Training activity information
Details
Review the hearing aid fitting for routine adult patients, and provide fine tuning if necessary
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
- Patient centred care and support
- Principles of rehabilitation
- Collaborative decision-making
- Use of interpreters
- Patient-reported outcome measures
- Objective outcome measures
- Patient-reported experience measures
- Integration with other technology
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 a hearing aid review and fine-tuning session? e.g., What information do you need to gather from the patient about their experience? What are the standard procedures for evaluating the fitting and making adjustments?
- What is your prior experience with hearing aid reviews or fine-tuning? e.g., What common issues do patients report with new hearing aids? What parameters in the fitting software might you need to adjust, and why? What challenges might you face (e.g., patient expectations, limited benefit), and how will you prepare? What is your scope of practice for making adjustments? How do you feel about conducting review appointments?
- What do you anticipate you will learn from this experience? e.g., What skills related to troubleshooting fitting issues, using fitting software effectively, or managing patient expectations do you want to develop? What insights do you hope to gain about the process of adapting to hearing aids and the impact of fine-tuning?
- What additional considerations you need to make? e.g., Have you reviewed notes from the initial fitting? Are there specific questions you plan to ask the patient about their experience?
In action
- Are you noticing anything surprising or different from what you anticipate during the process of reviewing and fine-tuning a hearing aid fitting for a routine adult patient? Are you encountering situations such as:
- The patient reporting unexpected issues or persistent difficulties despite prior adjustments or expected adaptation period?
- New symptoms or changes in hearing ability emerging since the last fitting, unrelated to the hearing aid itself?
- The patient requesting adjustments that contradict objective findings (e.g., wanting more volume when already at target) or best audiological practice?
- Difficulty identifying the precise cause of the patient’s reported issues (e.g., distinguishing between a patient perception issue, an acoustic feedback problem, or a technical malfunction)?
- Unexpected challenges with wireless connectivity to the hearing aid for fine-tuning, or software glitches during programming?
- How does this experience compare with previous experiences of similar activities?
- 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 performing re-tests (e.g., REMs, specific audibility checks) or re-verifying current hearing aid settings based on the patient’s feedback?
- Are you consulting hearing aid adjustment protocols, manufacturer guidelines, or patient feedback questionnaires to guide your fine-tuning decisions?
- Are you seeking advice from a more experienced colleague or your training officer regarding a complex fine-tuning request, a persistent complaint, or an unexpected outcome?
- Are you changing your approach to explaining the impact of adjustments or managing patient expectations based on their current feedback and your objective findings?
- 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 needs escalate beyond routine fine-tuning into a complex diagnostic or medical issue)?
- What are you learning in this moment as a result of any unexpected development? For example, are you learning more nuanced questioning techniques to elicit specific patient feedback, or advanced fine-tuning strategies for challenging acoustic environments?
On action
- Begin by summarising the key points of how you reviewed the hearing aid fitting and provided fine tuning for a routine adult patient. Describe the methods you used to assess the fitting and patient satisfaction.
- Consider specific events or interactions that felt important (e.g., patient reporting specific issues, successful fine tuning, discussing long-term management and care). How did you feel during this review?
- Include any ‘reflect-in-action’ moments, where you had to adapt your fine tuning approach based on the patient’s immediate feedback or a newly identified concern.
- Identify what learning you can take from this experience regarding reviewing hearing aid fittings and fine tuning.
- What strengths did you demonstrate (e.g., problem-solving, active listening to patient concerns, technical adjustment skills)?
- What skills and/or knowledge gaps were evident (e.g., understanding of complex patient complaints, advanced fine-tuning strategies, counselling on adaptation)?
- Compare this experience against previous engagements with similar activities. Were any previously identified actions for development achieved? Has your practice in hearing aid review and fine tuning improved?
- Identify any challenges you experienced (e.g., vague patient complaints, difficulty identifying the root cause of an issue, resistance to suggested changes) 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 a specific patient complaint or a fine-tuning strategy.
- 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.
- What will you do differently next time you review a hearing aid fitting or fine tune a device?
- 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 review and fine tuning (e.g., advanced programming, troubleshooting common issues, patient education) further?
Beyond action
- Have you revisited your previous reflections (reflect-before-action, reflect-in-action, and reflect-on-action) for this specific activity (reviewing and fine-tuning hearing aid fittings for routine adult patients)?
- When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to eliciting patient feedback effectively, identifying sources of dissatisfaction, making appropriate programming adjustments, or providing clear counselling on changes?
- 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 hearing aid reviews with peers, near peers, or colleagues? Has discussing these experiences with others changed your view or understanding of common patient complaints, effective fine-tuning strategies, or managing realistic patient expectations post-fitting?
- 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 reviewing and fine-tuning hearing aid fittings developed and evolved over time across multiple instances of undertaking this training activity?
- Can you identify specific examples of improvement or increased confidence in diagnosing fitting issues, making targeted programming changes, or improving patient satisfaction through effective adjustments?
- Based on your experiences, how has your ability to recognise when something related to hearing aid review/fine-tuning is beyond your scope of practice improved?
- Do you have a clearer understanding of when and from whom (e.g., supervisor, senior audiologist, hearing aid technical support) you need to seek advice or clarification regarding persistent patient dissatisfaction, complex acoustic feedback issues, or programming for unusual listening environments?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Assess and manage hearing function in adults, without co-morbidities. |