Training activity information
Details
Develop, and modify as appropriate, a holistic, individualised management plan for a routine hearing-impaired adult
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Considerations
- Family-centred care and shared decision making
- Cultural and social attitudes to hearing care
- Informed choice
- Effective communication
- Use of interpreters
- Technological and non-technological options
- Onward referrals
- Sign-posting to other services
- Scope of practice
- Amplification options
- Impression-taking if required
- Local and national guidelines and international best practice
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What does success look like for developing a holistic, individualised management plan for a routine adult? e.g., What elements constitute a holistic plan? How do you ensure it is individualised based on the patient’s needs, lifestyle, and preferences? What are the available management options you can include?
- What is your prior experience with developing management plans or discussing management options with adults? e.g., What do you already know about different management strategies for hearing loss? What challenges might you face in tailoring a plan or communicating options effectively, and how will you prepare? What is your scope of practice in recommending and developing plans? How do you feel about creating a plan for a patient?
- What do you anticipate you will learn from this experience? e.g., What skills related to integrating patient preferences, considering various management options, or writing comprehensive plans do you want to develop? What insights do you hope to gain about patient-centred care and rehabilitation?
- What additional considerations you need to make? e.g., Have you reviewed examples of well-developed management plans? Are there any clinic-specific resources or pathways you need to incorporate?
In action
- Are you noticing anything surprising or different from what you anticipate during the process of developing and modifying a holistic, individualised management plan for a routine hearing-impaired adult? Are you encountering situations such as:
- The patient’s preferences, lifestyle factors, or financial considerations unexpectedly influencing the feasibility or acceptability of a proposed plan?
- Difficulty integrating multiple aspects of care (e.g., technology, communication strategies, counselling, communication partners) into a coherent and easy-to-understand plan?
- New information emerging during discussion (e.g., previously unmentioned communication environments, social isolation) that necessitates a significant alteration to the initial plan?
- Resistance, misunderstanding, or strong emotional reactions from the patient regarding proposed management strategies or the implications of their hearing loss?
- Finding a gap in available resources or services (e.g., specific support groups, assistive listening devices) that impacts the ideal plan?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to the procedure? Is it affecting your ability to undertake the activity independently? Consider the steps you are taking in the moment, such as:
- Are you immediately rephrasing explanations, offering alternative solutions, or exploring the patient’s concerns in more depth?
- Are you consulting guidelines on patient-centred care, shared decision-making, or specific management plan frameworks?
- Are you seeking advice from a more experienced colleague or your training officer to brainstorm solutions for a challenging case or to address specific patient barriers?
- Are you changing your proposed plan based on immediate patient feedback, newly identified barriers, or their expressed readiness for change?
- How is any unexpected development being resolved as you progress during the activity? How are you working within your scope of practice? Are you successfully managing the situation yourself, or do you need support because it is beyond your current scope (for example, if the patient’s psychosocial needs are very complex or require external agency involvement)?
- What are you learning in this moment as a result of any unexpected development? For example, are you learning new negotiation skills, or a more effective way to present complex information clearly and empathetically to encourage patient buy-in?
On action
- Begin by summarising the key points of how you developed and, if applicable, modified the management plan for a routine hearing-impaired adult. Describe how you incorporated patient needs and preferences into the plan.
- Consider specific events or interactions that felt important, such as discussing options with the patient, integrating different aspects of care (e.g., communication strategies, hearing aids, aural rehabilitation), or making modifications based on patient feedback. How did you feel during this process?
- Include any ‘reflect-in-action’ moments, where you had to adjust the plan based on new information or the patient’s immediate reaction during the discussion.
- Identify what learning you can take from this experience regarding developing holistic, individualised management plans.
- What strengths did you demonstrate (e.g., patient-centred approach, ability to integrate information, communication skills)?
- What skills and/or knowledge gaps were evident (e.g., deeper understanding of various management options, effectively addressing psychosocial aspects, documenting comprehensive plans)?
- Compare this experience against previous engagements with similar activities. Were any previously identified actions for development achieved (e.g., more comprehensive plans, better patient engagement)? Has your practice in management plan development improved?
- Identify any challenges you experienced (e.g., patient resistance to recommendations, conflicting information, time constraints) and how you reacted to these. Did this affect your ability to deal with the situation? Were you able to overcome the challenges?
- Identify anything significant about this activity, such as needing to seek advice or clarification on specific management strategies or patient circumstances.
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learned, including from any feedback you received on the management plan.
- What will you do differently next time you develop a management plan for a hearing-impaired adult?
- Has anything changed in terms of what you would do if you were faced with a similar situation again?
- Do you need to practise any specific aspect of plan development (e.g., shared decision-making, exploring patient-reported outcome measures, documenting rationale) further?
Beyond action
- Have you revisited your previous reflections (reflect-before-action, reflect-in-action, and reflect-on-action) for this specific activity (developing and modifying management plans for routine hearing-impaired adults)?
- When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to incorporating patient preferences, considering a range of intervention options, setting realistic goals, documenting the plan clearly, or modifying plans based on feedback/outcomes?
- Have you completed these previously identified actions? If not, what are the barriers? If so, how did completing them impact your subsequent performance of this activity? Are you ready to demonstrate this new learning confidently and consistently when performing this task?
- Have you engaged in professional storytelling or discussed your experiences of adult management plan development with peers, near peers, or colleagues? Has discussing these experiences with others changed your view or understanding of patient-centred decision-making, the role of different interventions, or the long-term impacts of management strategies?
- Considering your cumulative experiences and reflections on this activity, how will the learning you have gained support you in preparing for relevant observed ‘in-person’ assessments for the module?
- How has your practice related to developing and modifying adult hearing management plans developed and evolved over time across multiple instances of undertaking this training activity?
- Can you identify specific examples of improvement or increased confidence in tailoring plans to individual needs, discussing options empathetically, or anticipating potential challenges in implementation?
- Based on your experiences, how has your ability to recognise when something related to adult hearing management planning is beyond your scope of practice improved?
- Do you have a clearer understanding of when and from whom (e.g., supervisor, multidisciplinary team members, social worker) you need to seek advice or clarification regarding complex communication needs, significant psychosocial barriers, or co-morbidities impacting management options?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Assess and manage hearing function in adults, without co-morbidities. |