“Peeling the Onion” is a monthly column by Harvey Abrams, PhD
In a recent post, I referred to the initiative by the American Board of Audiology (ABA) to create an advanced practice certificate for audiology preceptors. This is an important step toward improving the quality of the 4th year experience for AuD students.
Now along comes another important development that could have a significant impact on that 4th year experience in particular, and the training of AuD students in general.
Reframing Our Profession
ASHA just reported on a recently-conducted AuD Education Summit which was convened on October 27–28, 2016 at the ASHA National Office in Rockville, Maryland. The summit included presentations on the history of the AuD, the current AuD model and residency models from medicine, optometry, and physical therapy.
The summit was the outgrowth of the Report of ASHA’s Academic Affairs Board (AAB) on Critical Issues in AuD Education which, in addition to other content, reflected the recommendations of the Ad Hoc Committee on Reframing the Professions (on which I served as a member). That committee was charged with identifying specific trends that are reframing the profession of audiology in light of changing needs in both the health care arena and educational settings.
In addition to other professional issues, the Reframing Committee, in its final report, specifically addressed concerns associated with audiology education and recommended that academic programs continuously analyze external market changes and adjust the curriculum and clinic models accordingly.
Current AuD Education Model Revisited
The reframing committee identified several needs, questions, and concerns related to the current AuD education model to include:
- Adding interventional audiology to AuD curricula (i.e., prevention, early detection, and noninvasive alternatives to treatment, particularly as they relate to chronic health care conditions, such as heart disease and diabetes);
- The number of students entering the field (e.g., What level/degree of growth is needed to sustain the profession? Can we attract high quality students to the field?);
- Return on investment (ROI) for an AuD degree (e.g., consider the need to evaluate the cost of increasing professional education requirements, the disconnect between education cost and salary and reimbursement, and whether the educational costs are keeping minorities from entering the profession);
- Meeting student needs (e.g., Has there been a substantive change in training relative to the master’s degree? Are students adequately prepared for the new and evolving health care environment?);
- Meeting consumer needs (e.g., Are we serving consumers more effectively? Do consumers need better access to our services?);
- Requirements/accreditation or regulations (e.g., What encompasses the 4th year or the type of facility where the students are placed?);
- Interprofessional education (e.g., Are we teaching students how to provide services that are patient/family centered, community/population oriented, relationship focused, and outcomes driven?)
Critical Education Issues
In addition to the recommendations of the Reframing Committee, the AAB identified additional critical audiology education issues. These included:
- Reevaluating the current AuD education model to consider such alternatives, for example, as a 3-year program, a 2-year UG prep + 3-year AuD program = 5 years, etc.) and a consideration of a residency experience (similar to those in other doctoring professions) after the AuD degree has been awarded;
- Examining best practices in pedagogy for clinical education to ensure clinical educators acquire the skill set required in university programs to include that clinical educators in off-campus clinical sites acquire the required skill set and to ensure AuD students acquire the necessary Recruiting and retaining of PhD faculty for AuD programs to teach in the AuD programs and contribute to the science of the discipline. Also, what more can be done to encourage audiology students to enter PhD programs;
- Addressing the supply and demand issue for audiologists nationwide to include how we address the need to train more audiologists and reduce attrition and define the role of the continuum of service delivery (e.g., practicing at the top of the license, tele-practice, use of audiology assistants) in meeting workforce demands for audiologists and audiology-related services;
- Defining the prerequisites for entering AuD programs if, in fact, there is an ideal or uniform set of prerequisites to prepare students for successful audiology education and careers;
- Defining the kinds of research activity we expect AuD-educated audiologists to conduct or engage in, determine the research competencies necessary to engage in those activities and determine how those competencies can be incorporated into AuD education programs;
- Examining the role of clinical educators to include considering the promotion of clinical-faculty tracks with tenure and/or promotion opportunities in higher education.
Considering that it had been over 20 years since the advent of the AuD and in view of the many issues identified by the Reframing Committee and the AAB, the AAB recommended that the ASHA Board of Directors plan and budget for a summit of stakeholders to discuss the state of audiology education. The AuD Education Summit was the product of those recommendations. You can view the first day’s presentations and listen to the second day’s proceedings of the summit. At the conclusion of the meeting, attendees volunteered to contribute to one or more action items to include:
- student readiness for the externship;
- guidelines for AuD clinical training sites;
- student competency assessment throughout their program;
- standardization of the externship;
- optional postgraduate residency; and
- vision for the future of the profession.
Audiologists are facing real and significant challenges that seriously threaten our future. Successfully managing those threats may be largely determined by how well we redefine and deliver quality education and training to current and future generations of AuD students. The recommendations proposed by ASHA’s Ad Hoc Committee on Reframing the Professions, ASHA’s Academic Affairs Board and the attendees at the AuD Education Summit have provided us with a clear roadmap to follow to optimize our future as a relevant profession.
This is Part 21 of the Peeling the Onion series. Click here for Part 1,Part 2, Part 3, Part 4,Part 5, Part 6, Part 7, Part 8, Part 9, Part 10,Part 11, Part 12, Part 13, Part 14, Part 15, Part 16, Part 17, Part 18, Part 19, and Part 20.
Harvey Abrams, PhD, is a consulting research audiologist in the hearing aid industry. Dr. Abrams has served in various clinical, research, and administrative capacities in the industry, the Department of Veterans Affairs and the Department of Defense. Dr. Abrams received his master’s and doctoral degrees from the University of Florida. His research has focused on treatment efficacy and improved quality of life associated with audiologic intervention. He has authored and co-authored several recent papers and book chapters and frequently lectures on post-fitting audiologic rehabilitation, outcome measures, health-related quality of life, and evidence-based audiologic practice. Dr. Abrams can be reached firstname.lastname@example.org