Tinnitus, Dysacusis and Hyperacusis

Details

Title

Tinnitus, Dysacusis and Hyperacusis

Type

Stage Two

Module code

HPS249

Requirement

Compulsory

Module objective

By the end of this module Clinical Scientists in HSST, with respect to tinnitus, dysacusis and hyperacusis, will be able to analyse, synthesise, evaluate and apply knowledge and perform a specialist assessment and treatment of patients demonstrating the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist within a patient focused service and in particular will determine: 

• by careful history taking, examination, selection and interpretation of audiological and other investigations, where possible identify the cause of tinnitus, dysacusis and hyperacusis, define a management plan, and know when referral to medical or other colleagues is appropriate.
• the cause of pressure sensations, phonophobia (hyperacusis), echoing and other dysacuses, and know when referral to a medical colleague is required.
• the effects of tinnitus, dysacusis and hyperacusis on the individual and devise a management plan, and know when referral to a medical colleague is required.

Knowledge and understanding

By the end of this module Clinical Scientists in HSST will analyse, synthesise, evaluate and apply their expert knowledge required with respect to: 

• the different conditions which can cause or trigger tinnitus, dysacusis and hyperacusis.
• current pathophysiological theories of generation of tinnitus, dysacusis and hyperacusis.
• the prevalence of tinnitus and hyperacusis and the natural history of habituation.
• the psychological effects of tinnitus, dysacusis and hyperacusis on the patient and how these can be managed.
• the indications for, benefits of and problems with rehabilitative instruments such as hearing aids, tinnitus instruments (including WNG, sound ball etc.) and environmental modification.
• various retraining and relaxation techniques.the indications for, benefits of and problems with rehabilitative instruments such as hearing aids, tinnitus instruments (including WNG, sound ball etc.) and environmental modification.
• when a specialist medical, surgical, psychological or psychiatric opinion is required.

Technical and clinical skills

By the end of this module, with respect to tinnitus, dysacusis and hyperacusis, Clinical Scientists in HSST will be able to demonstrate a critical understanding of current research and its application to the performance and mastery of the following technical skills whilst critically reflecting and applying in practice a range of clinical and communication skills to advise and communicate effectively with patients, their families and carers and other healthcare professionals and will:

• take a relevant history and perform an examination as appropriate in the role of Consultant Clinical Scientist.
• select, carry out and interpret the results of audiological investigations.
• select other appropriate investigations and take appropriate action on the findings
• counsel the patient on the test results and causation of tinnitus, dysacusis and hyperacusis.
• perform a risk assessment with regard to self harm.
• select appropriate management strategies such as hearing aids, rehabilitative instruments, cognitive therapy, relaxation, pharmacological options.
• identify psychological problems needing referral to a psychologist or psychiatrist.
• work effectively within the multi-disciplinary team and liaise effectively with therapeutic staff, specialist medical staff, clinical psychologists, psychiatrists and GPs about the appropriate management of the patient.
• apply appropriate fitting strategies for fitting hearing aids and rehabilitative instruments.
• select and interpret appropriate outcome measures.
• reflect on the challenges of applying research to practice in relation to these areas of practice and suggest improvements, building on a critique of available evidence.

Attitudes and behaviours

By the end of this module Clinical Scientists in HSST will be expected to evaluate their own response to both normal and complex situations demonstrating the professional attributes and insights required of a Clinical Scientist in HSST working within the limits of professional competence referring as appropriate to senior staff and will:

• recognise the psychological impact of tinnitus, dysacusis or hyperacusis on the patient and of the patient’s psychological attitude on these symptoms.
• recognise the need for an empathetic, supportive and positive approach to the patient and his/her concerns.
• recognise the prevalence and impact of mental health problems in this population.
• recognise the importance of effective multidisciplinary team work and effective communication with colleagues both verbally and in writing.
• recognise the value of complementary medical approaches to holistic management of tinnitus, dysacusis and hyperacusis.
• recognise own scope of practice, and when another professional would be best placed to provide an opinion or an intervention.
• be committed to and support continuous improvement of therapeutic services, with particular reference to auditing practice, evidence based practice, innovative, new and improved technologies.