Curriculum for Graduate Courses in Amplification

Most academic programs have acknowledged that at least two courses devoted to amplification as well as extensive clinical practica are necessary for the adequate mastering of basic hearing aid evaluation, selection, fitting, verification, and validation. This, of course, would be in addition to courses in managing hearing loss (aural rehabilitation) in adults and children where assistive listening technology other than hearing aids also would be covered. A two-course sequence is often motivated by simply not having enough time to cover all of the material in one term. Therefore, it is tempting to try to find a logical breaking point and simply divide the material in two. It is the author's experience that this does not work when teaching and learning in the area of amplification. Students need a systematic course which presents the entire hearing aid fitting process and which flows without interruption. There is this need partially to create a logical presentation of the material and partially because of the demands of clinical practicum. The second course is then devoted to indepth examination of various areas covered in the preliminary course. The students leave the first course with a basic working knowledge of fitting hearing aids. They bring this knowledge to clinical practicum and to the second course and can then work with much more advanced material. When the course is simply split in two, the students do not come away with a complete picture and therefore are not able to apply the more indepth information. This curriculum covers a two-course sequence, but the second course is really a more indepth examination taken from the same outline. Appendix A provides an example syllabus for the first course. Each class period is divided into lecture/discussion and lab. The intention is to provide both the theoretical basis for the topic and the clinical application in the same class period in order to encourage the students to think of the two as inseparable and often indistinguishable. The second course is organized in a seminar format where each student is responsible for one course period (approximately 3 hours). The first few class periods are conducted by the instructor, clinical supervisors, and/or invited guest experts. This provides the students with several weeks in which to plan their sessions. Each student picks a topic related to amplification and must create a reading list, homework assignment, and activity for their class meeting. The student provides his/her classmates with all of the necessary materials and assignments two weeks prior to the class meeting. Although this allows a great deal of latitude in terms of topics, critical areas are chosen each semester. By the end of the first course, students are well aware of the areas that they need more knowledge and experience in and these tend to include: compression and the interaction of variable time constants, adaptation to hearing aid use, tinnitus evaluation and remediation, implantable hearing aids, transposition hearing aids, empirical evidence related to multi-channel and multi-memory technology, advanced microphone technology, verification techniques, etc. As mentioned, the students provide a required reading list to their classmates and some sort of assignment. Assignments have included dividing the class in two and creating teams that debated the existence (based on empirical data) of auditory perceptual learning, role playing regarding hearing aid trouble shooting and repair, comparing various programmable hearing aids in terms of programmable parameters, etc. Students also may use sessions of the course (beyond the one that they are responsible for) to bring in guest speakers (e.g., hearing aid repair workshop, hearing aid representatives presenting specific information, individuals presenting fitting protocols, etc.). The curriculum presented within these pages is meant to be a format within which to learn and think about amplification. In that sense, it is a living, changing document. This format has been developed over a period of a decade of fitting hearing aids and teaching about fitting hearing aids. Both activities have aided in the development of the structure of the curriculum. Students are able to manage the material and therefore expend their energy on the higher cognitive tasks of integrating and relating material from different courses and different components of the course when the material is presented in a logical structure related to fitting amplification. The format of the course has become so essential due to the content literally changing by the time a student graduates that students now are provided with the notebook dividers (Figure 1) that will organize the material and their thinking related to amplification. Figure 1. Sections of the hearing aid notebook. The major headings: introduction to hearing aids, diagnosis, up-front considerations, ordering/selecting the hearing aids, fine-tuning/verification of selection, orientation/follow-up/benefit, and trouble shooting have never changed. These take the student logically from the beginning to the end (the word “end” is used loosely) of a hearing aid fitting. Audiologists will always need to measure something about the auditory system or decide to use average data, the hearing aids will have to be obtained and pre-set, some sort of verification will always be necessary to insure that the audiologist has done what was planned, and an evaluation of some kind will be necessary to establish that the hearing aids have impacted the individual in some positive way. The subheadings have changed over the past decade, most notably under the up-front considerations (some headings have been deleted, some have been added) and under ordering/selecting the hearing aids. The subheadings are meant to change to reflect current practice and current empirical data. Most importantly, the readings under each subheading change constantly in order to reflect the most recent information on a given topic. This structure allows one to continue to integrate new information into the course and into clinical practice without having to start from scratch each time. As the students leave the program, the course outline provides them with a way to continue to learn about hearing aids as new information is reported. Furthermore, the format provides a method for evaluating new information and to see how it fits in with previous information and practice.