Training activity information
Details
Safely conduct appropriate assessments using additional diagnostic techniques for patients with complex audiological presentation, including:
- Single-sided deafness and significant asymmetrical hearing loss (≥30dB difference on four-frequency average)
- Flat, “cookie bite” and reverse-sloping hearing loss
- Steeply-sloping hearing loss
- Hearing difficulties with a normal audiogram
- Suspected non-organic hearing loss
- Progressive hearing loss
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
- Pathophysiology
- Patient history
- Referral information
- Local, national, international guidelines and standards
- Range of diagnostic testing techniques, such as speech audiometry, acoustic reflex thresholds, diagnostic otoacoustic emissions, Stenger test and aided speech testing
- Communication skills
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 principles and procedures for conducting assessments for each of these complex audiological presentations (e.g., TEN test, Stenger test for suspected non-organic hearing loss)?
- Consider reviewing the pathophysiology and assessment options for these conditions.
- What specific challenges do you expect when assessing these complex cases?
- Think about the process of synthesising results from different tests.
- What do you already know about these complex audiological profiles?
- Review the relevant protocols and interpretation guidelines for these tests.
- Consider how the results from these tests contribute to the overall diagnostic picture.
In action
- Which additional diagnostic techniques are you selecting and how are you performing them safely for this patient with a complex audiological presentation? Why are you choosing these specific tests?
- What decisions are you making regarding test parameters, infection control procedures, and patient comfort during these more complex assessments?
- How are you explaining the purpose and procedure of these tests to the patient?
- Are you encountering any technical difficulties while performing these additional diagnostic tests?
- What observations are you making about the patient’s responses and behaviours during these tests?
- Are there alternative diagnostic techniques you might need to consider if the initial choices are inconclusive or not well-tolerated by the patient?
- What guidance or supervision might you require from a qualified clinician when conducting these more specialised assessments?
- Are you ensuring that you are competent in the safe and accurate administration of these diagnostic techniques?
On action
- Summarise the specific additional diagnostic techniques you employed for the patient with the complex audiological presentation. What were the key findings from these additional tests? How did these findings contribute to a clearer understanding of the patient’s hearing profile? Were there any challenges in the safe performance or interpretation of these techniques?
- What new skills or deeper understanding did you gain in using these additional diagnostic techniques? Were there any unexpected results or interpretive challenges? What did you learn from these? How did your real-time observations and interpretations guide your selection and application of these techniques? How does this experience enhance your ability to assess complex audiological cases?
- What areas for further development in your use and interpretation of these advanced diagnostic techniques have been identified? How will you apply this learning to future assessments of patients with complex presentations? What specific actions will you undertake to improve your proficiency in these techniques? What resources or supervision would be beneficial for your continued learning?
Beyond action
- Looking back at instances where you’ve used additional diagnostic techniques for complex presentations, how has your confidence in selecting and interpreting these tests grown?
- How have these experiences improved your ability to formulate a comprehensive audiological picture when standard assessment findings are unusual or inconclusive?
- In what ways has your understanding of specific audiological conditions (e.g., single-sided deafness, non-organic hearing loss) deepened through the practical application of these diagnostic techniques?
- How has your awareness of the limitations and potential pitfalls of these advanced techniques evolved over time?
- What further opportunities will you seek to refine your skills in conducting and interpreting assessments for complex audiological presentations?
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. |