Paediatric Audiology —
Training activity: 7

Details

Select and safely verify  hearing aids for  school-age children and report the findings to the relevant professionals

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

• Principles of patient-centred care and support
• Hearing aid types, including air conduction and bone conduction devices
• Methods of verification
• Parental/child consent
• Integration with assistive listening devices, including wireless systems and radio aids
• External educational support
• Hearing aid programs and features

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?
  • What are the criteria for selecting appropriate hearing aids and safely performing verification (e.g., using real-ear measures like RECD) for school-age children with diverse hearing losses?
  • Have you discussed expectations with your training officer?
• What is your prior experience of this activity?
  • Have you selected or verified hearing aids for school-age children before?
  • What do you already know about paediatric hearing aid technology and verification procedures?
  • What specific challenges related to selecting aids for complex losses, obtaining accurate verification measurements, or using fitting software might you face? How might you plan to handle them?
  • What is the scope of your own practice for selecting and verifying hearing aids in school-age children?
  • When should you seek advice on selection rationale or verification procedures, and from whom?
  • How do you feel about fitting hearing aids on school-age children?
• What do you anticipate you will learn from the experience?
  • What specific aspect of hearing aid selection or verification (e.g., understanding different technology levels, mastering RECD measurement, applying prescriptive targets) do you want to focus on improving, drawing upon previous experiences?
  • What specific insights into optimising hearing aid fittings for children do you hope to gain?
• What additional considerations do you need to make?
  • Have you reviewed any actions identified from your previous reflections on hearing aid fitting or verification?
  • Do you need to check that the verification equipment is calibrated and ready?
• Do you need to review the child’s audiogram and history, and potentially review different hearing aid options or verification protocols?

In action

• During the activity is anything unexpected occurring?
  • Are you noticing anything surprising or different from what you anticipate during the selection and verification process? Are you encountering situations such as:
    • Significant technical difficulties in safely recording an RECD (Real-Ear-to-Coupler Difference) due to anatomical issues or child movement?
    • Verification results showing a major deviation from prescriptive targets, suggesting a technical issue with the device or the selection?
    • Unexpected complexities arising during the selection of hearing device technology due to the child having additional needs (e.g., severe physical disabilities)?
  • How is this experience comparing with previous experiences of similar activities?
• How do you react to the unexpected development?
  • How is the unexpected development being resolved as you progress during the activity? Are you successfully managing the situation yourself (e.g., troubleshooting equipment, adjusting the programming), or do you need support because the issue requires complex hearing device technology knowledge or assistance from relevant professionals?
  • What are you learning in this moment as a result of the unexpected development? For example, are you learning a quicker way to troubleshoot verification software, or a more robust method for tailoring hearing aid technology selection to fit specific complex needs?
  • How is this impacting your actions?
    • Are you responding to the situation appropriately? Are you adapting or changing your approach to the verification procedure (e.g., modifying the measurement sequence, immediately consulting device protocols)?
    • Is this unexpected event affecting your ability to undertake the activity independently?
    • Specifically, are you immediately consulting colleagues regarding the selection and verification of advanced hearing device technology, or are you re-measuring the RECD to verify the unexpected result?
  • How are you feeling in this moment?
• What is the conclusion or outcome?
  • How are you working within your scope of practice? E.g. Are you practising within your scope by safely verifying hearing aids, ensuring that you are identifying and rectifying technical issues (like RECD failure), or are you re-measuring results to verify any unexpected deviations? Are you successfully selecting technology, ensuring complex decisions regarding hearing devices align with the school-age child’s additional needs, consulting relevant professionals when necessary?
  • What do you learn as a result of the unexpected development? E.g Are you gaining increased proficiency in troubleshooting verification software and equipment efficiently during the appointment? Are you learning a more robust method for tailoring hearing aid technology selection to fit specific, complex needs in order to provide appropriate hearing recovery?

On action

• What happened?
  • Begin by summarising the process of hearing aid selection and verification, detailing the verification methods used (e.g., Real-Ear-to-Coupler-Difference (RECD)).
  • Consider specific events or interactions that felt important, such as successfully recording a reliable RECD or encountering unexpected results during real-ear measurements that contradicted prescriptive targets. How did you feel when faced with unexpected verification results?
  • Include any ‘reflect-in-action’ moments, where you adapted your steps, such as immediately adjusting the hearing aid coupling or troubleshooting the verification equipment in response to an immediate reading.
• How has this experience contributed to your developing practice?
  • Identify what learning you can take from this experience. What strengths did you demonstrate (e.g., proficiency in verification equipment, technical knowledge of paediatric hearing aid features)? What skills and/or knowledge gaps were evident (e.g., achieving target gain efficiently, accurate interpretation of complex verification data, understanding specific software limitations)?
  • Compare this experience against previous engagements. Has your practice in hearing aid verification improved?
  • Identify any challenges you experienced (e.g., persistent equipment errors during RECD measurement, difficulty obtaining a stable measure from the child) and how you reacted.
  • Identify anything significant, such as needing to seek advice or clarification on reporting verification findings to a Teacher of the Deaf.
• What will you take from the experience moving forward?
  • Identify the actions or ‘next steps’ you will take.
  • What will you do differently next time? Do you need to practise any specific aspect of verification (e.g., troubleshooting equipment, optimising probe microphone placement) further? E.g.
    • Troubleshooting Real-Ear-to-Coupler-Difference (RECD) equipment errors and optimising probe microphone placement to secure reliable measures quickly.
    • Developing a standard protocol for adjusting hearing aid coupling immediately after observing unexpected results during verification to efficiently achieve prescriptive targets.
    • Clarifying and documenting specific reporting requirements for verification findings when communicating with relevant professionals, such as a Teacher of the Deaf.

Beyond action

• Have you revisited the experiences?
  • Have you revisited your previous reflections (reflect-before-action, reflect-in-action, and reflect-on-action) for this specific activity (selecting and safely verifying hearing aids and reporting findings)?
  • When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to accurate selection of hearing aids based on prescription, performing safe and precise Real-Ear-to-Coupler Difference (RECD) measurements, achieving verification targets using Real Ear Measurement (REM), or concisely reporting technical findings to professionals?
  • 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 hearing aid verification with peers, near peers, or colleagues? Has discussing these experiences with others changed your view or understanding of managing technical challenges during REM, the impact of verification results on habilitation, or best practices for inter-professional report writing?
• How have these experiences impacted upon current practice?
  • 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? For example, your improved skill in verification enhances your overall ability to provide hearing habilitation for school-age children.
  • How has your practice related to selecting and safely verifying hearing aids and reporting findings developed and evolved over time across multiple instances of undertaking this training activity? Can you identify specific examples of improvement or increased confidence in troubleshooting technical issues during verification, interpreting complex verification results, or tailoring reports to the needs of the receiving professional?
  • Based on your experiences, how has your ability to recognise when something related to hearing aid verification or reporting is beyond your scope of practice improved? Do you have a clearer understanding of when and from whom (e.g., manufacturer technical support, senior verification specialist, Teacher of the Deaf) you need to seek advice or clarification regarding persistent acoustic feedback issues, unusual verification discrepancies, or complex reporting requirements for legal/educational purposes?

Relevant learning outcomes

#	Outcome
# 6	Outcome Provide hearing habilitation for school-age children.