Generation Z (Gen Z) is an epithet given to those born between the late 1990s and 2010s. This distinctive cohort was born into a world of modern technology and globalization, which consequentially shaped the type of consumers and coworkers they have become. Understanding the idiosyncrasies of Gen Z, from their patient needs to their anticipated impact on our work environment, can help us embrace the future of health care (Dimock, 2019).

It should be noted that an entire generation of individuals cannot all be described by the same generalizations mentioned in this article, especially when considering varying economic status and disparities in high-speed internet access. This article will focus on the observations of Gen Z behaviors evaluated by educators and health-care providers in the United States.

As patients, Gen Z are expected to take a new approach to the way they engage in their health care. Technology will likely be of paramount importance to these consumers, as it plays an integral role in their daily lives. For hearing aid users, this may mean a greater value placed on features such as Bluetooth connectivity, rechargeable technology, mobile app accessibility, and remote programming. Additionally, these hearing aid users may investigate the emerging market of over-the-counter hearing aids. Gen Z consumers utilize direct-to-consumer medicine including therapy, medications, and genetic testing. Over-the-counter hearing aid producers may also pursue an e-commerce model to attract Gen Z clientele (Almufarrij et al, 2019).

Convenience will also play a key role in how this group selects their health-care providers. Gen Z’s use of telehealth services has increased since the start of the Covid-19 pandemic, however, these patients still desire in person options as well (Waselewski et al, 2022). Audiology clinics with online scheduling and telehealth appointments will have a competitive edge in attracting this population.

Many Gen Z patients are interested in holistic health and wellness and want to take a “whole-person” approach to their health care. As providers, we can support these patients by understanding other aspects of their health-care needs, and how those needs may impact their care from an audiological perspective. For example, Gen Z has a higher prevalence of depression and anxiety compared to other generations (Twenge et al, 2019). Understanding how to recognize mental health needs, and where to refer patients who are in need, may foster a better health-care experience. Clinicians can obtain trainings related to mental health and trauma informed care. Resources for such trainings can be found below this article.

In addition to welcoming more Gen Z patients into our clinics, this generation will soon be the predominant group of students in medical graduate programs (Shatto and Erwin, 2017). A multigenerational workforce faces challenges to mesh varying communication preferences and technological literacy levels, among other differences. Successful workplaces bridge the gaps of these differences and highlight the skills that each group brings to the team.

As audiology students, Gen Z have faced many challenges. These students have spent a portion of their education in COVID-19 pandemic precautions. For clinical preceptors, this may require an initial adjustment of expectations, as circumstances may have limited their clinical experiences thus far. It will be important to identify clinical strengths as well as areas of improvement to have students focus their remaining clinical training. Gen Z continues to desire more integration of technology in the classroom. This includes a preference for electronic classroom materials and electronic examinations (Cilliers, 2017). Innovating curriculum to accommodate these preferences may facilitate improved educational experiences for Gen Z.

Conversations around Gen Z often focus on technology dependance and a short attention span craving quick hits of internet content. However, this cohort has many valuable skills and perspectives to bring to our clinics, both as clinicians and as patients. Gen Z’s early immersion in technology makes them adept at navigating the exponential growth of technology in today’s world. Gen Z students may help us find new and more engaging ways to teach by combining face-to-face interactions with remote learning opportunities. Our new Gen Z colleagues may integrate technology into our clinic to expedite procedures and make virtual connections to prospective patients.

Audiologists can prepare for the inclusion of Gen Z both as coworkers and as patients. Appreciating the potential needs of Gen Z patients, as well as their skillsets as clinicians, may lead to a more effective integration. Each generation has a distinct set of knowledge and abilities. Forging collaborative relationships between generations can strengthen our workplaces and our patient to provider relationships. If we take the time to better understand each cohort, we can benefit from our differences and prepare for the future.

Melanie Lutz, AuD, is a clinical audiologist at the UPMC Children’s Hospital of Pittsburgh. She is a member of the Academy’s New Professionals Committee.

References

Almufarrij I, Munro KJ, Dawes P, et al. (2019) Direct-to-consumer hearing devices: Capabilities, costs, and cosmetics. Trends Hear 23.

Cilliers EJ. (2017) The challenge of teaching generation Z. PEOPLE: Inter J Soc Sci. 3:322.

Dimock, M. (2019). Defining generations: Where Millennials end and Generation Z begins. Pew Research Center 17(1):1-7.

Shatto B, Erwin K. (2017) Teaching Millennials and Generation Z: bridging the generational divide. Creat Nurs 23(1):24–28.

Twenge JM, Cooper AB, Joiner TE, Duffy ME, Binau SG. (2019) Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. J Abnorm Psychol 128:185–199.

Waselewski ME, Waselewski EA, Wasvary M, Wood G, Pratt K, Chang T, Hines AC. (2022) Perspectives on Telemedicine from a National Study of Youth in the United States. Telemede J e-Health J Amer TelemedAssoc28(4):575–582.

Resources

FAST (First Approach Skills Training) provides handouts and clinician training on topics such as anxiety and depression.

Depression and Hearing Loss

Diabetes and Hearing Loss

Heart Disease and Hearing Loss

The post Generation Z: Patients and Professionals appeared first on American Academy of Audiology.

If your college experience was anything like mine, when you entered your undergraduate program, your preliminary class schedule included a course in public speaking. Following admission to graduate school, I was lucky enough to interview for and receive a coveted graduate teaching position with this public-speaking course.

My time taking the course as an undergraduate student, (and then working as a graduate assistant) delivering four speeches and helping students as they prepared, provided me with a level of appreciation for public speaking and speech delivery that has been invaluable. In this month’s news byte, I want to address public speaking. Specifically, I wanted to focus on practical tips that audiologists can employ in various contexts to help with common apprehensions when it comes to speaking in public.

Merriam-Webster defines public speaking as “effective oral communication with an audience” (Merriam-Webster, n.d.). When we think about public speaking, we often think about giving a formal speech. But public speaking can be any form of communication with an audience. Think of a one-on-one hearing aid evaluation or a web-based video call with local physicians describing and marketing audiological services. Being an effective verbal/oral communicator comes into play in many of our daily interactions. So, let’s dive into practical tips to help when preparing for and delivering your speech.  

Prepare

Any public-speaking engagement requires some preparation. Websites may provide you with ideas for reducing anxiety with public speaking. These include remembering to practice, wearing comfortable clothing, and being familiar with the area you will be giving the speech (Toastmasters International, n.d.). Here are some similar tips that I have found to work well.

Be passionate about the topic.

This obviously is a main part of preparation and what sites will call, “know your topic.” But we have a unique ability in that when we discuss audiology, most of us can let our passion for audiology shine. Once you have an idea of what your host would like you to speak on, take time to ensure that you can exude passion for the topic in your speech. Focusing on this first can make the entire process go more smoothly.

Focus on main points—do not memorize a script.

We have all heard speakers who just sound too much like they are reading from a script. When someone reads from a script, it removes the idea that the person speaking has command of their subject matter. To avoid this, focus on main points and then elaborate on them in the moment. This allows for a more natural flow of the speech. Also, by focusing on the main points, the speaker remains organized, making it easier to flow from one point into the next (Fruciano, n.d.).

Make focused eye contact and practice it.

Making eye contact seems like an obvious point, but at the same time, can be exceedingly difficult. Wouldn’t it be better if you picked a spot at the back of the room or focused on just one person? As far as calming nerves over giving a speech, research has shown that maintaining eye contact with one person for a period of three to five second and then moving to another as you present (focused eye contact) helps you concentrate and keeps your mind from wandering off topic (Wyeth, n.d.). Focused eye contact can also improve memory performance for your audience (Lanthier et al, 2021).

Watch your pauses.

When grading speeches during the public-speaking course, use of pauses accounted for a sizable portion of the grade. Criteria for the pauses also included that they be in-audible meaning the pauses could not be filled with, “um,” “ah,” or the like. When used in a speech, these audible pauses, or fillers, distract from the message and could diminish our credibility.

Three ways to eliminate or at least reduce the use of these fillers are to be aware that you are using fillers, create an action to go with the filler each time you use it, and then, practice being silent versus using the filler (Zandan, 2018). For example, if your filler word is, “um,” every time you use it when talking, tap your leg. The tapping of your leg reminds you to use silence instead of the audible pause. But of course, all of this leads into the final tip which is to practice.

Practice

The final tip on any form of public speaking is to practice what you are going to say. Aside from practicing what you will say, it will also be important to practice employing the other tips that have been mentioned here. The amount of time needed to practice these will be entirely individual, but you will be amazed on the improvement in your public speaking by practicing when you can.  

Give Your “Speech”

Even if you never find yourself preparing a formal speech to give at a conference, you may be surprised by the number of opportunities you will have during your career to give a public speech. In time you may find that you are asked to talk to local physicians about audiological services that your practice provides.

A local university may be seeking a professor to teach one of their classes, and they reach out to you as a local professional for the job. A community group for patients with acoustic neuromas may invite you to speak to them on the options for single-sided deafness. Or, as mentioned earlier, daily interactions with your patients and their families are excellent opportunities to hone and harness effective public-speaking skills.

Conclusion

For audiologists, public speaking opportunities can take many forms. By being prepared, you exude professionalism and provide information with authority. I hope this quick review has provided you with some practical tips that you can employ immediately as you interact with colleagues, patients, and families as well as some areas to focus on as you prepare for, practice, and then give any future speeches.  

Rachel Bell, AuD, is a clinical audiologist at UT Southwestern Medical Center in Dallas, Texas, working mostly with the adult population providing comprehensive amplification and cochlear implant services. Dr. Bell has been practicing in the Dallas/Fort Worth, Texas, area since 2015 after receiving her doctorate from West Virginia University.

References

Fruciano M. (n.d.) Why Memorizing Your Speech is Bad. Effective Presentations. www.effectivepresentations.com/blog/memorizing-speech-bad (accessed April 6, 2022).

Lanthier S, Zhu M, Buyn C, Jarick M, Kingstone A. (2021) The costs and benefits to memory when observing and experiencing live eye contact. Visual Cog 30(1-2):70–84.

Merriam-Webster. (n.d.). Public Speaking. In Merriam-Webster.com dictionary. www.merriam-webster.com/dictionary/public%20speaking (accessed April 8, 2022).

Toastmasters International. (n.d.) Preparing a Speech. Toastmasters. www.toastmasters.org/resources/public-speaking-tips/preparing-a-speech (accessed April 7, 2022).

Wyeth S. (n.d.) 10 Reasons Eye Contact is Everything in Public Speaking. Inc. www.inc.com/sims-wyeth/10-reasons-why-eye-contact-can-change-peoples-perception-of-you.html (accessed April 8, 2022).

Zandan N. (2018) How to stop saying “um,” “ah,” and “you know.” Harvard Bus Rev. https://hbr.org/2018/08/how-to-stop-saying-um-ah-and-you-know (accessed April 8, 2022).

Academy Resources

• PUBLIC RELATIONS | Hone Your Skills for a Great Interview with the Press
• PUBLIC RELATIONS | Media Training: Do I Need This?

The post Three Minutes on Public Speaking: Practical Tips for ANY Professional appeared first on American Academy of Audiology.

Clinical supervisors are tasked with the honor of training the next generation of audiologists. As supervisors, it is our duty to make sure each student receives sufficient training and a fair assessment of their skills and knowledge, regardless of their disability status. Supervising audiology doctoral students with disabilities can sometimes come with a few additional responsibilities, but there are some resources available to you that can help you understand how to serve these students best.

Audiologists frequently recommend work and school accommodations for individuals with hearing loss, and this knowledge can help with managing students with hearing loss in your clinic. However, you may have a student needing accommodations for physical limitations or other sensory challenges related to a disability that we are not as familiar with in this field.

Even for students with hearing loss, appropriate accommodations may not be obvious to clinicians with normal hearing, such as how to complete listening checks for devices or how to accurately score word recognition testing. The Americans with Disabilities Act (ADA) (2008) states that students with disabilities who are otherwise qualified, meaning those individuals who meet the essential technical and academic standards established by the university or program, will not be denied access simply because they have a disability (Khubchandani, 2011).

Students are entitled to reasonable accommodations that allow them equal opportunity to meet graduation requirements of the degree program. Students with disabilities may need accommodations to allow them to fully participate in the program, but with those accommodations they should still ultimately meet the requirements of graduation.

It is the responsibility of the student to register with the school’s disability department and to request accommodations in advance of starting classes and clinic. If the student waits until they start to fall behind or have difficulty in clinic, it may be too late to request accommodations. Not all accommodation requests are required to be granted. It is up to the disabilities department and the clinical department to determine if the request is possible or reasonable, as well as if it changes the fundamental nature of the degree program requirements.

There may need to be a discussion between the department and the student to figure out the best accommodation. Accommodations and modifications of policies and practices are not required when it would fundamentally alter the nature of the service, program, or activity or give rise to an undue financial or administrative burden. It is also the responsibility of the student to let their supervisor know that they have accommodations for the clinic and to have that discussion at the start of the clinical rotation. They do not have to disclose their disability, only that they have agreed upon accommodations in place.

As the supervisor, your responsibility to simply assess if the student is meeting the standards set for all students in the program, and to make sure the skills you are assessing are essential for graduation and completion of the program, just like with any student you supervise. Regardless of the disability or accommodation your job is to teach them the skills required to be an audiologist and to honestly assess their skills and knowledge.

If you notice problems with performance, you can discuss this like you would with any student and make sure they understand where they are in their skill level compared to where they need to be to graduate, and work with them to determine how to get them to where they need to be. Accommodations are there to allow equal access, not to guarantee success, so it is important to continue to make sure that all clinicians leaving your program are competent and ready to work independently as audiologists. The two best resources available to you are the disabilities department and clinical coordinator of the student’s school or program. They can give you specific information about policies and already agreed upon accommodations.

See below for additional resources and stay tuned for future resources related to this topic from the Students with Hearing Loss Subcommittee of the Student Academy of Audiology, including a preceptor training module.

References and General Resources

Amended Americans with Disabilities Act (ADA) (2008) https://www.eeoc.gov/statutes/ada-amendments-act-2008 (accessed March 1, 2022).

The ADA National Network: Postsecondary Institutions and Students with Disabilities. https://adata.org/factsheet/postsecondary (accessed March 1, 2022).

Khubchandani A. (2011) Supervising Trainees with Disabilities. Presentation transcript. https://www.apa.org/pi/disability/resources/supervising-trainees (accessed March 1, 2022).

SAA SPOTLIGHT | Audiologists with Hearing Loss: What We Bring to the Table https://www.audiology.org/news-and-publications/audiology-today/articles/saa-spotlight-audiologists-with-hearing-loss-what-we-bring-to-the-table/ (accessed April 26, 2022)

Working Effectively with Audiology Students Who Are d/Deaf or Hard of Hearing: Tips for Clinical Preceptors https://www.audiology.org/news-and-publications/audiology-today/articles/working-effectively-with-audiology-students-who-are-d-deaf-or-hard-of-hearing-tips-for-clinical-preceptors/ (accessed April 26, 2022)

Hearing Loss Specific Resources

Resources for students with hearing loss: https://saa.audiology.org/get-involved/committees/students-with-hearing-loss/

Bethel M, Mormer E. (2020) Examining self-disclosure and terminology preferences of DHoH students. Part 1 of 3. Hear J. November.

Bethel M, Mormer E. (2020) Solutions to clinical challenges faced by students with hearing loss. Part 2 of 3. Hear J. December.

Bethel M, Mormer E. (2020) Impact of hearing loss on motivation and self-efficacy of AuD students. Part 3 of 3. Hear J. November.

Brandy Stephens, AuD, has worked as a pediatric audiologist at Vanderbilt University Medical Center in Nashville, Tennessee, since 2015 and has been a clinical supervisor since that time. She is a member of the Academy’s New Professionals Committee. 

The post Clinical Supervision in Audiology: Resources for Working with Students with Disabilities appeared first on American Academy of Audiology.

Our intention is that this club will offer opportunities to discuss leadership topics and professional issues that apply to audiologists and other health-care professionals—and, also could be a  great excuse to read something that isn’t a research article!

This book club is free to join and will be conducted via Zoom with guided discussion topics. Breakout groups will be used during our meetings to ensure open discussions can occur amongst all participants.

The New Professionals Committee has continuously reviewed potential books for our first meeting. These books include the following themes:

• Social psychology and workplace culture
• Self-esteem and self-improvement
• Financial literacy
• Civil rights and liberties
• Racial injustice
• Stress management

However, before our first meeting, we need your input! Please fill out this questionnaire to help us pick our first book and be added to our email list for further information.

Who knows, maybe you’ll be able to connect with another audiologist with shared clinical or extracurricular interests, meet someone virtually who happens to live in your area or state, or potentially find your next job!

We look forward to reading and meeting with you soon!

The post New Professionals Virtual Book Club appeared first on American Academy of Audiology.

Patient-centered care is a common phrase in the current health-care market. Described briefly, patient-centered care highlights the importance of considering the patient’s desired health outcomes and social and emotional needs in addition to clinical treatment of the patient. This approach treats the patient as a partner in their medical decision-making and encourages a broader assessment of the patient, rather than an evaluation and treatment of individual diagnoses. One effective way to integrate patient-centered care is to evaluate and treat the patient as part of a multidisciplinary team (MDT) (Cordis Bright, 2018, Durand and Fleury, 2021). 

According to Taberna et al (2020), “The core function of a multidisciplinary team  is to bring together a group of health-care professionals from different fields in order to determine patients’ treatment plan.” A well-functioning multidisciplinary team theoretically allows for collaborative treatment with improved outcomes, improved access to expert providers, enhanced patient satisfaction, more efficient use of resources, and has even been shown to reduce provider burnout (Gorbenko et al, 2019; Iliffe, 2008).

Current research indicates that even primary care practices would benefit from a multidisciplinary care model to better address patient-centered care and improve “quality and efficiency” or current patient care (Leach et al, 2017). Audiologists can be a crucial part of a MDT, whether the audiologist is part of a hospital system, school, ENT office, or private practice.

A recent survey of 159 audiologists indicated that 100 percent of surveyed audiologists felt they should be included on multidisciplinary teams, but <50 percent of those were currently participating on a team (Landsman, 2020). Landsman indicated opportunities for audiologists to become involved in teams for patients with Autism Spectrum Disorder, Down Syndrome, Fetal Alcohol Spectrum Disorder, or patients who require long term care as an adult or in the neonatal intensive care unit, for all of which the respondents felt they were being underutilized. Other examples of opportunities to be involved in team care as an audiologist would be in schools, on cleft-craniofacial teams, or for management of patients with certain cancer diagnoses.

One of the barriers to effective participation on a MDT is the variety of team structure and execution (Iliffe, 2008). Some teams meet weekly or monthly for care conferences, while other teams do not have formal meeting times. Teams also have a variety of professionals as the ‘lead,’ and one team may have a coordinating provider while others rely solely on individual contributions. This can make navigating joining a team stressful and challenging for the audiologist; however, the results for both the patient and the audiologist typically outweigh the costs.

Team participation allows for important connections between the health-care providers that improve overall patient care as well as create awareness about the importance of hearing health care. Audiologists as part of a team can educate the team regarding the patient’s communication needs, changes in their communication function as part of a treatment, and participation in conversations regarding collaborative solutions.

Some advice for participating in multidisciplinary teams has been provided by the American Association for Respiratory Care (2021). These professionals strongly encourage active listening, consistent and open communication, and availability. They advise being prepared with knowledge about the patient during communication with other professionals to show that you are patient-centered, while being respectful of the professionals’ time. Another recommendation for being a respected team member is by ensuring your involvement on the team is known. This includes showing up for meetings, going to patient rounding, being accessible to professionals, and providing timely intervention when appropriate.    

Audiologists can advocate for involvement on MDTs by interacting with their referring providers in a respectful and informative manner. Building working relationships with these providers allows for conversations regarding best practices for patient care and can open doors for opportunities to join care teams. It is probable that audiologists are seeing and treating many patients that are already being evaluated by MDTs, and therefore audiologists may be able to capitalize on opportunities to be part of the conversation on the team by using their connections and inquiring regarding team participation.

Need help reaching out to other healthcare providers? Check out the Academy’s Reaching Healthcare Providers web page for practical tips and resources.

References

American Association for Respiratory Care. (2021) This is How to Fit in on a Multidisciplinary Team at Work. Professional Development. www.aarc.org/careers/career-advice/professional-development/multidisciplinary-team. Accessed September 10, 2021.

Cordis Bright. (2018). What are the key factors for successful multidisciplinary team working? Integrated health and social care evidence reviews.  www.cordisbright.co.uk/admin/resources/05-hsc-evidence-reviews-multidisciplinary-team-working.pdf. Accessed September 10, 2021.

Durand F, Fleury MJ (2021) A multilevel study of patient-centered care perceptions in mental health teams. BMC Health Serv Res 21:44. https://doi.org/10.1186/s12913-020-06054-z. Accessed September 10, 2021.

Gorbenko K, Mendelev E, Keefer L. (2020) Can multidisciplinary team meetings reduce burnout? J Eval Clin Pract26: 863– 865. https://doi.org/10.1111/jep.13234. Accessed September 10, 2021.

Iliffe S. (2008) Myths and realities in multidisciplinary team-working. London J Prim Care. 1(2):100–102. https://doi.org/10.1080/17571472.2008.11493220. Accessed September 10, 2021.

Landsman J. (2020) “Survey of Audiologists’ Role on Interprofessional Teams” IdeaFest. 156. https://red.library.usd.edu/idea/156. Accessed September 10, 2021.

Leach B, Morgan P, Strand de Oliveira J, Hull S, Østbye T,  Everett C. (2017) Primary care multidisciplinary teams in practice: a qualitative study. BMC Family Practice18(1):115. https://doi.org/10.1186/s12875-017-0701-6. Accessed September 10, 2021.

Taberna M, Gil Moncayo F, Jané-Salas E, Antonio M, Arribas L, Vilajosana E, Peralvez Torres E,  Mesía R. (2020) The Multidisciplinary Team (MDT) Approach and Quality of Care. Front Oncol10:85. https://doi.org/10.3389/fonc.2020.00085. Accessed September 10, 2021.

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As clinics begin to emerge from the challenges of the pandemic and focus on what’s next, the start of the next externship application cycle is just around the corner. The past year has certainly presented many challenges to prospective externs and externship sites alike. However, for many years students have consistently described the process as stressful, confusing, and unstandardized. The externship year is a critical step in the development of the next generation of audiologists as it provides an opportunity to translate academic knowledge to real-world clinical situations. High-quality externship sites are always in demand to ensure the next generation is prepared to tackle the challenges of the changing hearing health-care landscape.

Recently, a group of audiologists including Dr. Ian Windmill launched the Audiology Clinical Education Network (ACEN) to promote standardization of the externship process. When asked why the decision to act, Dr. Ian Windmill stated,

The decision to act evolved from the clinical sites who also found the externship process stressful and unorganized. Though most individual academic programs had organized processes for placing students, there was no organization or coordination across the programs. Subsequently the clinical sites were subject to differing requirements every year depending on which program the student attended. 

Though this was problematic, there were greater concerns around the manner in which clinical sites were competing for students, moving their interview and offer process earlier and earlier in the year in order to assure access to quality students. In addition, students were being asked to make decisions before they had a chance to interview with different clinical sites.

Over the years, these factors became more problematic for all the clinical sites, finally reaching the point where serious discussions among the sites was necessary to develop a more standardized process. In fact, the concept of “standardization” was a driving construct in the formation of a network. Though the timeline for the interview, offer and acceptance process was the first aspect of the externship process tackled, there are other parts the network would like to see standardized as well, including the assessment tools, the feedback process, the application process, etc. 

Also important for the network is to learn best clinical practices from each other. As this learning takes place, there will be greater standardization in teaching/learning and experiences within the sites, which will lead to better outcomes for graduates, and a positive benefit for the profession.”

The reaction to this new the newly formed ACEN has been overwhelmingly positive as over 65 different sites had joined the network by summer of 2021. Additionally, the network has a wide array of different types of sites including academic medical centers, VA hospitals, private practices, large medical complexes, and multi-disciplinary clinics.

The network is focused on the application/acceptance timeline. Below is the network’s proposed common timeline for the upcoming externship cycle for Fall 2021: 

• September 10, 2021: Deadline for students to submit application materials to individual sites.
• September 11, 2021: Externship sites begin interviewing applicants.
• October 15, 2021: Interviews completed.
• October 20, 2021: Offers of externships extended to students at noon eastern time.
• October 24, 2021: Deadline for students to accept offers of externships.
• Ongoing: Supplemental offers may be extended to students if positions are not filled.
• November 20, 2021: Process closes.

Whether you are an established externship site or considering opening your doors to an extern for the first time, the timeline above can serve as a starting point to ensure your clinic stays competitive for the best applicants. To date, there is no central repository of externship sites. However, there are plans for the ACEN to be able to provide a list of participating clinical sites soon, and there are plans to post the list on a website, however the website has not been developed as of now. 

In addition, the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD) has had a task force in place to address issues of concern for clinical education. Dr. Katie Colella, chair of the Academy’s Academic Programs Committee (APC), represented the Academy in the task force in its early stages and brought to the task force the outcome of discussions by the APC. Additionally, the APC and Student Academy of Audiology (SAA) have conducted surveys that have shown that a standardized timeline is a priority and concern for both externship sites and students.

For more information, visit the Audiology Clinical Education Network website. Dr. Windmill is currently serving as the point of contact for the ACEN and can be reached at ian.windmill@cchmcc.org.

Looking for more externship resources or externship opportunities?

Audrey Taylor, AuD, is an audiologist with UT Physicians and serves patients at Memorial Hermann Hospital in the Texas Medical Center. Dr. Taylor currently serves as a volunteer on the American Academy of Audiology New Professionals Committee and as a volunteer on the Texas Academy of Audiology Membership Committee.

The post Professional Issues: <br/>Externships appeared first on American Academy of Audiology.

Samantha Ramirez, AuD, is a clinical audiologist at Kaiser Permanente in Northern California. She is the committee chair for the Academy’s New Professionals Committee and committee member of the Academy’s Nominations Committee.

Everything has changed since the onset of the COVID-19 pandemic, including the way we attend conferences and professional events. I am grateful that the Academy and other professional organizations are continuing to offer educational content, networking, and the expo hall virtually and safely.

I am reminiscent of the small experiences from past in-person conferences, like wearing my lanyard badge, flipping through the pages of a printed program, and running into old classmates and colleagues in the halls of a convention center.

Even though we cannot meet face-to-face this year, there are several ways to make the most out of your AAA 2021 Virtual conference experience.

Ergonomics

In the days of in-person conferences many of us would pack comfy back-up shoes, the alternative to this in a virtual setting is good ergonomics. A quiet, bright space with a supportive chair, desk table, and laptop/computer is optimal for your work from home and virtual conference experience. Make sure to take breaks between sessions to move your body, stretch, and give your eyes a rest. Check out this article from the BBC How to work from home – comfortably.

Giving Back

The cost for an Academy Member to attend AAA 2021 Virtual is $299. For two and a half days of educational content, this is a great deal! The cost of an in-person conference racks up very easily due to travel, lodging, food, and drink. Consider registering and attending the PAC Wine-Tasting event for $50 or AAA Foundation’s Trivia Night (sponsored by Signia) for $40. Learn more about the PAC and the AAA Foundation and how they are directly impacting and advancing our profession.

Networking

You can still meet-up with colleagues and build professional relationships in the virtual setting. Check out the list of Interactive Lounges, which highlight nine different topics and areas of interest.

Exhibit Hall Freebies

Will you miss going booth to booth collecting pens, lip balms, and other useful, but branded gadgets? Check out the virtual exhibit hall and collect points as you visit each exhibitor to earn curated prizes! There will be 75+ exhibitors to interact with during these times, Wednesday, April 14: 12:00–4:00 pm; Thursday, April 15: 11:30 am–6:00 pm; Friday, April 16: 10:00 am–3:30 pm.

New Professionals Committee Learning Module

Traditionally, our committee hosts the popular “Speak Up, Speak Out” session where new professionals come together for stimulating conversations surrounding topics pertinent to early-career audiologists. For AAA 2021 Virtual, we prepared a CEU-approved session, Avoiding Burnout Through Student Loan Management. This session will be held on Friday, April 16, 2:15-2:45 pm. We will be breaking down the signs of workplace burnout and how student loan repayment plans or forgiveness can aid in a fulfilling and comfortable career.

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Most of us should be familiar with Bundled vs. Unbundled service models; designating audiological services included in the purchase of devices (Bundled) versus purchasing the devices and paying for services as needed (Unbundled). I have seen different models where services might be available up to one year following the fitting date, throughout the warranty period from the manufacturer, or even the lifetime of the device.

This is not a discussion about the future of over-the-counter (OTC) devices and how our profession should navigate this topic. We can and should be forward-thinking about how audiology will change over time, but we also need to be proactive as we encounter patient concerns in the present. I’d like to discuss how we handle, and more importantly, serve patients coming in with “non-traditional” devices that they did not purchase directly from us. I am going to refer to these devices as “Unbundled Devices.” Unbundled Devices may include, but are not limited to the following:

• Personal sound amplification products (PSAPs) and “Hearables”
  • Pocket talkers
  • Bluetooth-enabled earpieces
  • Over-the-ear amplifiers
• Hearing Aids fit at another clinic
  • Previous clinic closes
  • Patient relocates to a new city/state/country
• Hearing Aids previously worn by a family member or friend
• Over-the-counter devices (OTCs)
  • These devices are not currently available
  • Follow FDA Reauthorization Act of 2017 for more information

While the list above may appear daunting, it can also be viewed as opportunity. As audiologists, we have the tools and knowledge to educate our communities and provide services, regardless of what someone is coming to us for. During hearing aid consults, we have all heard patients say, “well, you’re the expert” or “what do you think is best?” Individuals with communication difficulties are coming to us for guidance and we have to step up and lead them in the right direction. We have the chance to show our value as healthcare providers and remind the general public who audiologists are and what we do. 

Lastly, I want to provide practical ways audiologists can continue to serve anyone walking into the clinic:

1. Hearing Aid Consult. Following a comprehensive examination, we can then discuss the results and educate the patient. We can determine the degree of hearing loss and identify if medical evaluation is needed.
2. Check and Clean. At the very least, we can make sure the device is working.
3. Re-programming. Confirm with the manufacturer and have the device re-issued under the individual you are seeing. If the device is appropriate for the hearing loss, go ahead and program.
4. Real Ear Measures (REMs). If available, run REMs as a conformity evaluation, especially on devices that we are unable to program. Again, this could really be an educational opportunity for the patient.

None of these services are new and innovative ideas. The difference is that we are expanding our services to everyone, not just the individuals whom are ready to purchase new hearing aids. This is a proactive approach, giving us a chance to build rapport with a new patient population. Implementing services for unbundled devices will look different across clinic settings, but the idea should at least be considered by all audiologists.

I am happy to discuss this in more detail and hear how your clinic is handling services for unbundled devices. Please contact me via email as needed: jasonbakeraudiology@gmail.com

Jason Baker, AuD

Disclaimer

This article represents the opinions of the author and not those of the American Academy of Audiology.

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Networking is often the key to job offers and the quintessential, “It’s About Who You Know” has some truth. However, networking is not simply about finding job opportunities. Audiology itself is a very small profession, and we are naive to believe that audiologists alone can move the profession forward.

Let’s think beyond the primary care physicians, otolaryngologists, and speech pathologists. Similar to the general public, many health professionals are unaware that audiology even exists. Creating collaborative relationships with other specialties will create a direct path to referrals and serve our patients better. The vestibular patients will have a physical therapist and optometrist. The patients suffering from memory loss or cognitive decline will have appropriate guidance and expectations from their psychologist. The pharmacist who now has OTC hearing devices at their store will have an audiologist he/she can refer patients to when they need more help with their hearing. How do we connect with these professionals? This type of networking can be easier when working for a larger health system or medical center. You can start by attending employee events like lectures, lunches, town halls, or leadership meetings. For the smaller clinic or practitioner, research the specialties in your area – contact those offices to meet for coffee or invite them to your office.

Who are better advocates for audiologic services than the patients receiving those services? Many clinics utilize patient testimonials, reviews, and referrals, but actively playing a role in the local community, not only increases clinic visibility, but allows audiologists to create dialogue and ask for these patients to become our advocates. Many audiologists provide consumer content by publishing podcasts, blogs, online videos, and coordinating aural rehabilitation groups. These tools help spread awareness about audiologic care and as the general public learns about audiology, eventually they can be called to action to help support awareness campaigns and legislative efforts. Even small actions like your clinic participating in a local health fair or sponsoring a community sports team creates visibility for audiology.

Networking efforts always start with small acts. If we begin to think of every patient encounter, continuing education training, or staff meeting as a networking event, audiology visibility will grow and be seen as important to our legislators, leaders, and communities.

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What does this mean for us as hearing healthcare professionals? If we as audiologists don’t challenge the heuristics that guide our decision-making, our cognitive bias may lead to ineffectiveness and poorer health outcomes for our patients. While there are many types of cognitive bias that have been well-studied in psychological research, it is important that we make ourselves aware of potential pitfalls so that we can become better clinicians. Below is a table adapted from Schlonsky et al. (2019) that looks at a few that are commonly documented in the medical field.

Preventable medical errors are estimated to cost the US healthcare system $20 billion annually. Misdiagnosis in medicine has been explored in critically acclaimed texts such as To Err is Human: Building a Safer Health System, and How Doctors Think. Medical errors have also made it to the big screen in documentaries such as HBO’s Bleed Out (2018). In a recent analysis by Galvin et al. (2019) in the Journal of the American Academy of Audiology (JAAA), they found no peer-reviewed studies that look at strategies to reduce biases in the audiology clinic. Best practices continue to be a hot-button issue within audiology and is a topic that is often explored within our Academy. It’s a topic that is heavily researched and was likely emphasized throughout your educational coursework, one that is increasingly prevalent in social media, and one that our patients are continuing to be aware of as they walk through the doors of our clinic. While more research continues to explore this topic, what can we do in our day-to-day to help reduce cognitive bias and ensure we are sticking to best practices?

How can we start to address these issues as they pertain to the work that we do? First off, we should do our best to listen to the opinions of our coworkers and patients. Our intuitions are very useful, but not always 100% correct. Reminding ourselves about the importance of being open-minded and accepting that we are not always right is perhaps the first step in talking about potential bias that may be influencing our work. In a recent column in Signal & Noise by Brian Taylor,¹ the following suggestions were made to help override our executive processes and avoid blind spots in routine clinical testing:

1. Collecting a thorough case history and performing a comprehensive audiological assessment
2. Using checklists to ensure that every step of the evaluation has been conducted
3. Conducting all tests in a manner that reflects current bests practices
4. Taking a diagnostic “time out” to review your work and ensure you are not missing details
5. Reporting all findings with referring physicians, including when findings indicate a possible nonbenign condition
6. Conducting meetings or grand rounds with staff to discuss challenging or unusual cases
7. Using Big Data to build your own set of normative data for each test you conduct

More research needs to be done on how bias can impact other aspects of our scope such as hearing aid dispensing, vestibular assessment, and other special testing considerations within our profession. Take a moment to think about your own clinical practice and how you make quick decisions. Sometimes it’s a good thing for all of us to pause, stop, and consider how we think with ourselves and others, and walk through how we reach our clinical impressions.

Works Cited

• Taylor B. Avoiding clinical blind spots with good audiology. Hearing Health & Technology Matters Web site. https://hearinghealthmatters.org/hearingeconomics/2017/audiology-clinical-blind-spots/. Updated 2017.
• Groopman J. How doctors think. First Mariner Books; 2008.
• To Err is Human: Building a safer health system. Washington DC: National Academies Press; 2000.
• Shlonsky A, Featherston R, Galvin K, et al. Interventions to mitigate cognitive biases in the decision making of eye care professionals: A systematic review. Optometry and Vision Science. 2019;96(11):818-82 https://search.proquest.com/docview/2310675514. doi: 10.1097/OPX.0000000000001445.
• Galvin KL, Featherston RJ, Downie LE, et al. A systematic review of interventions to reduce the effects of cognitive biases in the decision-making of audiologists. Journal of the American Academy of Audiology. 2019. https://www.ncbi.nlm.nih.gov/pubmed/31287054. doi: 10.3766/jaaa18096.

Additional Resources & Further Reading

• Take a Quiz! There’s plenty of websites out there that will try to pinpoint what may be steering your decisions. This one only takes a few minutes.
• https://www.ideastogo.com/articles-on-innovation/quiz-what-cognitive-bias-are-you
• Quick Youtube infographic video on heuristics
• https://www.youtube.com/watch?v=ReFqFPJHLhA
• Hosford-Dunn H. Audiologists not immune to dunning-kruger effect. Hearing Health & Technology Matters Web site. https://hearinghealthmatters.org/hearingeconomics/2017/dunning-kruger-effect/. Updated 2017.
• Saposnik G, Redelmeier D, Ruff CC, Tobler PN. Cognitive biases associated with medical decisions: A systematic review. BMC medical informatics and decision making. 2016;16(1):138. https://www.ncbi.nlm.nih.gov/pubmed/27809908. doi: 10.1186/s12911-016-0377-1.

Eric Bostwik, AuD is currently an Instructor and Clinical Audiologist at Temple University Hospital. He attended the University of Wisconsin-Madison for both his Doctorate of Audiology and Bachelor of Arts degree. His current clinical scope includes comprehensive diagnostic testing, vestibular evaluation, electrophysiological testing, and auditory rehabilitation (hearing aids and implantable devices).

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