experience with the goal of realizing effective and rewarding patient and personal outcomes. Reflective thinking has become incorporated into clinical practice and education across health-care professions. Facilitators for development of reflection and reflective practice include appropriate timing, a supportive environment, feedback, and mentorship. This article introduces the reader to models and forms of reflection, discusses facilitators and detractors to effective reflection, and reviews critical commentary. The Reflective Journal, 4 Habits of Effective Audiologic Service, and Self Reflection of Learning are three tools that guide students or practitioners in reflective activities.

The American Hearing Loss Epidemic: Few of 46 Million With Hearing Loss Seek Treatment

The American Hearing Loss Epidemic: Few of 46 Million With Hearing Loss Seek Treatment

Telepractice and the Public Sector Audiologist

The American Speech-Language-Hearing Association (ASHA) defines telepractice as the application of telecommunications technology to deliver professional services at a distance by linking clinician to client; or clinician to clinician for assessment, intervention, and/or consultation (ASHA, 2005a). Telepractice has become a standard delivery process for the medical community. ASHA has recognized telepractice as a viable and appropriate venue for audiologist. They have provided a position statement to guide audiologists using telepractice. The advent of high speed Internet and computerized testing equipment has increased the capability of audiologists to use telepractice technology. Research has shown significant evidence that telepractice could be used to provide many aspects of audiological assessment and treatment. There are three types of telepractice technology that can be used to aid the audiology practice: synchronous, which uses real time technology, asynchronous, which uses store-and-forward technology, and hybrid, which is a combination of both. Telepractice could be a valuable resource for public sector audiologists in the near future. Newborn hearing screening and educational audiology programs will likely benefit greatly from the use of telepractice. If the advances in technology continue at the current pace, telepractice will be poised to help provide services to difficult-to-reach patients all over the world.

New and Revised OAE Codes Take Effect in 2012

New and Revised OAE Codes Take Effect in 2012

¿QUÉ PASA?: “What’s Happening” in Overcoming Barriers to Serving Bilingual Children?

¿QUÉ PASA?: “What’s Happening” in Overcoming Barriers to Serving Bilingual Children?

Incorporating a Client-Centered Approach to Audiologic Rehabilitation

Incorporating a Client-Centered Approach to Audiologic Rehabilitation

The role of active middle-ear implants in the rehabilitation of hearing loss

The surgical implantation of auditory devices to improve or restore the sensation of hearing in affected individuals is a rapidly growing area of modern ear, nose and throat, and audiological practice. Following the enormous success of cochlear implantation and set to take an increasing role in the rehabilitation of deafness is the active middle-ear implant. They should be viewed as an alternative to conventional hearing aids for individuals who are either unable to wear hearing aids or reject them for a variety of reasons. This article discusses the different types of middle-ear implant that are currently in use and examines the significant challenges that remain to be overcome to further advance this field.

Educational Audiologist Moves Forward—and Gives Back

You have accessThe ASHA LeaderIn the Limelight1 Jun 2011Educational Audiologist Moves Forward—and Gives Back Kellie Rowden-Racette Kellie Rowden-Racette Google Scholar More articles by this author https://doi.org/10.1044/leader.LML.16072011.20 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In http://www.asha.org/Publications/leader/2011/110607/In-the-Limelight--Educational-Audiologist-Moves-Forward—and-Gives-Back.htm Sometimes it’s hard to move forward while you’re giving back, but educational audiologist Mike Macione is doing just that. Macione, an audiologist for the past 25 years, is in an enviable position. Macione absolutely loves his job and can’t see himself doing anything else. At the same time, he’s giving back by serving the professions—he is 2012 president-elect of the Educational Audiology Association (EAA) and has written a chapter on educational audiology in a recently published e-book on early hearing detection and intervention (see sidebar). “My wife always tells me that I’m the happiest ’job person’ she knows,” he said. “But really I don’t know any audiologists who don’t love their jobs. I know people in other professions who are close to burnout. I can’t see that happening to me.” Mike Macione and his wife, Margot Beckerman, both audiologists, enjoy a hike at Pictured Rocks National Lakeshore in northern Michigan. As a young man growing up in Connecticut, Macione had a mentor—his high school biology teacher—who was married to an audiologist. It was the first time Macione had heard of the field and he thought it was interesting. As fate would have it, during his sophomore year at the University of Connecticut, Macione had a stapedectomy, which resolved some hearing loss he had been experiencing. His recovery involved working with audiologists, a process that only further piqued his interest in the field. He took some classes, got hooked, and chose his career path. After graduate school, he began working with children at what is now called the Connecticut Department of Developmental Services, providing school services to students with multiple disabilities. In 1989, he met his future wife, fellow audiologist Margot Beckerman, at ASHA’s national convention. The couple married and moved to her home state of Michigan in the early 1990s. Shortly after relocating, Macione was hired by the Jackson County Intermediate School District and has been there ever since. He provides educational audiology services to all the schools in the county, and diagnostic services to Head Start and other early childhood programs. He loves what he does, but still says that he needs to explain to people what educational audiologists actually do. “For example,” he explained, “if there’s a student in fifth grade with a hearing loss, I’m going to determine what I have to do to make sure that student has a successful school year.” He said his favorite part is the interaction with the teachers and the students. “I love seeing the students’ successes. When I see a student succeed, that’s what makes me happiest.” But Macione’s efforts certainly don’t stop at the schoolyard. He’s always believed in being a part of organizations and since his arrival in the Wolverine State, Macione has been on the board of the Michigan Speech-Language-Hearing Association (MSHA), and also served as the president of the Michigan Educational Audiology Association. Through those two organizations he continued to meet people throughout the country, and eventually was elected EAA’s 2012 president. His wife, Margot Beckerman, is also giving back to the professions—she is MSHA vice president for audiology practice and serves on ASHA’s Audiology Advisory Council. “Being a part of national organizations like ASHA and EAA has opened up doors, opportunities, and relationships for me that I wouldn’t otherwise have,” Macione said. “I wish people could understand how important it is to get involved and give back because you get so much in return.” ContactMike Macione, AuD, CCC-A,at[email protected]. New E-Book Michael Macione is co-author with Cheryl DeConde Johnson of “The Role of Educational Audiologists in the EHDI Process,” a chapter in the second edition of A Resource Guide for Early Hearing Detection and Intervention. To access the chapter, visit the National Center for Hearing Assessment’s website. Author Notes print and online editor for The ASHA Leader, can be reached at[email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 16Issue 7June 2011 Get Permissions Add to your Mendeley library History Published in print: Jun 1, 2011 Metrics Downloaded 184 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2011 American Speech-Language-Hearing AssociationLoading ...

Disability, Technology and Politics: The entangled experience of being hard of hearing.

About 10 % of a population have a hearing loss. Combining analytical resources from two interdisciplinary field – Science and Technology Studies and Disability Studies - this thesis investigates the complex interplay between people, technologies and material surroundings. The aim is to learn about how hearing disability becomes ordered in policy making, audiological practice, and everyday life. Disability has traditionally been treated as a physical defect, a problem that can be compensated for utilizing medicine and assistive technologies. Over the last decades, disability policy has undergone a discursive shift. Today, disability is conceptualized as a natural part of societal diversity. Thus, rather than normalizing the disabled individual, society should enable the full inclusion and participation of disabled people in societal life. But how to realize the vision of the universal society? How to translate social rights into empowering medical consultation, enabling technical aids, including material surroundings, and respectful social relations among the people that live and work with hearing disability? Following policy to practice; hearing aids from design to use, and hard of hearing people from the audiological clinic and home, this investigates the transition from disability policy to practice. The result is a comparative, qualitative study of hearing loss in Norway and the Netherlands.

Knowledge translation in audiology: promoting the clinical application of best evidence.

The impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitate the development and dissemination of evidence for clinical audiology practice. Finally, a project that uses the knowledge-to-action (KTA) framework for the development of outcome measures in pediatric audiology is introduced.

The Top Ten Hottest Topics in Communication Sciences and Disorders

You have accessThe ASHA LeaderFeature1 Mar 2011The Top Ten Hottest Topics in Communication Sciences and Disorders Marat Moore Marat Moore Google Scholar More articles by this author https://doi.org/10.1044/leader.FTR6.16032011.np SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In http://www.asha.org/Publications/leader/2011/110315/The-Top-Ten-Hottest-Topics-in-Communication-Sciences-and-Disorders.htm Last August ASHA tried something new—surveying a group of you in speech-language pathology practice, audiology practice, research and academic settings, and the National Student Speech Language Hearing Association (NSSLHA) about what you consider the most important or “hottest” topics in the discipline. ASHA fielded traditional surveys and asked the same questions on ASHA’s Facebook site. What did you say? First, some issues touch members across professions and work settings, particularly issues related to reimbursement. Cochlear implants also crossed boundaries, capturing the interest of students and researchers and of course audiologists. Ethics made the top 10 in audiology and speech-language pathology. See “ Hot Topics” [PDF] for full results. Unfortunately, the response rates were less than robust. Was August a bad time to field a survey? Are you not interested in these questions? Whatever the reason, the invitation is again open to weigh in on what issues you consider important (add your comments below). It’s one way to find out what topics you might like to read about in future issues of The ASHA Leader. The results from the survey and Facebook are reported separately because not all of ASHA’s Facebook “friends” are members. Author Notes is the managing editor of The ASHA Leader and can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 16Issue 3March 2011 Get Permissions Add to your Mendeley library History Published in print: Mar 1, 2011 Metrics Current downloads: 1,607 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2011 American Speech-Language-Hearing AssociationLoading ...

Ethical Dilemmas in Audiology

Purpose: The purpose of this study was to reveal current areas of ethical concern for practicing audi- ologists and to provide insight into the ethical perspec- tives of audiologists across the country. Additionally, the intent was to identify areas of ethical dilemmas in order to provide a focus for ethics education in audiology pro- grams and to offer a basis for continuing ethics education in the field. Method: An online questionnaire on ethical dilemmas was constructed by the authors and was completed by 225 audiologists employed in different professional settings, including private practices, clinics, hospitals, schools, col- leges/universities, and medical practices throughout the country. When asked, your professional experience, which of the following have caused you ethical dilemmas professions, including audiology, ethics is defined as a system of rules or principles of behavior against which actions of group members can be judged (Hills, 2009, p. 293). The term ethics refers to decisions not only about what is right or wrong, but also about what is worthy of praise or blame (Lo, 2009). In clinical practice, audiologists may be faced with situations that question their ethical standards. Ethical standards for the practice of audiology have been evolving continually since the foundation of the profession. Practicing audiologists need to be aware of the Code of