merry christmas

Reader’s Choice 2014: The Crabby Audiologist & A Journey Into Audiology

Dear Readers:

During this holiday season, the editors at Hearing Health & Technology Matters (HHTM) are taking some time off. However, we are not leaving you without anything to read on our blog this week. Instead, we are publishing a special holiday edition filled with what we call our Readers’ Choices.

HHTM has had more than half a million page views in 2014, and the Readers’ Choices featured this week are the posts published on each of our individual blogs that drew the largest number of viewers during the year.

Here this week on Hearing Views, the Readers’ Choices are the initial posts by each of the two editors, Angela Loavenbruck and Lilly Wigall, who joined us this fall.

Whether or not you have read these Readers’ Choice posts before, we think you will enjoy them.  And be sure to return next week when all of us editors, our batteries recharged, will publish a New Year’s Eve issue filled with fascinating new posts to get 2015, HHTM’s fifth year, off to a great start.


The Crabby Audiologist – Who’s Teaching Who, and When?

By Angela Loavenbruck, Ed.D

crabby-audiologist-small-2Ever since I agreed to join my illustrious colleagues writing for Hearing Views (a decision that coincided with a brief moment of insanity, given my hatred of writing deadlines), I’ve been thinking a lot about Lucy Van Pelt, my all-time favorite cartoon character. She was pretty crabby, and after 45 years of practicing audiology, there are some things that bring out the Lucy in me. I’m going to start small and look at our entire system of educating future audiologists.

Early Study Revealed Shortcomings of Audiology Education

Way back in 1987, I participated in an elegantly designed study that ASHA developed with the Educational Testing Service (ETS).{{1}}[[1]]Greenberg, S., & Smith, I.L. (1987). Evaluation of the Requirements for the Certificates of Clinical Competence of the American Speech-Language_Hearing Association. New York: Professional Examination Service.[[1]]A similar study was repeated in 1996.{{2}}[[2]]Tannenbaum, Richard J., & Rosenfeld, Michael (1995). The Practice of Audiology: A Study of Clinical Activities and Knowledge Areas for the Certified Audiologist. Division of Applied Measurement Research, Educational Testing Service, Princeton, NJ[[2]]The studies were intended to define the tasks, knowledge and skills needed for the Certificates of Clinical Competence. Note that the study was not designed to determine what was needed for licensure or for graduation from an accredited audiology program, but rather for the purchase of ASHA’s certificates in speech-language pathology and audiology.

The initial study brought together large numbers of audiologists from various practice settings who were asked to outline every task performed by audiologists, and then to delineate the knowledge and skills needed for each of those tasks. Following this massive undertaking, participants were asked at which point in the continuum of education the knowledge and skills should be obtained – in the academic program, in the clinical fellowship year (CFY), or as part of continuing education after the attainment of the certificate.

Three groups of participants (practicing audiologists, employers and supervisors of audiologists, and academics) were then asked how well the then-current educational system was working; i.e., was the appropriate knowledge and skill set being attained at the appropriate place in the continuum? So the questions were: What knowledge and skills do you need, where should you learn them, and where did you actually learn them?

excellence-compass

The results were surprising – or maybe not. Practicing audiologists and supervisors and employers indicated that the vast majority of knowledge and skill should be attained in the academic program. Academics felt that less needed to be taught in the academic program, putting more responsibility on the CFY year and continuing education.

Finally, each group was asked how well the educational responsibilities were being carried out by the respective groups. Academic participants almost universally felt the university programs were doing a great job.

However, practicing audiologists and their supervisors and employers felt very differently.  They said that academic programs were producing graduates who had far less knowledge and skill than they needed to practice, and they said  that too much of the educational process was being left to employers and continuing education.

The dramatically different perceptions among the various groups in the study were among the earliest indications that the master’s degree/CFY package was not sufficient for instilling the knowledge and skills that an entry-level audiologist needed.

The findings lent support to the audiologists who had begun talking about the need for a professional doctorate as the entry-level degree in the profession.

Still Crabby After All These Years…

STILL A
Enough to make you crabby! Too many mediocre AuD programs continue to be accredited. Image courtesy islandperspectives.

So, why am I crabby about all of this? As a participant in the long, ongoing struggle to improve and change the accreditation and culture of our audiology educational programs, I think today’s AuD programs still fall short in their content and rigor, and I believe that  far too many mediocre programs are accredited.

Too many students are left to find externships in hopes that unpaid supervisors will instill in them the knowledge and skill that should have been the responsibility of the program.

Employers are expected to pay young audiologists while simultaneously providing education and training that should have been completed under the auspices of the academic program. Furthermore, our professional audiology organizations are focused mostly on creating continuing education institutions to solve the problem, instead of investing fully in creating and enforcing rigorous standards for recruiting and educating future audiologists in our academic programs.

In my next several blogs, I’d like to look more closely at these issues and their effects on how students are recruited, educated and employed, and on the culture of our profession in general.  As Lucy van Pelt said:  “Look out, everybody, I’m going to be crabby for the rest of the day!”


My Journey Into Audiology

By Lolly Wigall

As an audiologist I am frequently asked by patients, “How did you ever get into this field?” Audiology is not one of those fields you dream about when you are a child. Most people dream of becoming a physician, a lawyer, a nurse, a teacher, scientist, a forest ranger or an astronaut. But, dreaming to become an audiologist? Probably not.

Actually, most people have never even heard of audiology, let alone wanted a career in the profession. It’s an unusual sort of field. It is in healthcare, but it is also retail since many audiologists sell or dispense hearing aids. Audiologists work in a variety of locations such as a hospital, an ear, nose and throat (ENT) physician’s office, or a private practice.

audiology. Image courtesy albumarium.
Not that kind of doctor: Audiologists typically use stethoscopes to listen to hearing aids. Image courtesy albumarium.

The complementary field of speech and language is better known because there are so many speech pathologists working in school systems. They also work in hospitals and some in private practice. The two fields are complementary but very different. Today’s speech pathologists usually earn a master’s degree. The Audiologist now must earn a doctorate degree. This consists of three years of graduate school, followed by a year of an externship working in the field.

 The Start of My Journey

I grew up in a large family. As soon as my youngest sister was in kindergarten, my mother restarted her college career. She used to commute one or two hours a day, take 18 units, maintain a B+ average, cook for and care for five children. My mother also sewed all of our clothes, was active in the community and took her education very seriously. My father worked as a truck driver on the night shift so someone would be there when we children arrived home after school. My mom earned her teaching degree.

My ambition was to become a teacher like my mother. She was a great teacher. She even won the Freedoms Foundation Teacher of the Year Award–twice! I had a great role model I wanted to follow.

When I was in high school I met a girl I will call Q. She has cerebral palsy and wears hearing aids. Q and I had gym together and I chose her to be my partner in tennis, even though she had significant physical challenges. It seemed to me that it was more important to include everyone in the game than to exclude someone because of their handicaps. After all, I grew up in a large family and we had to include everyone, even those pesky younger sisters and brothers!

During our high school years, Q and I became good friends. Because of her hearing loss and cerebral palsy, she took “speech correction” and “lip reading” classes. Today we would call that speech therapy. She asked me to attend some sessions with her, but I never did.

We attended junior college together and then went on to separate schools to finish our college education. I was on track to be a history teacher. She was on track to be a librarian. Back in the days before the Internet, every college had catalogs from other schools. Q found that the University of Redlands, which I was attending, had a “speech reading” class.

In a letter she reminded me of my promise to take a lip reading class. I had to take two classes in audiology as pre-requisites before I could take the lip reading class. Audiology was new to me. I didn’t know what I was in for. Dr. Henry Schmidt taught the classes. He had a private practice in town and also taught at the University.

I discovered that audiology was never the same two days in a row. Seeing patients meant listening intently to understand their hearing problems. It meant suggesting how to solve those problems with hearing aids. It meant fitting patients with hearing aids and counseling not only the patient but the family on what to expect.

audiologist ear
The audiology clinic is never the same each day: Every client presents with their own unique hearing loss experience. Image courtesy Dept Veteran’s Affairs.

There were no lesson plans as there would have been in teaching history. Each person’s hearing loss was a little different. Each person’s story had a different twist.

It was interesting to try to “solve” a puzzle with each client. I found I really enjoyed meeting people and helping them improve the quality of their lives and their relationships. It was challenging and fulfilling at the same time. And, I found I was pretty good at it.

The next step was changing my major as a senior in college and finishing all the requirements in one year.  I took freshman, sophomore, junior and senior classes in order to meet the requirements and earn my bachelor’s degree.  I realized I had to earn a master’s degree.  I applied to Bradley University in Peoria, IL, and  was awarded a full scholarship, which included money to live on and fully paid tuition for two years.

That was many years ago. Since then, I have seen the field of audiology expand and change.

Today, I am the owner of a private practice that I purchased in 1989. It all started with a casual promise to attend a lip reading class with a friend.  We are still friends today, and she changed my life.


About HHTM

HHTM's mission is to bridge the knowledge gaps in treating hearing loss by providing timely information and lively insights to anyone who cares about hearing loss. Our contributors and readers are drawn from many sectors of the hearing field, including practitioners, researchers, manufacturers, educators, and, importantly, hearing-impaired consumers and those who love them.