Enhancing audiology students' understanding of person-centered care: insights from an multi-national virtual student conference.

OBJECTIVE: This project sought to investigate the impact of a multi-national peer learning initiative in facilitating a student-led conference on person-centred care (PCC). The primary objective was to assess students' comprehension of PCC elements before and after engaging in the opportunity, with a concurrent evaluation of the efficacy of the opportunity. DESIGN: A mixed-methods study protocol was followed. Following the conference, participants completed a four-part survey including (a) demographics, (b) retrospective pre-post Likert scale, (c) Likert rating of conference experience and (d) five open-ended questions. STUDY SAMPLE: One hundred and four participants (92.4% female) with a mean age of 21 years (0.07 SD) participated in the study. RESULTS: A significant difference in awareness pre-post conference was demonstrated across all topics (WSR, p < 0.001) with participants satisfied with the conference. Qualitative analysis revealed three main themes: (a) application of PCC; (b) perspectives of PCC; and () barriers to PCC; with nine sub-themes. CONCLUSION: The conference was beneficial in enhancing students' awareness of topics and principles of PCC. Innovative pedagogical approaches should be considered in order to enhance healthcare education allowing future clinicians to better meet the dynamic needs of their clients.

Incorporating Parents' Lived Experiences Into the Pediatric Audiology Course: A Qualitative Analysis of Student Reflections.

PURPOSE: This study explores the underutilized pedagogical approach of incorporating lived experiences of parents with children possessing diverse hearing profiles and their family characteristics into the audiology curriculum for students. The aim was to investigate the impact of integrating such experiences into the classroom as an andragogical learning experience through the qualitative analysis of written student reflections. METHOD: Twelve (N = 12) third-year female audiology students enrolled in a pediatric auditory (re)habilitation course attended a parent panel presentation during their regularly scheduled face-to-face class. Five parents of children with diverse hearing differences and diverse technology, communication, and educational choices participated on the panel as guest speakers via the Zoom platform. Students completed written reflections based on Rolfe's reflective framework. Written reflections were downloaded from Canvas and de-identified prior to uploading to NVivo software for coding, utilizing an inductive grounded theory coding strategy coupled with content analysis. FINDINGS: This study underscores the effectiveness of written reflections as an effective andragogical learning model. Through reflective practice, students gained a deeper understanding of their experiences, values, and learning journeys, enhancing their competency in pediatric audiology and auditory (re)habilitation. Students articulated previous knowledge and learning experiences, utilized newfound insights from exposure to the parent panel of shared lived experiences, and connected this knowledge with future clinical applications. CONCLUSIONS: Key findings underscore the effectiveness of reflective practice as an andragogical learning model, facilitating the integration of prior experiences with new knowledge. Moreover, it aids the transition of the professional journey from the familiar to the unfamiliar, demonstrating the impact of combining real-world lived experiences to reinforce and highlight classroom topics. Additionally, reflective practice enhances professional efficacy by valuing patient/parent perspectives regarding clinical care and aligning with evidence-based principles.

The Use of Simulation in Audiology Education: A Systematic Review.

PURPOSE: This study aimed to assess the level and quality of evidence supporting the use of simulation in audiology education regarding enhanced knowledge, skills, self-confidence, and satisfaction. METHOD: A systematic review of qualitative and quantitative peer-reviewed literature published between 2000 and 2023 was conducted. The PICO mnemonic (where P = population, I = intervention, C = comparison, and O = outcomes) was used to frame the clinical question and generate search terms. Search strategies were executed in seven databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to track the peer-reviewed literature identification and selection process. The Joanna Briggs Institute Critical Appraisal Checklists and Levels of Evidence were used to characterize the research studies. RESULTS: A total of 668 records were identified. Nineteen peer-reviewed publications met the inclusion criteria. Diverse study designs, interventions, assessment techniques, and simulation types were identified. Characteristics of included studies (e.g., author, year, study purpose) were reported by evidence tables. Primary and secondary outcomes were identified and described. Results indicate statistical and/or clinically significant improvements in knowledge, skills, and/or self-confidence following simulation training. Each study was critically appraised, and the level, quality, and strength were assigned. CONCLUSIONS: The use of simulation as an educational method among audiology students has been shown to dramatically increase knowledge, skills, and self-confidence. However, the use of simulation in audiology education is still behind compared to other health professions. As a result, there are a limited number of simulation-based studies in audiology. Most health academic institutions have well-designed simulation centers; therefore, audiology programs are urged to collaborate with colleagues in other professions and benefit from the services offered by these facilities.

Vestibular Rehabilitation Effectiveness for Adults With Mild Traumatic Brain Injury/Concussion: A Mini-Systematic Review.

OBJECTIVE: Millions of people suffer from traumatic brain injuries every year with common sequelae, including dizziness, disequilibrium, compromised vision, and gait abnormalities. Individuals suffering a mild traumatic brain injury (mTBI) or concussion may be prescribed bed rest, but for some, symptoms may persist and require different treatment options. The aim of this mini-systematic review was to synthesize the best available evidence regarding the effectiveness of vestibular rehabilitation therapy (VRT) as a treatment option for adults with mTBIs. METHOD: A systematic review of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search term concepts were VRT and mTBI. Records meeting the inclusion criteria were extracted from the following databases: PubMed and CINAHL. A manual search of reference lists identified additional studies. Inclusion criteria were (a) participants with mTBI/concussion characterized by dizziness, balance, and/or other vestibular symptoms; (b) VRT as the primary treatment; and (c) self-reported and/or performance-based outcome measures. Data were extracted using a standardized tool, and studies were critically appraised. RESULTS: Five studies were included in the systematic review: one randomized controlled trial, two retrospective chart reviews, one pre-/post-intervention study, and one case series. Four of the five studies found VRT to be effective at reducing postconcussion symptoms after head injury. Self-reported measures were included in all studies; performance-based measures were included in four out of five studies. None of the studies reported adverse effects of intervention. CONCLUSIONS: Results suggest VRT is an effective treatment option for patients with persistent/lingering symptoms after concussion/mTBI, as demonstrated by self-reported and performance-based outcome measures. Results of this study emphasize the need for audiologists to be thoroughly familiar with VRT as an effective treatment for patients with persistent symptoms following mTBI.

Analysis of Health Disparities in the Screening and Diagnosis of Hearing Loss: Early Hearing Detection and Intervention Hearing Screening Follow-Up Survey.

PURPOSE: The purpose of this study was to (a) provide introductory literature regarding cultural constructs, health disparities, and social determinants of health (SDoH); (b) summarize the literature regarding the Centers for Disease Control and Prevention (CDC) Early Hearing Detection and Intervention (EHDI) Hearing Screening Follow-Up Survey (HSFS) data; (c) explore the CDC EHDI HSFS data regarding the contribution of maternal demographics to loss-to-follow-up/loss-to-documentation (LTF/D) between hearing screening and audiologic diagnosis for 2016, 2017, and 2018; and (d) examine these health disparities within the context of potential ethnoracial biases. METHOD: This is a comprehensive narrative literature review of cultural constructs, hearing health disparities, and SDoH as they relate to the CDC EHDI HSFS data. We explore the maternal demographic data reported on the CDC EHDI website and report disparities for maternal age, education, ethnicity, and race for 2016, 2017, and 2018. We focus on LTF/D for screening and diagnosis within the context of racial and cultural bias. RESULTS: A literature review demonstrates the increase in quality of the CDC EHDI HSFS data over the past 2 decades. LTF/D rates for hearing screening and audiologic diagnostic testing have improved from higher than 60% to current rates of less than 30%. Comparisons of diagnostic completion rates reported on the CDC website for the EHDI HSFS 2016, 2017, and 2018 data show trends for maternal age, education, and race, but not for ethnicity. Trends were defined as changes more than 10% for variables averaged over a 3-year period (2016-2018). CONCLUSIONS: Although there have been significant improvements in LTF/D over the past 2 decades, there continue to be opportunities for further improvement. Beyond neonatal screening, delays continue to be reported in the diagnosis of young children with hearing loss. Notwithstanding the extraordinarily diverse families within the United States, the imperative is to minimize such delays so that all children with hearing loss can, at the very least, have auditory accessibility to spoken language by 3 months of age. Conscious awareness is essential before developing a potentially effective plan of action that might remediate the problem.

Verification of speech spectrum audibility for pediatric Baha Softband users with craniofacial anomalies.

OBJECTIVE: The purpose of this study was (1) to determine benefit of the Baha Softband coupled to the Softband for infants and children with bilateral conductive hearing loss; and (2) to verify audibility of the speech spectrum for octave frequencies 500 through 4000 Hz. DESIGN: The research design for this retrospective chart study is pretest-posttest repeated measures. SETTING: The study was conducted in the Department of Audiology and Speech Pathology, Arkansas Children's Hospital. PARTICIPANTS: Twenty-five children aged 6 months to 18 years with craniofacial disorders and bilateral conductive hearing loss participated in the study. Participants were consistent, full-time unilateral Baha users with the Baha Compact bone-conduction amplifier coupled to the head via the Softband. INTERVENTIONS: The intervention was the Baha device coupled to the head via the Softband as a prerequisite to surgical implantation. MAIN OUTCOME MEASURE(S): The primary study outcome measures used aided and unaided soundfield audiometric thresholds to calculate functional gain. Audibility of the speech spectrum was verified by comparison with target aided thresholds. RESULTS: Results revealed an improvement in soundfield thresholds with Baha amplification for the four octave frequencies. Means, standard deviations, and confidence intervals for aided and unaided thresholds are reported. Percentages of thresholds meeting target levels were significant at all frequencies, exceeding the 80% criterion. CONCLUSIONS: Benefit of the Baha in providing audibility of the speech spectrum for infants and children with bilateral congenital conductive hearing loss has been demonstrated, offering important and timely data supporting third-party reimbursement.

Cochlear Implant Behavioral Outcomes for Children With Auditory Neuropathy Spectrum Disorder: A Mini-Systematic Review.

Objective The aim of this mini-systematic review was to evaluate the evidence reporting speech, language, and auditory behavioral outcome measures for children with a diagnosis of auditory neuropathy spectrum disorder (ANSD) who received cochlear implants (CIs) prior to 3 years of age. Method A mini-systematic review of the literature supporting evidence-based practices was performed. Two databases were searched utilizing a search strategy derived from the PICO (patient, intervention, comparison, outcome) framework. Peer-reviewed articles published between 2009 and 2019 evaluating children with a diagnosis of ANSD who were implanted prior to 3 years of age with a range of speech, language, and auditory behavioral outcomes were included. Four articles meeting inclusion criteria were critically appraised for reputable research design and risks of bias. Each of the four studies was assigned a level of evidence for effectiveness and quality assessment rating. Results Evidence supports cochlear implantation as an appropriate intervention for children with ANSD. Improvements in outcome performance were observed in all the included studies. Children with ANSD fit with CIs can achieve outcomes similar to children with sensorineural hearing loss and CIs, despite the heterogeneity of ANSD. Conclusion These findings have implications for clinical practice and for future research with current CI technology for facilitating parent education, counseling, and realistic expectations for children with ANSD and CIs.

The relationship of audiometric thresholds elicited with pulsed, warbled, and pulsed-warbled tones in adults with normal hearing.

OBJECTIVE: American Speech-Language-Hearing Association (ASHA) guidelines allow pulsed and warbled tones in measuring audiometric thresholds and include test frequencies of 3000 and 6000 Hz. However, no research has examined the relationship between thresholds obtained with these stimuli at these frequencies. This study investigated the relationship between thresholds obtained with pulsed, warbled, and pulsed-warbled tones. DESIGN: Thresholds from 25 listeners were obtained using pulsed, warbled, and pulsed-warbled tones at test frequencies recommended by ASHA. RESULTS: Thresholds elicited with pulsed, warbled, and pulsed-warbled tones did not significantly differ. CONCLUSIONS: Findings support using pulsed, warbled, and pulsed-warbled tones for threshold measurements at the frequencies recommended by ASHA.

Audiology and Speech-Language Pathology Simulation Training on the 1-3-6 Early Hearing Detection and Intervention Timeline.

Purpose This study aimed to find out more about the effect of the use of the 1-3-6 early hearing detection and intervention (EHDI) timeline and interprofessional simulation training on audiology and speech-language pathology graduate students' confidence level of knowledge and skills. Method A 1-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills. The mean age for 50 graduate students participating in this study was 25.32 years ( SD = ±3.77, range: 22-37 years). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Three case scenarios represented by standardized parents were developed, and 8 students volunteered to participate in implementing the 1-3-6 EHDI timeline, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each scenario. Participants were asked to rate their readiness for interprofessional education/practice and their satisfaction of the educational experience after the last case scenario. Results Overall, the pre- and postsimulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels in knowledge and skills. The mean difference between pre- and postevent scores was 0.78 ( p < .01). The mean interprofessional learning was 2.13 (range: 1.16-2.57, SD = ±0.24) based on a Likert scale, where 1 = strongly agree and 5 = strongly disagree. The mean satisfaction level was 4.37 (range: 3.94-4.72, SD = ±0.24) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied. Conclusions The results demonstrated the value of using interprofessional simulation training among audiology and speech-language pathology students to improve their confidence in knowledge and skills. The curriculum developed in this study for the 1-3-6 EHDI timeline provides resources for educators in both professions and other related professions.

Impact of Tai Chi Exercise on Balance Disorders: A Systematic Review.

Purpose Tai chi is receiving increasing research attention with its benefit of improving flexibility and balance. The objective of this review was to examine the evidence concerning the impact of tai chi as a practical therapy for vestibular rehabilitation on individuals with balance and vestibular disorders. Method A systematic review using 4 electronic databases was conducted. Randomized clinical trials and quasi-experimental studies were included. Results Four studies met the inclusion criteria and were included for data analysis. Results indicate positive effect of tai chi practice on dynamic postural stability in balance of its practitioners. Conclusion Tai chi may be a useful therapy as for vestibular rehabilitation as it improves dynamic balance control and flexibility of individuals with balance and vestibular disorders.

Test-retest reliability of in situ unaided thresholds in adults.

PURPOSE: The purpose of this study was to examine test-retest reliability of in situ unaided thresholds measured using a handheld hearing aid programmer coupled to a hearing aid transducer in adults with normal hearing. METHOD: Randomized in situ thresholds at 4 octave frequencies were established in 1 ear of 43 adults twice using the Widex Diva SP3 device with the stimulus generated by and transduced through a Widex Diva SD-9 behind-the-ear hearing aid. Insert earphone tips were used in each of the measures to couple the hearing aid/transducer to the ear canal. RESULTS: Mean decibel differences between the test and retest thresholds were less than 1 dB at each frequency. Using an 80% statistical test criterion, results revealed test-retest reliability within 5 dB for all frequencies: 98% at 500 Hz, 100% at 1000 and 2000 Hz, and 93% at 4000 Hz. CONCLUSIONS: Test-retest reliability of in situ unaided thresholds using the SP3/SD-9 device is equivalent to that of currently accepted audiometric procedures.

Use of Baby Isao Simulator and Standardized Parents in Hearing Screening and Parent Counseling Education.

PURPOSE: The primary purpose of this study was to test the effect of the combined use of trained standardized parents and a baby simulator on students' hearing screening and parental counseling knowledge and skills. METHOD: A one-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills and satisfaction of the educational experience with standardized parents and a baby simulator. The mean age of the 14 audiology students participating in this study was 24.79 years (SD = 1.58). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Six students (2 students in each scenario) volunteered to participate in the infant hearing screening and counseling scenarios, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each of 3 scenarios. After the last scenario, participants were asked to complete a satisfaction survey of their learning experience using simulation and standardized parents. RESULTS: Overall, the pre- and post-simulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels regarding knowledge and skills. The mean difference between pre- and postevent scores was 0.52 (p < .01). The mean satisfaction level was 4.71 (range = 3.91-5.00; SD = 0.30) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied. CONCLUSIONS: The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.