HLTAU403B Conduct hearing assessments
Logbook and reflective skills journal
Contents
Introduction 4
Logbook 5
Instructions to supervisors 7
Elements of competency for HLTAU403B 8
Record of hours worked 21
Record of hours worked 22
Record of hours worked 23
Reflective skills journal 24
Acknowledgements
Material in this book was developed by San Eng Chen and Janette Brazel for TAFE NSW and adapted from versions developed by Lee Cummings, Jean Tsembis, Bettina Turnbull, Gary Wood and Gloria Armstrong.
This record of training belongs to:
Name:Contact details:
Supervisors:
Name:Contact details:
Name:
Contact details:
Teacher/course coordinator:
Name:Contact details:
Introduction
This unit of competency, HLTAU403B Conduct hearing assessments, describes the skills and knowledge required for conducting hearing assessments.
The conducting of hearing assessments involves preparing the environment, establishing client relationship, undertaking hearing assessments, interpreting the results of the hearing assessments, developing realistic goals with client and referring client if required to an appropriate facility.
The elements of competency are:
1 prepare for hearing assessments
2 establish a positive relationship with the client
3 conduct otoscopy
4 conduct hearing assessments
5 conduct speech audiometry testing
6 review results of hearing assessments with client
7 clean and store equipment.
All tasks are conducted in accordance with industry standards, organisation policies and procedures, and infection control guidelines.
Students are required to be competent in all performance criteria to complete this unit, that is, the supervisor must believe that the student is competent to perform all the elements/performance criteria listed in this logbook.
Logbook
The logbook provides the evidence that the student demonstrates the essential knowledge and skills to confirm that they are competent in this unit. It is recommended that this be gathered over a period of time and cover the normal range of workplace situations.
It is the responsibility of the student to ensure that the logbook is kept up-to-date and that each entry is endorsed by their supervisor.
A significant change from previous audiometry course is that there is no requirement for a minimum number of practicum hours. The focus on competency allows flexibility for students to achieve competence in their own time—the time it takes for each student will, of course, vary. However, to provide some tracking for the student and supervisor there is a ‘Record of hours worked’ table at the end of each of the logbooks.
Note: As a guide, the clinical hours for this unit are approximately 70 hours.
The student will be expected to have certain knowledge and skills.Essential knowledge
Essential knowledge must include:
· appropriate physical environment for audiometric assessments of all types
· Australian and international standards that apply to the conduct of a hearing assessment
· anatomy of the ear, including peripheral auditory system
· common physical abnormalities of the peripheral auditory system
· causes and types of hearing loss
· the interrelationships with other professions
· hearing aids and their functioning
· temporary threshold shift and permanent threshold shift and their implications for assessment
· characteristics of speech tests (eg carrier phrase versus no carrier phrase, recorded versus live voice, open versus closed set tests)
· materials that can be used for speech testing, particularly in relation to what the test is designed to assess, who the test is appropriate for and the reliability/validity of particular tests.
Essential skills
Essential skills must include:
· meet client needs and establish realistic goals through effective communication with client
· conduct the full range of hearing assessments accurately and reliably
· correctly select required hearing assessment
· select and use appropriate equipment and instruments
· recognise and respond correctly when a client is not giving true thresholds
· interpret and record results accurately and identify options available to clients
· establish effective working relationships with external agencies
· write comprehensive and accurate reports
· operate audiometry equipment and instruments correctly and in accordance with manufacturers’ specifications
· perform hearing assessments, including otoscopy, accurately
· interpret pure tone audiometry and impedance audiometry test results accurately
· compare assessment results across and within assessments to ensure they are cohesive
· use test results to determine type of hearing loss
· use reading and writing skills; literacy competence required to fulfil job roles safely and effectively. The level of skill required involves reading and documenting clinical information and understanding procedure manuals.
· use oral communication skills; language competence required to fulfil job role in a safe manner and as specified by the organisation. Assessors should look for skills in asking systematic questions, providing clear information, listening to and understanding client areas of concern, and demonstrating ethical practice and procedures in dealing with clients. Effective verbal and non verbal communication skills with a range of internal and external persons are essential together with competence in English or a community language, depending on the client group.
· use interpersonal skills to relate to people from a range of social, cultural and religious backgrounds and physical and mental abilities
· use numeracy skills including the ability to interpret data and record client results
· use problem solving skills including an ability to use available resources and determine accuracy of test results
· work with others.
Instructions to supervisors
Thank you for taking on a student of Audiometry. Your support is vital to the student’s completion of the Certificate IV in Audiometric Assessment.
Teachers/supervisors/assessors will be required to be eligible for Ordinary membership of the Australian College of Audiology (ACAud) or full membership of the Audiological Society of Australia (ASA) with a current Certificate of Clinical Practice (CCP). A minimum of three years experience in the rehabilitation of the hearing impaired is also required.
Teachers/supervisors/assessors must be able to demonstrate current competence in the outcomes of this unit. They must be able to demonstrate a broad perspective and depth of understanding of the vocational area of audiometry based on current and relevant experience in the industry.
Students are not required to fulfill a number of hours. The training package requires students to be considered competent to perform the tasks necessary to comply with industry standards.
Note: As a guide, the clinical hours for this unit are approximately 70 hours.
In most instances, students will need to observe you to understand how the tasks should be done. They will then need close supervision and at times you may need to take over the situation. When you feel the student is able to complete the tasks in a manner that does not require your close supervision then you should complete the relevant section indicating that the student is competent to do the task.
If you feel that the student does not have the required knowledge and skills you should discuss this concern with the student. If this does not satisfy your concerns please speak with the relevant teacher at TAFE. There is a section at the front of this logbook where the student will complete the details of their teacher or course coordinator.
When the student is competent, please provide them with three clients to take through the entire test battery. These three clients will be the case studies that the student needs to discuss in their reflective skills journal found at the back of their logbook.
Elements of competency for HLTAU403B
1. Prepare for hearing assessments
The student is able to:1 Ensure information, including required forms are accessible and ready for use
2 Prepare the environment suitably for hearing assessments
3 Check equipment and instruments for assessments and calibrated for use
4 Ensure personal protective equipment is available and used if required
Supervisor’s signature:
Supervisor’s name:
Date:
Information may include:
· client medical history
· referral letter
· correspondence
· consent forms
· current standards
· information for clients.
Environment may include: a consulting room or an acoustically-treated assessment room.
Equipment and instruments may include:
· audiometer (clinical, screening and diagnostic)
· headphones
· otoscope (hand-held and video)
· screening tympanometer
· recorded speech sources
· sound field audiometer
· impedance audiometer
· computer.
Equipment checking must include:
· acoustic calibration and integrity check of an audiometer
· all parts are correctly assembled.
Personal protective equipment may include:
· gloves
· masks
· eye protection.
Supervisor’s comments (optional):
Student’s reflection:
2. Establish a positive relationship with the client
The student is able to:1 Take client case history and explain practice/hearing service administrative procedures to client
2 Determine client’s expectations
3 Gain informed consent from clients where applicable
4 Give client the opportunity to ask questions and discuss concerns
5 Identify and meet special needs of client
6 Maintain confidentiality of client information
Supervisor’s signature:
Supervisor’s name:
Date:
Clients may include adults, including aged persons.
Informed consent may include consent that is either written, verbal or implied.
Confidentiality of client information may include:
· legal and ethical requirements
· secure location for written records
· telephone conversations
· offering a private location for discussions
· information disclosed to an appropriate person consistent with the responsibility of this position
· adherence to the Privacy Act
Supervisor’s comments (optional):
Student’s reflection:
3. Conduct otoscopy
The student is able to:1 Follow personal hygiene/infection control procedures
2 Conduct otoscopy in a non-threatening manner to produce valid, reliable and accurate results and in accordance with relevant policy and procedures
3 Identify abnormalities of the ear canal
4 Identify contra-indications for proceeding with further hearing assessments
5 Make referral to appropriate agency for further assessment and treatment if required
Supervisor’s signature:
Supervisor’s name:
Date:
Personal hygiene/infection control procedures may include:
· washing hands
· current National Health and Medical Research Council (NHMRC) guidelines for infection control in health care settings
· standard precautions and additional precautions as defined by the NHMRC
· current Australian Standards
· local government ordinances
· other legislative requirements.
Relevant policies and procedures may include:
· organisation
· industry standards (state and national)
· Office of Hearing Services
· contract requirements
· relevant Commonwealth and state/territory privacy legislation
· research organisations eg National Acoustic Laboratory (NAL)
· relevant state/territory OHS bodies
· industry professional bodies
· relevant Australian standards.
Abnormalities of the ear canal may include:
· excessive cerumen
· foreign body
· discharge from the ear
· signs of inflammation/infection
· atresia
· exostosis
· collapsed ear canals
· presence of grommets
· otitis externa
· perforated tympanic membrane.
Contraindications for proceeding with further tests include:
· excessive cerumen
· foreign body
· discharge from the ear
· signs of inflammation/infection
· atresia
· exostosis
· collapsed ear canals
· presence of grommets
· otitis externa
· perforated tympanic membrane.
Referral agencies may include:
· audiologist
· medical practitioner
· medical facilities
· rehabilitation centres
· self-help organisations.
Supervisor’s comments (optional):
Student’s reflection:
4. Conduct hearing assessments
The student is able to:· Identify significant features of client history
· Select appropriate hearing assessment/s and explain procedure to client
· Wear appropriate personal protection clothing correctly and follow infection control procedures
· Conduct assessments to produce valid, reliable and accurate results and in accordance with relevant policy and procedures
· Use results to identify specific hearing loss and/or any abnormal functions
· Record results in accordance with relevant policy and procedures
Supervisor’s signature:
Supervisor’s name:
Date:
Hearing assessments must include:
· pure tone audiometry assessments ie air conduction screening and threshold assessments, threshold air and bone conduction assessments with masking as required, Stenger
· impedance audiometry assessments ie screening tympanometry and contralteral stapedius reflex recording, stapedial reflex delay
· speech audiometry assessments using at least two levels, one being at least 10dB above PB max ie phonetically balanced monosyllables, AB words, spondees.
Results of hearing assessments may include:
· sensori-neural hearing loss
· conductive hearing loss
· mixed hearing loss
· identification of non-organic hearing loss.
Supervisor’s comments (optional):
Student’s reflection:
5. Conduct speech audiometry testing
The student is able to:1 Verify audiograms
2 Assess speech discrimination abilities and their implications for rehabilitation
3 Identify any possible retro-cochlear pathology
Supervisor’s signature:
Supervisor’s name:
Date:
Supervisor’s comments (optional):
Student’s reflection:
6. Review results of hearing assessments with client
The student is able to:1 Communicate results of assessments clearly and simply to the client
2 Discuss options to support client and consider with client
3 Negotiate and establish realistic goals for the client
4 Record, document and file results in accordance with relevant policies and procedures
5 Compile report, including recommendations for further assessment or referral to an appropriate facility or hearing aid fitting
Supervisor’s signature:
Supervisor’s name:
Date:
Options for client may include:
· fitting of a hearing aid or assistive listening device
· referral to a general practitioner
· referral to a local support group for training in communication strategies.
Indications for medical referral include:
· visible evidence of cerumen accumulation or the presence of a foreign body which precludes assessment or taking an impression
· previously unreported apparent or confirmed perforation
· reported pain, discomfort or tenderness in the ear
· any history of active drainage from the ear during the past three months and/or apparent infection
· a hearing loss associated with a traumatic insult to the ear
· chronic dizziness or vertigo
· reported facial numbness, weakness or asymmetrical facial movements
· a hearing loss of sudden or recent onset
· unilateral hearing loss
· unilateral tinnitus
· sudden onset of tinnitus
· reported feeling of blockage or fullness in ear(s)