Continuing professional development barriers and recommendations: Perspectives of audiologists.

BACKGROUND:  Continuing professional development (CPD), a compulsory requirement of the Health Professions Council of South Africa (HPCSA), is undertaken by healthcare professionals (HCPs), including audiologists, to remain up-to-date with the latest developments, technology and best practices within their discipline. However, the low compliance rates of audiologists engaging in CPD need to be investigated to establish the barriers that audiologists encounter as well as possible interventions to improve their participation. OBJECTIVES:  This study aimed to explore the barriers that audiologists encounter when participating in CPD activities and to highlight their suggestions for improving its uptake. METHOD:  The descriptive qualitative research design entailed the use of semi-structured online interviews with 11 audiologists practising within the private sector in the province of KwaZulu-Natal, South Africa, their responses being thematically analysed. RESULTS:  Three barriers were identified, namely: (1) personal, (2) financial and (3) structural barriers, with eight subthemes and nine recommendations provided by participants. CONCLUSION:  It is anticipated that implementing the proposed strategies will address the barriers and allow active engagement of audiologists in their continued education.Contribution: Limited literature has been documented on the barriers that young, private sector audiologists encounter within the South African context while also providing suggestions to address these barriers.

South African speech-language therapists' and audiologists' professional quality of life.

BACKGROUND:  Limited research is available regarding the professional quality of life experiences of South African speech-language therapists and audiologists, despite the implications this has for wellbeing, quality of patient care, productivity and attrition from the professions. OBJECTIVES:  This study explored levels of compassion satisfaction, burnout, and secondary traumatic stress, the relationships between these, differences on the basis of registration and years of experience and participants' perceptions of their professional quality of life. METHOD:  A sample of 92 South African speech-language therapists and audiologists completed an online survey that included the Professional Quality of Life (ProQOL) scale. The data were analysed using descriptive statistics, analysis of variation (ANOVA), correlations and thematic analysis. RESULTS:  The findings indicated that participants experienced slightly higher levels of secondary traumatic stress and burnout and slightly lower levels of compassion satisfaction than international samples. There were significant inter-relationships between the three elements of professional quality of life, and no significant differences for these on the basis of registration or years of experience. Participants identified a range of factors that contributed to their experiences of compassion satisfaction and fatigue, as well as suggestions for improvement. CONCLUSION:  Professional quality of life plays an important role in South African speech-language therapists and audiologists' professionalism, job performance and satisfaction and retention.Contribution: The data collected provide valuable insights into the professional quality of life experiences of South African speech-language therapists and audiologists, as well as those working in similar contexts. It also offers suggestions that may contribute to future research and interventions.

Occupational Stress in United Kingdom Audiologists.

PURPOSE: Occupational stress is known to have detrimental effects on health care professionals worldwide. This study aimed to address a research gap by investigating sources and levels of occupational stress in U.K. audiologists. METHOD: A mixed-methods cross-sectional design and convenience sampling were utilized. The study used the Audiologist Occupational Stress Questionnaire (AOSQ) and an audiological working practices questionnaire. The study included 100 registered U.K. audiologists. RESULTS: The research revealed that over a third of participants reported experiencing moderate or higher levels of occupational stress. Pediatric audiologists and those with a high daily patient load reported significantly higher stress scores than other specialties and those seeing fewer patients per day. Identified sources of stress for U.K. audiologists included clinical demands and time constraints, staffing issues, leadership in the workplace, and equipment availability. Reported impacts of stress encompassed mental health issues, fatigue, social life disruptions, and physical health concerns. CONCLUSIONS: The research validated the use of the AOSQ in a U.K. setting, and the findings provided insights into the sources and levels of occupational stress experienced by U.K. audiologists, supporting existing research on occupational stress in audiologists in other countries. The identification of consistent stress themes across the literature underscores the need for targeted support and interventions to ensure the well-being of audiologists and empower them in maintaining their pivotal role in health care.

Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids.

Importance: With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy. Objective: To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists. Design, Setting, and Participants: Building on a previous randomized clinical trial, this follow-up comparative effectiveness research study reassessed a number of the original participants that were not lost to follow-up. Participants were initially divided into those with self-fit OTC hearing aids and those with audiologist-fit devices. Approximately 8 months after fitting, participants completed self-reported questionnaires. Missing data were addressed through multiple imputation. The original noninferiority trial was conducted at the University of Pretoria in South Africa from April 2022 to August 2022. The current analysis took place between July 7, 2023, to November 20, 2023. Interventions: In the original trial, participants in the self-fit device group received a pair of OTC hearing aids and independently fit them with remote support as needed. The audiologist-fit device group received the same hearing aids fit by a certified audiologist using best practices. Main Outcomes and Measures: The main outcomes were self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the International Outcome Inventory for Hearing Aids (IOI-HA). Results: Of 64 participants in the trial, 44 participants were included in the extension study (21 [47.7%] in the audiologist-fit group; 23 [52.3%] in the self-fit group). The mean (SD) age of these participants was 63.0 (13.2) years, and 21 (47.7%) were male. At the long-term follow-up, self-fit and audiologist-fit groups showed no significant differences in the APHAB global score (mean difference, 0.02 [95% CI, -7.1 to 7.1]; Cohen d, 0.01 [95% CI, -0.5 to 0.5]) or the IOI-HA total score (mean difference, 1.5 [95% CI, -1.4 to 4.4]; Cohen d, 0.3 [95% CI, -0.2 to 0.8]). From 6 weeks to 8 months, no clinically meaningful group-time interaction was found between groups for the APHAB global score (Cohen d, 0.1 [95% CI, -0.2 to 0.3]), but a significant interaction for the IOI-HA total score was found (Cohen d, -0.6 [95% CI, -0.8 to -0.3]), with the self-fit group generally performing better. Conclusion: This comparative effectiveness research study demonstrated that self-fit OTC hearing aids can offer comparable long-term benefits to audiologist-fit hearing aids for individuals with mild to moderate hearing loss.

Adolescent-Centered mHealth Applications in a Collaborative Care Model: A Virtual Focus Group Study With Audiologists.

PURPOSE: Technology-enabled care, including the use of mobile health (mHealth), is emerging as a viable hearing health care delivery method. While the integration of mHealth with adult populations currently supports a wide array of hearing services, a better understanding of the implementation across the lifespan is needed. Literature surrounding the unique population of adolescent hearing aid users is currently lacking. Research is needed to highlight factors important to the use and clinical integration of mHealth hearing aid applications (apps) with adolescents. This study explored two primary objectives: (a) audiologists' perceptions around the use of mHealth apps to enable collaborative, child-inclusive hearing aid personalization, and (b) person-centered ideation around potential app design components to benefit users aged 12 to 17 years. METHOD: Twelve audiologists participated in virtual synchronous focus groups, across three group sessions using Cisco Webex. Sessions were recorded, transcribed, and analyzed using an inductive, codebook thematic analysis approach. RESULTS: Six main themes resulted from group discussion analyses: (a) client candidacy: characteristics impacting suitability for mHealth use; (b) clinical implementation: organizational, professional, or patient-level strategies for mHealth adoption; (c) collaboration: the use of two or more individuals working together; (d) empowerment: process of acquiring and using knowledge, skills, and strategies; (e) remote technology: technologies enabling remote hearing aid personalization; and (f) application functionality and design: features and characteristics important to an adolescent-focused app. CONCLUSIONS: Findings identified the potential for clinical integration of hearing aid apps with adolescents in a collaborative care model, including consideration of child-specific use patterns, outcomes, and key design and technology components to support real-world implementation and use. Results may guide development and tailoring efforts around existing and future hearing aid apps for use with adolescent populations.

Demographic Disparities in Drive Times to the Nearest Audiologist in the United States.

PURPOSE: Audiological services are underused, possibly because patients need to drive long distances to see a provider. In this study, we measured the association of drive times to the nearest audiologist with population density, income, ethnicity, race, and distance to the nearest audiology graduate program. METHOD: Drive times for each census block group to the nearest audiologist were measured using census data, the National Provider Identifier Registry, and a geographic analyzing tool called ArcGIS for all block groups within the United States. The association between drive times and population density, income, ethnicity, race, and audiology program distance was evaluated with a population density-matched case-control study and multiple linear regression analyses. RESULTS: Approximately 5.29 million Americans need to drive at least 1 hr to visit their closest audiologist. The 10% most rural-dwelling Americans drive an average of 33.8 min. The population density-matched case-control study demonstrated that percent below poverty, percent identifying as Hispanic, and travel times to the nearest audiology program were all significantly higher in census block groups with high drive times to the nearest audiologist. An average of 7.96% of individuals in census block groups with low drive times identified as Hispanic, but 18.8% identified as Hispanic in high drive time groups. The multiple linear regression showed that the effect of demographics and distance to the nearest audiology program was highest in rural areas. In both analyses, adjusting for poverty did not drastically change the effect of percent identifying as Hispanic on drive times. CONCLUSIONS: Long drive times restrict access to audiological care for those who live in rural areas. This restriction disproportionately affects those in rural areas who identify as Hispanic or have low income.

Exploring the Performance of ChatGPT-4 in the Taiwan Audiologist Qualification Examination: Preliminary Observational Study Highlighting the Potential of AI Chatbots in Hearing Care.

Background: Artificial intelligence (AI) chatbots, such as ChatGPT-4, have shown immense potential for application across various aspects of medicine, including medical education, clinical practice, and research. Objective: This study aimed to evaluate the performance of ChatGPT-4 in the 2023 Taiwan Audiologist Qualification Examination, thereby preliminarily exploring the potential utility of AI chatbots in the fields of audiology and hearing care services. Methods: ChatGPT-4 was tasked to provide answers and reasoning for the 2023 Taiwan Audiologist Qualification Examination. The examination encompassed six subjects: (1) basic auditory science, (2) behavioral audiology, (3) electrophysiological audiology, (4) principles and practice of hearing devices, (5) health and rehabilitation of the auditory and balance systems, and (6) auditory and speech communication disorders (including professional ethics). Each subject included 50 multiple-choice questions, with the exception of behavioral audiology, which had 49 questions, amounting to a total of 299 questions. Results: The correct answer rates across the 6 subjects were as follows: 88% for basic auditory science, 63% for behavioral audiology, 58% for electrophysiological audiology, 72% for principles and practice of hearing devices, 80% for health and rehabilitation of the auditory and balance systems, and 86% for auditory and speech communication disorders (including professional ethics). The overall accuracy rate for the 299 questions was 75%, which surpasses the examination's passing criteria of an average 60% accuracy rate across all subjects. A comprehensive review of ChatGPT-4's responses indicated that incorrect answers were predominantly due to information errors. Conclusions: ChatGPT-4 demonstrated a robust performance in the Taiwan Audiologist Qualification Examination, showcasing effective logical reasoning skills. Our results suggest that with enhanced information accuracy, ChatGPT-4's performance could be further improved. This study indicates significant potential for the application of AI chatbots in audiology and hearing care services.

Help-seeking journey to accessing audiology services in a peri-urban community in South Africa.

BACKGROUND:  Hearing impairment is an invisible disability affecting one in five people globally. Its ability to affect participation in activities of daily living means that it requires prompt identification and intervention. OBJECTIVE:  This article aims to define the process of accessing audiologists from the onset of symptoms for adults with hearing impairment in a peri-urban community in South Africa. METHOD:  Twenty-three participants were recruited through purposive sampling from an audiology department of a public hospital. Semi-structured interviews were conducted using an interview guide, and data were mapped according to the participants' responses from the onset of ear and hearing symptoms to the point of audiologist consultation for analysis. RESULTS:  Seventeen (74%) participants had long journeys to accessing the audiologist after seeking help from multiple providers, with those with short journeys (26%) being referred mostly by public healthcare providers. Despite participants being from one peri-urban community, their journeys were influenced by socio-economics, health illiteracy and other structural factors. Finally, Ear-Nose-Throat specialists linked participants with audiology services. CONCLUSION:  Accessing audiology services is a complex process in some contexts. The disparities in the social environment, lifestyle factors and pluralistic healthcare models influence access to audiologists. Healthcare providers must take cognisance of the journeys of adults with hearing impairment in their clinical interventions. Universal health coverage, in the form of the planned National Health Insurance (NHI) for all South African citizens, will play an important role in addressing the societal inequalities in accessing healthcare. Factors leading to long journeys should be addressed to facilitate early intervention.Contribution: The study raises implications for the planned NHI in South Africa, suggesting that universal health coverage could play a vital role in addressing societal inequalities in accessing healthcare, including audiology services.

Audiology Students' Clinical Communication During Simulated Peer Role Play Consultations: An Exploratory Study.

PURPOSE: The objectives of this study were to describe the clinical communication practices of student audiologists during case history taking and feedback giving using simulated peer role play consultations and to explore whether clinical communication skills outcomes can be achieved through simulated peer role play. METHOD: An exploratory, qualitative research design was used for this pilot study. A total of four simulated peer role play consultations were video-recorded, comprising two adult diagnostic audiology case scenarios. Eight online interviews were conducted with the student participants following the simulated audiological consultation. Analysis of the video-recorded sessions incorporated an interactional sociolinguistic focus, and interviews were analyzed using inductive thematic analysis. RESULTS: Findings from the video analysis and interviews were triangulated, with a specific focus on establishing commonalities in terms of communication skills of student clinicians, reflections of their own skills, and the simulated peer patient's reflections on the student clinician's skills. Although variation was noted in terms of case history taking skills, feedback giving was similar among all student clinicians. These communication practices are consistent with findings from related literature on consultations with real patients. Student clinicians reflected on feedback giving as more challenging than case history taking, with room for improvement suggested by the simulated peer patients. CONCLUSIONS: Our findings highlight key questions regarding the use of peer simulation in facilitating the development of communication skills for audiological consultations among student audiologists. We discuss some considerations for using this approach to clinical training more effectively. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25492804.

A Preliminary Analysis of the Clinical Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy Delivered via Video Calls for Rehabilitation of Misophonia, Hyperacusis, and Tinnitus.

PURPOSE: Cognitive behavioral therapy (CBT) is a key intervention for management of misophonia, hyperacusis, and tinnitus. The aim of this study was to perform a preliminary analysis comparing the scores for self-report questionnaires before and after audiologist-delivered CBT via video calls for adults with misophonia, hyperacusis, or tinnitus or a combination of these. METHOD: This was a retrospective cross-sectional study. The data for 37 consecutive patients who received CBT for misophonia, hyperacusis, or tinnitus from a private institute in the United Kingdom were analyzed. Self-report questionnaires taken as part of routine care were as follows: 4C Questionnaires for tinnitus, hyperacusis, and misophonia (4C-T, 4C-H, and 4C-M, respectively), Tinnitus Impact Questionnaire (TIQ), Hyperacusis Impact Questionnaire (HIQ), Misophonia Impact Questionnaire (MIQ), Sound Sensitivity Symptoms Questionnaire (SSSQ), and Screening for Anxiety and Depression in Tinnitus (SAD-T). Responses were also obtained to other questionnaires related to tinnitus, hyperacusis, insomnia, and anxiety and mood disorders. A linear mixed-model method was used to assess the changes in response to the questionnaires pretreatment and posttreatment. RESULTS: Pretreatment-posttreatment comparisons showed that scores for the 4C-T, 4C-H, 4C-M, TIQ, HIQ, MIQ, SSSQ, and SAD-T improved, with effect sizes of 1.4, 1.2, 1.3, 2.6, 0.9, 0.7, 0.9, and 1.4, respectively (all p < .05). CONCLUSIONS: This preliminary analysis suggests that CBT via video calls may be effective in reducing the impact of misophonia, hyperacusis, and tinnitus. However, this study did not have a control group, so its results need to be interpreted with caution.

Understanding, experience and attitudes towards artificial intelligence technologies for clinical decision support in hearing health: a mixed-methods survey of healthcare professionals in the UK.

OBJECTIVES: Clinician acceptance influences technology adoption, but UK health professionals' attitudes towards artificial intelligence (AI) in hearing healthcare are unclear. This study aimed to address this knowledge gap. METHODS: An online survey, based on the Checklist for Reporting Results of Internet E-Surveys, was distributed to audiologists, ENT specialists and general practitioners. The survey collected quantitative and qualitative data on demographics and attitudes to AI in hearing healthcare. RESULTS: Ninety-three participants (mean age 39 years, 56 per cent female) from three professional groups (21 audiologists, 24 ENT specialists and 48 general practitioners) responded. They acknowledged AI's benefits, emphasised the importance of the clinician-patient relationship, and stressed the need for proper training and ethical considerations to ensure successful AI integration in hearing healthcare. CONCLUSION: This study provides valuable insights into UK healthcare professionals' attitudes towards AI in hearing health and highlights the need for further research to address specific concerns and uncertainties surrounding AI integration in hearing healthcare.

Exploring facilitators and barriers for delivering person-centered care in a socio-economically diverse context: Perspectives of speech-language pathologists and audiologists.

OBJECTIVE: The study aimed to explore facilitators and barriers in delivering person-centered care from the perspective of speech-language pathologists and audiologists in a socio- economically diverse workplace across micro, meso, and macro levels. METHOD: A national cross-sectional e-survey was conducted among pooled speech-language pathologists and/or audiologists from South Africa. The e-survey included quantitative components to describe participant demographics which was analysed using descriptive and inferential statistics. The qualitative data was analyzed using metaphor and thematic analysis approaches to describe respondents' perspectives of barriers and facilitators in delivering person-centered care. RESULTS: The e-survey was completed by 63 clinicians (36.5% Audiologists; 36.5% Speech-Language Therapists; 27.0% dually qualified Speech-Language Therapists and Audiologists) mostly between the ages of 26 to 35 years old (33.3%). Respondents were working in various settings including the public sector (41.3%), private sector (44.4%) and in academia (14.3%). Facilitators and barriers were identified within all three systems (macro, meso and micro). The metaphor analysis resulted in six categories: uncertainty of Person centered care; its essential nature; associated challenges; relational aspect; analogies referring to animals; and food-related analogies. Thematic analysis of open-ended questions revealed five barriers, with three relating to micro systems; i) clinician factors, ii) client factors, iii) clinician and client interaction, and two related to factors within the meso system; iv) resources, and v) workplace. Only two themes were identified as facilitators towards PCC, clinician factors (mirco) and workplace factors (meso).' CONCLUSIONS: Insights gained from exploring Speech-Language Pathologists' and Audiologists' perceptions of implementing PCC in a socio-economically diverse setting highlight the need to address contextual (meso and macro systems) and personal (micro system) factors to promote and deliver PCC effectively. Notably, for the public sector, resources emerged as a major concern and barrier on the macro system level. Despite these challenges, the investigation revealed two noteworthy facilitators: clinician factors, at the micro level, and workplace factors, at the meso level. This nuanced understanding emphasizes the necessity of tailored interventions targeting both individual and systemic aspects to enhance the successful implementation of person-centered care. PRACTICAL IMPLICATIONS: Strategies should focus on enhancing clinicians' communication skills, collaboration, and teamwork, as well as addressing resource limitations through the adaptation of tools and implementation of PCC ISO standards.

Education Intervention on 'Hearing Impairment - Its Assessment and Management' among Medical Practitioners in Sikkim, India.

BACKGROUND: Health care providers must be aware of the choices in aural rehabilitation methods and assessment procedures available presently to those with hearing impairment in order to facilitate early identification and intervention and ensure quality of care to those hearing impaired individuals. The referrals from the medical fraternities for the audiological services are not uniform across India. Part of reason may be that awareness about the roles of and responsibilities of audiologist's is poor among medical practitioners. In some regions of India medical practitioners may be only grossly be aware of audiologists per se. They may not know enough to refer all individuals with hearing or balance disorders for the required audiological services. AIM: To evaluate changes in pre survey and post survey after education intervention specifically planned for medical practitioners in the state of Sikkim, India. Education intervention included awareness about hearing impairment and its assessment and management by audiologists. METHOD: A pre and post survey comparison research design with purposive convenient sampling technique was applied. Participants were medical practitioners working in geographical area of Sikkim at the time of the study. Inspection of demographic data of respondents showed that they were in their age range of 24 and 60 years and with work experience ranging 1-40 years. Participants were invited for an awareness talk which included, information about hearing loss, early identification and early intervention, tests and management of hearing loss in different age groups, need for hearing aids/cochlear implants, auditory training, and the role of an audiologist in the management of hearing loss and ways to prevent hearing loss. A pre and post awareness program responses were collected from all the participants using a customized questionnaire tool. RESULTS: Respondents exhibited, in the pre-survey questionnaire, lack of awareness in many aspects of audiology, including assessing hearing impairment, diagnosing hearing loss, and the role of an audiologist. There was an overall, statistically significant difference in the level of performance on the pre-awareness and post-awareness responses. CONCLUSION: Following an awareness campaign among the medical professionals in Sikkim, there was a considerable change in their level of awareness of hearing impairment, its assessment, and management by audiologists. The reach of the awareness campaign was significant as around 70% of subjects showed significant change in their knowledge and attitude towards hearing impairment, its management.

Survey of collaboration supporting students who are deaf and hard of hearing.

Collaboration between teachers of students who are deaf and hard of hearing (TSDHH) and educational audiologists is essential when developing successful, comprehensive service delivery plans for students who are deaf and hard of hearing. Despite the importance, little is known about how these two professions work together. This study sought to describe the current state of collaboration between educational audiologists and TSDHH and to explore the barriers and facilitators to this collaboration. Anonymous survey responses from 752 educational audiologists and TSDHH showed that collaboration is considered valuable and is occurring frequently, via a variety of formats and despite significant barriers. More research is needed to understand how efforts to minimize barriers to collaboration might improve the quality of collaboration and ultimately impact the success of student support.

Survey of Wideband Acoustic Immittance Use by Clinical Audiologists.

PURPOSE: Wideband acoustic immittance (WAI) is a promising measure of middle-ear mechanics. In contrast to standard tympanometry, which is generally measured at a single stiffness-dominated low frequency, WAI detects mechanical effects on both the mass and stiffness properties of the middle ear across a wide range of frequencies, resulting in a more comprehensive assessment of middle-ear mechanics in healthy and pathological ears. Despite a plethora of research demonstrating the clinical utility of this measure, clinical adoption of WAI is still limited. This work explores audiologists' use and perceptions of WAI, with the goal of identifying the barriers to its clinical adoption. METHOD: A survey on the perception and use of WAI by clinical audiologists in the United States was developed and administered using the Research Electronic Data Capture application. The survey was distributed broadly across the United States. Participation was voluntary and anonymous, and no compensation was provided. RESULTS: Findings from 132 survey respondents across 32 states were included in the analyses. Overall, findings suggest the largest barriers to clinical adoption of WAI are lack of access to equipment that measures WAI and lack of training and/or confidence in measuring or interpreting WAI. CONCLUSIONS: Several barriers to clinical adoption of WAI were identified. However, findings also provide optimism in that audiologists utilizing WAI find it more useful than standard tympanometry, and most audiologists who do not currently use WAI are open to implementing the measure in their clinical practice. We proposed steps to address the highest priority issues and increase the clinical viability of WAI.

Telehealth Awareness, Perception, Practice, and Influence of the COVID-19 Pandemic: A Questionnaire to Speech-Language Pathologists and Audiologists.

Introduction: The objective of this work was to investigate Speech-Language Pathologists' (SLPs) and audiologists' telehealth awareness, experience, and perception in terms of applicability, effectiveness, barriers, facilitators, and the influence of the coronavirus disease 2019 (COVID-19) pandemic on telehealth practice. Methods: A questionnaire was developed and validated based on relevant literature, authors' clinical expertise, and a published survey. Sample size was determined through power analysis, and participants were recruited using a snowball-sampling technique. Results: Ninety-five (n = 95) clinicians completed a survey. A majority (87.4%) reported awareness of and 68.4% reported experience with telehealth. The SLPs (86.4%) had more experience than audiologists (38.9%). Overall, 78.5% first used telehealth during the COVID-19 pandemic, with no significant difference in telehealth use during versus after the pandemic lockdown; 63.8% reported telehealth being less effective than in-person. However, there were differences in perceived telehealth effectiveness: Telehealth was significantly more effective for consultations and counseling, with adults aged 18-40 years; and clients with fluency and speech sound disorders. The highest significant barrier to telehealth delivery was network issues, and available workplace resources was the highest facilitator although this was not significant. Conclusions: Most clinicians were aware of telehealth, had a positive attitude toward it, and had experience using telehealth. More SLPs than audiologists used telehealth. The COVID-19 pandemic had a positive influence on telehealth service provision with an increase in use that was maintained after in-person services were re-initiated. Perceived effectiveness of telehealth services varied depending on the type of clinical service, the client's age, and diagnosis. These factors must be considered while planning telehealth services in Speech-Language Pathology and Audiology.

Hyperacusis Diagnosis and Management in the United States: Clinical Audiology Practice Patterns.

PURPOSE: Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this study, we surveyed U.S. clinical audiologists to understand their education and clinical practices surrounding the evaluation and treatment of hyperacusis. METHOD: An online survey was distributed to clinical audiologists across the United States. Survey responses were quantified using descriptive statistics and inductive content analysis. RESULTS: Hyperacusis definitions and clinical practice patterns varied widely across the 102 respondents. Respondents cited a lack of education and training as the primary barrier to effective audiological diagnosis and management of hyperacusis, with most respondents reporting ≤ 5 hr of hyperacusis education. Other primary barriers to effective audiological management of hyperacusis included time constraints, reimbursement, poor sensitivity and specificity of available diagnostic tools, and poor efficacy of available treatments and management strategies. Most respondents (82.5%) agreed that audiologists are the primary professionals who are responsible for implementing hyperacusis interventions. However, 63.3% of respondents reported that their clinic does not have a hyperacusis management protocol, and 80.0% routinely recommend treatment that is outside their scope of practice to implement (cognitive behavioral therapy). CONCLUSIONS: Clinical audiologists in the United States do not receive uniform education on hyperacusis, and they report multiple barriers to its evidence-based diagnosis and management. Effective hyperacusis management necessitates a multidisciplinary approach. The information obtained via this survey will pave the way toward the refinement of interprofessional education programs and the development of systematic, evidence-based clinical protocols for hyperacusis. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24431188.

Perceptions of the Scope of Practice of Audiology.

PURPOSE: The primary purpose of this study was to determine which scope of practice roles and responsibilities are attributed to the profession of audiology (AUD) relative to other health care disciplines by a group of health and human services faculty and students. METHOD: An online survey inquiring about participant knowledge of different health professions' scopes of practice, and experience with and attitude toward the profession of AUD, was sent to faculty and students in the Western Michigan University College of Health and Human Services. Students also completed two subscales of the Interprofessional Attitudes Scale. Descriptive statistics and chi-square and Kruskal-Wallis analyses evaluating response differences between groups are presented. RESULTS: Thirty-six faculty and 118 students (48 graduate and 70 undergraduate) completed the survey. AUD was the profession most often associated with all hearing-related scope of practice activities. Speech-language pathology was often associated with hearing-related scope of practice activities. Audiologists were less commonly associated with vestibular, balance, and mobility scope of practice activities. Group was significant for four scope of practice activities. About half of respondents indicated they knew nothing or a little about AUD, and a majority had no or rare interactions with audiologists in class or clinic. Only about half of participants responded they were likely or very likely to refer patients to an audiologist. CONCLUSION: Increased knowledge of the scope of practice and exposure to the profession of AUD may benefit other health care professionals and patients, possibly leading to increased interprofessional practice and an increased number of appropriate referrals.

Auditory Processing Disorder: Protocols and Controversy.

PURPOSE: This study examined current auditory processing disorder (APD) protocols and audiologists' perspectives on the active debate seen in the literature regarding the status of APD as a unique disorder. METHOD: This study used a cross-sectional, nonexperimental survey design. The participants were 134 U.S. audiologists, representing diversity across experience level and work setting. RESULTS: Popular APD tests from prior surveys remain popular, and a few new tests have emerged. Most audiologists use diverse strategies to identify potential comorbid disorders as part of their APD protocol, including multidisciplinary assessment and referral to other specialists. Most participants disagreed with the assertion that APD is not a unique disorder; however, many also pointed out that patients' struggles with listening need to be the primary focus of APD assessment and management, regardless of the label of the disorder. Qualitative analysis of participant comments on the controversy yielded six themes: Clinical Experience, Comorbidity, Listening Skills, Literature Support, Overdiagnosis, and More Information Needed. CONCLUSION: Most participants consider APD to be a unique disorder, citing clinical experience and the literature for support; however, many also indicated APD is complicated by comorbidity and APD may be overdiagnosed.

A Survey of U.S. Audiologists' Usage of and Attitudes Toward Otoacoustic Emissions.

PURPOSE: Otoacoustic emissions (OAEs) provide information on outer hair cell function and have multiple clinical applications. Two types of OAEs, transient-evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs), are currently utilized in clinical practice. However, it remains unknown how confident U.S. clinicians are in performing and interpreting TEOAEs and DPOAEs. Additionally, the extent to which U.S. audiologists incorporate OAEs for different clinical applications and populations has not been thoroughly investigated. To fill these gaps in knowledge, this study characterized the attitudes toward and usage of TEOAEs and DPOAEs in a sample of U.S. audiologists. METHOD: This study utilized an online survey distributed to U.S. audiologists through multiple channels from January to March 2021. A total of 214 completed surveys were included in the analysis. Results were analyzed descriptively. Associations between variables and comparisons between users of DPOAEs only and users of TEOAEs and DPOAEs were also examined. RESULTS: DPOAEs were reportedly utilized more frequently and with greater confidence than TEOAEs. The most common clinical application of both OAE types was a cross-check. Significant associations were found between responses to DPOAE questions and the clinician's setting and patient age. There were some significant differences between users of DPOAEs only and users of TEOAEs and DPOAEs. CONCLUSIONS: Results suggest that U.S. audiologists utilize OAEs for multiple clinical purposes and that there are appreciable differences in terms of attitudes toward and usage of DPOAEs versus TEOAEs. Future work could investigate the reasons that underlie these differences to further improve clinical implementation of OAEs.