Document 1. – Knowledge & Skills Guide Intern’s Name: ……………………………………………………………………
COMPETENCY LEVEL DESCRIPTORS:
LEVEL ONE – Duration: Minimum of four weeks or the time taken to be ready to move to ‘Consolidating’ Novice: ; Performs the activity with significant supervision and guidance ; Performs basic routines and predictable tasks ; Little or no responsibility or autonomy Developing: ; Supervision is only required in more complex circumstances ; Some individual responsibility or autonomy
LEVEL TWO – Duration: Minimum of 10 weeks or the time taken to be ready to move to ‘Competent’ Consolidating: ; Performs the activity in some complex and non routine contexts ; Significant responsibility and autonomy ; Can oversee the work of others LEVEL THREE – Duration: Balance of 12 months (EFT) focussing on transition to ‘Independent’ Competent: ; Performs the activity in a wide range of complex and non-routine contexts ; Substantial personal autonomy ; Can develop others in the activity
CERTIFICATE OF CLINICAL PRACTICE = Independent: ; Can take a strategic view ; Applies a significant range of fundamental principles and complex techniques across a wide and often unpredictable variety of contexts. ; Wide scope of personal autonomy.
KNOWLEDGE & SKILLS GUIDE THEORETICAL KNOWLEDGE & ABILITIES – POINTS 1 – 8 Clinical Clinical Skills ; The first 8 items are assumed knowledge for Graduates from Australian Skills your Intern Audiology Programs, but it may be useful to review this in light of a Graduate’s Available in Requires for particular Tertiary Results or Clinical Practicum Report. Your Clinic Your Clinic ; In the case of an Overseas Trained Audiologist, it is mandatory that the Supervisor ascertain this Intern’s knowledge base with particular reference to the Australian clinical environment, client base and any other relevant factors.
1. Auditory pathology Interns should be able to identify and describe conditions that cause hearing loss, tinnitus, vertigo, ear pain or discharge, and other auditory symptoms. They should be able to relate this knowledge to a client's audiological history and findings and identify situations where urgent medical follow-up is required.
2. Acoustics and instrumentation Interns should have a working knowledge of the physics of sound transmission and measurement and instrument calibration and should know where to find appropriate acoustical standards.
3. Auditory physiology Interns should be able to describe and explain the anatomy and physiology of the auditory system and auditory neural pathways.
4. Psychoacoustics and psychology Interns should be able to describe and explain the processing skills of the normal auditory system and relate these to known physiological mechanisms.
5. Tests and measurement Interns should also be able to select and evaluate audiometric test procedures according to the basic principles of test development and selection (e.g. reliability, sensitivity, etc.).
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131 (Suite 7, 476 Canterbury Road, Forest Hill Vic 3131) V.1 December 2009
Document 1. – Knowledge & Skills Guide
Intern’s Name: ……………………………………………………………………
Clinical Clinical
Skills Skills your
Available Intern
in Your Requires for
Clinic Your Clinic 6. Speech, language and communication Interns should have a working knowledge of acoustic phonetics, language development, audio-visual speech reception, and speech production. They should be able to apply this information to assess or estimate the impact of hearing loss upon the perception and production of speech, and upon language development.
7. Medical background for audiology Interns should be able to identify and describe the basic principles underlying otological conditions, such as the effects of ototoxic agents, the pathology and natural history of infectious disease, basic genetics, and embryological development of the auditory system. They should also be able to describe some common treatable conditions affecting the auditory system and the usual medical or surgical interventions for these.
8. Professional practice Interns should demonstrate knowledge of the ethical practice of audiology and be familiar with the codes of ethics of the relevant professional associations. Interns should also be familiar with the broad areas of expertise and practice of other health and related professionals - e.g. speech pathologists, general and specialist medical practitioners, clinical psychologists, occupational therapists, special education teachers - sufficient to refer their clients appropriately to these professionals.
AUDIOLOGICAL SERVICES – THESE DESCRIPTORS MAY BE AMENDED TO
BETTER DESCRIBE THEIR APPLICATION TO YOUR CLINIC
9. Diagnostic audiology and otoscopy Interns should be able to recognise the presence of conditions of the external ear preventing accurate threshold audiometry and refer appropriately for management. Interns should be able to obtain accurate pure tone air and bone conduction thresholds, using appropriate masking techniques, for most hearing loss configurations. They should be able to take account of subject variables, such as age, motivation, tinnitus, and intellectual ability, and modify or simplify procedures in an appropriate way. They should also be aware of tester variables, which could affect results, such as rate of presentation and additional cues, and be able to modify their technique when necessary. They should be aware of the effects of calibration errors and be able to take account of such errors with unfamiliar equipment. They should be able to practise identification audiometry according to the principles of screening.
10. Paediatric Diagnostic audiometry Interns should be able to select and/or modify procedures for the assessment of hearing thresholds in children of all ages; carry out these procedures in children over three years, developmentally, in a manner likely to obtain accurate results; interpret results appropriately, and recommend follow-up assessment that is likely to provide accurate diagnosis of hearing loss as early as possible. Please indicate below the age range the clinic offers assessments for:
Neonates
9 months – 3 years of age
3 years – 6 years
6 years +
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131 (Suite 7, 476 Canterbury Road, Forest Hill Vic 3131) V.1 December 2009
Document 1. – Knowledge & Skills Guide
Intern’s Name: ……………………………………………………………………
Clinical Clinical
Skills Skills your
Available Intern
in Your Requires for
Clinic Your Clinic 11. Impedance (immittance) audiometry Interns should be able to recognise conditions of the external ear and canal preventing tympanometry and refer appropriately for management. Interns should be able to obtain accurate tympanometry and acoustic reflex results under most clinical conditions with all age groups. They should be able to assess impedance results against audiometric findings and evaluate their consistency.
12. Speech audiometry Interns should be able to select appropriate speech audiometry measures for clients and carry out such testing in a manner likely to give reliable results. They should be able to assess speech results against audiometric findings and evaluate their consistency.
13. Evoked potential testing Interns should be able to recommend the use of suitable evoked potential testing in the diagnosis of hearing loss (e.g. ABR, ERA, ECochG). In particular, the applications of Auditory Brainstem Response (ABR) audiometry to identifying retrocochlear pathology and to the assessment of hearing in infants and other difficult-to-test clients should be thoroughly understood. Interns should be able to carry out ABR assessment, interpret results appropriately and integrate these with other audiological findings.
14. Integration of audiological results Interns should be able to form reasonable conclusions about the likely type and site of pathology in patients with auditory symptoms based on case history and interview, behavioural audiometric information and electrophysiological measures. In particular, Interns should be able to analyse the results for consistency and recommend further action that is likely to resolve inconsistencies. They should also be able to evaluate results to recommend medical and/or other follow up. Interns should be able to produce clear and concise reports on audiological findings and their interpretation for clients, parents, and other health and education professionals, and to write clear and concise referrals to other professionals.
15. Communication assessment and intervention Interns should be able to assess a client's communication needs and formulate an appropriate management plan. Interns should be able to provide basic advice on hearing re/habilitation options and services to the client and relevant others.
16. Prescription and Fitting of Hearing Aids Interns should be able to recommend, fit and evaluate appropriate amplification and monitor and document outcomes. It is expected that they should be able to take into account factors including the type and degree of hearing loss, use appropriate prescriptive techniques and modify their approach according to client variables such as age and communication needs. It would be expected that they perform a communication needs analysis to establish realistic rehabilitation goals and develop appropriate strategies. They should have the ability to select appropriate earmould features and take quality ear impressions
17. Informational counselling Interns should demonstrate the basic communication skills required to impart useful information about audiological results and management to clients.
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131 (Suite 7, 476 Canterbury Road, Forest Hill Vic 3131) V.1 December 2009
Document 1. – Knowledge & Skills Guide
Intern’s Name: ……………………………………………………………………
Clinical Clinical
Skills Skills your
Available Intern in Your Requires for
Clinic Your Clinic 18. Standards and procedures Interns should be able to perform simple electro-acoustic measures of audiometer output and of sound-field acoustics. Interns should be able to describe and apply local standards of workplace safety, including infection control.
19. Otoacoustic emissions Interns should be able to explain the principles of otoacoustic emissions and their application to the description of auditory function. They should be able to recommend OAE testing and interpret the results appropriately and integrate them with other audiological findings.
20. Vestibular assessments Interns should be able to explain the principles of electro-nystagmography and caloric testing and be able to recommend vestibular tests appropriately for clients with balance disorders. They should be able to interpret results from these assessments appropriately and integrate them with other audiological findings.
21. Central auditory function assessments Interns should be able to explain the principles of central auditory function and assessment and be able to recommend tests of central auditory function for clients with auditory disorders. They should be able to interpret results from these assessments appropriately and integrate them with other audiological findings.
Adults: School Aged Children:
22. Aural Rehabilitation and Communication programs for complex clients Interns should be able to devise an aural rehabilitation program to meet the individual needs of a client. The program should address the specific goals the client has outlined. Interns should be able to identify additional tests complex clients may require to assess their communication needs and assist with formulating a specific rehabilitation program including device(s) fitting/strategies/communication training. Interns should be able to provide basic advice on hearing re/habilitation options and services to the client and relevant others.
23. Sensory devices Interns should be able to describe the principles of cochlear implant and other sensory device technology (e.g. vibrotactile aids, implantable hearing aids) and their application to assist people with severe and profound hearing loss. They should be able to interpret audiological results and histories in relation to candidacy for sensory devices for adults and children and advise clients on their suitability.
24. Assistive listening devices Interns should be able to describe the principles of assistive listening device technology (e.g. alarms, telephone devices, FM devices) and their applications to assist people with hearing loss. They should be able to interpret audiological and communication assessment results and recommend appropriate devices for adults and children, which are compatible with their personal device use.
25. Tinnitus assessment and intervention Interns should be able to recommend assessment and management strategies for clients with tinnitus and to advise of their effectiveness. They should be able to make appropriate referrals to specialist tinnitus services and interpret the information thus acquired.
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131 (Suite 7, 476 Canterbury Road, Forest Hill Vic 3131) V.1 December 2009
Document 1. – Knowledge & Skills Guide
Intern’s Name: ……………………………………………………………………
Clinical Clinical
Skills Skills your
Available in Intern
Your Clinic Requires for
Your Clinic 26. Hyperacusis Assessment Interns should be able to describe the causes and possible mechanism of hyperacusis. They should be able to outline an appropriate test battery and appropriate management strategies. They should be able to make appropriate referrals to specialist services and support networks.
27. Educational audiology Interns should be aware of the range of educational options available to hearing-impaired children and be able to provide descriptions and information about these to parents and to other professionals.
28. Occupational hearing loss Interns should be able to explain the principles of hearing conservation and describe the legislation, which applies in their state. They should have the skills to advise employers and employees of their rights and obligations under the relevant sections of their state Occupational Health and Safety Act.
29. Earplugs (Custom noise/swim/musicians plugs) Interns should be able to take quality impressions of the ear. Interns should be familiar with the different styles and types of earplugs available and be able to recommend the appropriate type to meet the client needs.
30. Community Education Interns should be able to describe a range of formal and informal methods to educate individuals and groups of all ages about audiology and hearing health care.
31. Deafness studies Interns should understand the needs and aspirations of the Deaf community. They should have an understanding of the variety of non-verbal communication systems used by members of Deaf communities and be able to recognise and describe these.
32. Intra-operative monitoring Interns should demonstrate an understanding of common situations in which audiologists may use electro-physiological tests to monitor cranial nerve function during surgery.
33. Practice management Interns should demonstrate an understanding of a range of issues relevant to the conduct of an independent audiological practice; e.g. business, legislative, management, ethical, promotional and marketing issues.
Audiology Australia, PO Box 504, BRENTFORD SQUARE VIC 3131 (Suite 7, 476 Canterbury Road, Forest Hill Vic 3131) V.1 December 2009