Adult Audiology —
Training activity: 5

Details

Modify hearing assessment and management plans for patients with related healthcare needs or diagnoses, including:

• Dual sensory impairment
• Physical disabilities/difficulties
• Mental health conditions

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Considerations

• Principles of patient-centred care
• Patient history
• Effective communication and counselling
• Use of interpreters
• NHS Accessible Information Standard
• Holistic patient care and patient experience
• Referral pathways
• Risk assessment and mitigation plans.
• Modifications to the clinical environment, case history, assessment and management techniques
• Setting of appropriate expectation levels
• Environmental modifications to aid discrimination
• Shared decision making
• Communication barriers
• Scope of practice
• Onward referrals
• Ongoing audiology support and alternative methods of support for the patient
• 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 are the specific considerations for assessing patients with dual sensory impairment, physical disabilities, and mental health conditions?
• Consider reviewing information about patient-centred care approaches for these groups. Are there specific modifications to standard audiological tests that might be necessary?
• Discuss with your training officer any specific protocols or resources available for working with these patient groups.
• What specific challenges do you anticipate in modifying assessment and management plans for these patients?
• Think about how you will need to adapt your communication and approach.
• Consider potential barriers to assessment and management and brainstorm potential solutions.
• Think about how you will ensure patient comfort and engagement during the assessment process.
• What other healthcare professionals could you need to collaborate with to ensure more effective assessment and management for these patients?
• Think about how you may need to engage with and involve family, friends, or care-givers in the appointment with these patient groups.

In action

• How are you modifying the standard assessment and management plan to accommodate the patient’s specific healthcare needs or diagnoses? Why are you making these modifications?
• What decisions are you making regarding the pace of the assessment, the positioning of the patient, the clarity of instructions, and the inclusion of support persons?
• What adaptations to your counselling approach are you implementing to address the patient’s dual sensory impairment, physical disabilities, or mental health condition?
• How effective are your modifications in obtaining reliable assessment results and facilitating the patient’s understanding?
• What challenges are you encountering due to the patient’s related healthcare needs or diagnoses?
• What can you learn from the patient’s engagement and feedback as you implement the modified plan?
• Are there alternative modifications you could consider if your initial adaptations are not meeting the patient’s needs?
• What resources or information might you need to better understand the implications of the patient’s other conditions on their hearing care?
• Are you ensuring that the modified plan remains within your professional boundaries and adheres to best practice guidelines?

On action

• Begin by summarising the key modifications you made to the standard assessment and management plans. What specific healthcare needs or diagnoses significantly impacted the assessment or management process? What adjustments did you observe needing to be made to accommodate dual sensory impairment, physical disabilities/difficulties, or mental health conditions? How did these modifications affect the patient experience and the outcomes of the assessment or management?
• What skills or knowledge did you develop or improve in adapting audiological procedures for patients with additional needs? Were there any unexpected challenges or successes in modifying the plans? What did you learn from these? How did your reflection-in-action influence your approach to modifying the assessment and management? How does this experience relate to the principles of patient-centred care?
• What areas for continued development in adapting audiological care for diverse patient needs have been identified? How will you apply this learning to future cases involving patients with related healthcare needs or diagnoses? What specific actions or further learning will you undertake to enhance your skills in this area? What resources or support might be beneficial for your ongoing development?

Beyond action

• Looking back at different times you’ve modified assessment and management plans for patients with co-morbidities, what key adaptations have become more intuitive in your practice?
• How have these experiences shaped your understanding of patient-centred care and the importance of considering individual needs beyond their audiological presentation?
• Can you identify specific examples where your learning from this DTA has helped you to approach other complex cases, even those without the exact same co-morbidities?
• How has your knowledge of resources and interdisciplinary collaboration for patients with these related healthcare needs grown since undertaking this activity?
• What further learning or experiences would you seek out to enhance your ability to adapt hearing assessment and management plans for diverse patient populations?

Relevant learning outcomes

#	Outcome
# 1	Outcome Use a range of tests to safely assess the extent and nature of auditory problems in adults, including those with complex aetiologies, complex audiological configurations and comorbidities.
# 2	Outcome Apply shared decision-making to develop an individualised management plan and counselling for adults with hearing loss and other auditory difficulties, taking into account differing cultural and social attitudes to hearing care.
# 3	Outcome Evaluate individual patient outcomes and safely manage a range of routine and complex hearing losses.
# 4	Outcome Practice within their own personal and professional scope, identifying where onward referral is appropriate.