Training activity information
Details
Take a clinical history and formulate an appropriate hearing assessment strategy for school-age children without complex needs
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
- Collaborative decision making
- Family and patient centered care
- Use of interpreters
- Scope of practice
- Consent
- Collaborative decision making and patient centered care
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 when taking a history and planning assessment for school-age children? e.g., How do history-taking techniques differ for children compared to adults? What assessment tests are appropriate for this age group, and how do you choose?
- What is your prior experience with paediatric history-taking or assessment planning? e.g., What communication strategies have you used with children or parents before? What do you know about common hearing issues in this age group and relevant tests like play audiometry? What challenges might you face (e.g., child engagement, parental anxiety), and how will you prepare? What is your scope of practice here? How do you feel about assessing children?
- What do you anticipate you will learn from this experience? e.g., What skills related to engaging with children or adapting assessment strategies for paediatric patients do you want to develop? What insights do you hope to gain about paediatric audiology?
- What additional considerations do you need to make? e.g., Have you reviewed protocols for assessing school-age children? Are there any specific notes on the child’s referral or behaviour you should be aware of?
In action
- Are you noticing anything surprising or different from what you anticipate during the process of taking a clinical history and formulating an assessment strategy for a school-age child without complex needs? Are you encountering situations such as:
- Difficulty engaging the child or parents/carers to obtain a comprehensive and reliable history due to shyness, distraction, or conflicting accounts?
- The child’s behaviour unexpectedly impacting your ability to gather information or plan the assessment, such as significant restlessness or withdrawal?
- Unanticipated developmental considerations or subtle signs of additional needs that affect the choice or interpretation of the assessment strategy?
- Conflicting information between the child and parents/carers regarding the hearing concerns or their impact on daily life?
- 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 adjusting your communication style, tone, or using play-based techniques to build rapport and gather information?
- Are you consulting guidelines on paediatric history-taking or adaptable assessment strategies for uncooperative children?
- Are you seeking advice from a more experienced colleague or your training officer regarding a challenging interaction or an unexpected developmental concern?
- Are you changing your initial assessment plan (e.g., prioritizing certain tests, introducing breaks) based on the child’s immediate presentation or parental input?
- 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 child’s needs suddenly appear complex or require multidisciplinary input)?
- What are you learning in this moment as a result of any unexpected development? For example, are you learning new techniques for engaging children and their families, or a more adaptable approach to paediatric assessment planning in dynamic situations?
On action
- Begin by summarising the key points of how you took the clinical history and formulated the hearing assessment strategy for a school-age child without complex needs.
- Consider specific events, actions, or interactions that felt important, such as engaging with the child or parent, obtaining relevant information from different sources, or adapting the strategy to the child’s behaviour or attention span. How did you feel during this process?
- Include any ‘reflect-in-action’ moments, where you had to adapt your communication approach or initial strategy as the child’s cooperation or the parent’s input unfolded.
- Identify what learning you can take from this experience regarding clinical history taking and strategy formulation for school-age children.
- What strengths did you demonstrate (e.g., child-friendly communication, engaging with parents, flexibility)?
- What skills and/or knowledge gaps were evident (e.g., specific paediatric history questions, understanding age-appropriate tests, managing dynamic situations)?
- Compare this experience against previous engagements with similar activities. Were any previously identified actions for development achieved? Has your practice in paediatric history taking and strategy formulation improved?
- Identify any challenges you experienced (e.g., difficulty obtaining information from a shy child, managing parent expectations, limited attention span) 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 regarding the history or the assessment strategy for a school-aged child.
- 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 take a history or formulate a strategy for a school-age child?
- 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 aspect of communication with children/parents or tailoring assessment strategies further?
Beyond action
- Have you revisited your previous reflections (reflect-before-action, reflect-in-action, and reflect-on-action) for this specific activity (taking clinical history and formulating assessment strategies for school-age children)?
- When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to engaging with children and parents/carers, adapting questions for age-appropriateness, managing child behaviour during history taking, or selecting suitable paediatric assessment techniques?
- 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 paediatric history taking and strategy formulation with peers, near peers, or colleagues? Has discussing these experiences with others changed your view or understanding of effective communication with children and families, the impact of developmental stage on history, or the nuances of paediatric test selection?
- 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 taking clinical histories and formulating assessment strategies for school-age children developed and evolved over time across multiple instances of undertaking this training activity?
- Can you identify specific examples of improvement or increased confidence in building rapport with children, obtaining relevant information from parents, or confidently adapting assessment strategies based on the child’s needs and cooperation?
- Based on your experiences, how has your ability to recognise when something related to paediatric patient history or assessment strategy is beyond your scope of practice improved?
- Do you have a clearer understanding of when and from whom (e.g., supervisor, paediatric audiologist, child psychology/development specialist) you need to seek advice or clarification regarding complex paediatric cases, safeguarding concerns raised during history, or assessment of children with significant developmental delays?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 5 |
Outcome
Assess hearing function in school age children and assist in the hearing assessment of infants and pre-school children using a range of standard diagnostic tests. |