Classroom in the Clinic Nationwide, some AuD programs follow the tried-and-true formula of offering a general pediatric audiology course that familiarizes students with, for example, audiologic rehabilitation or cochlear implants. This foundation in pediatric audiology is essential, but without associated clinical training it does not prepare students adequately to evaluate children. And the fact ... Features
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Features  |   March 01, 2012
Classroom in the Clinic
Author Notes
  • associate professor and coordinator of the audiology program in the Department of Communication Sciences and Disorders, Missouri State University. She is a member of Special Interest Group 6, Hearing and Hearing Disorders: Research and Diagnostics. Contact her at wafaakaf@missouristate.edu.
    associate professor and coordinator of the audiology program in the Department of Communication Sciences and Disorders, Missouri State University. She is a member of Special Interest Group 6, Hearing and Hearing Disorders: Research and Diagnostics. Contact her at wafaakaf@missouristate.edu.×
Article Information
Hearing Disorders / School-Based Settings / Professional Issues & Training / Features
Features   |   March 01, 2012
Classroom in the Clinic
The ASHA Leader, March 2012, Vol. 17, 16-18. doi:10.1044/leader.FTR2.17032012.16
The ASHA Leader, March 2012, Vol. 17, 16-18. doi:10.1044/leader.FTR2.17032012.16
Nationwide, some AuD programs follow the tried-and-true formula of offering a general pediatric audiology course that familiarizes students with, for example, audiologic rehabilitation or cochlear implants. This foundation in pediatric audiology is essential, but without associated clinical training it does not prepare students adequately to evaluate children. And the fact is, many audiology students lack access to hands-on clinical work with children (Oyler & Matkin, 1987), and some pediatric audiologists lack “pediatric expertise” (Madell, 2009).
Wafaa Kaf (far left) supervises her former students (from left) Katie Lewis and Kristin Robinette(Gossett) as they prepare a child for play audiometry.
An uncooperative or inattentive child can skew a valid, reliable behavioral hearing assessment. For this reason, students’ inadequate clinical experience with children is a concern. And it is underlined by a significant shortage of pediatric audiologists (ASHA, 2007). When students entering the workforce aren’t prepared to evaluate and treat children, it can be challenging to meet state requirements for newborn hearing screening and intervention services, as well as Joint Committee on Infant Hearing (JCIH) recommendations for universal early hearing detection and intervention. Using a service-learning model may provide AuD programs with the means to meet these challenges head-on.
A service-learning model moves beyond traditional lectures and textbooks to active learning (Fink, 2010). Students participate in educational activities that meet community needs (Bringle et al., 2004). Because community experiences are an integral part of service-learning courses, these activities can be designed to serve children at risk for hearing loss and otitis media—such as children attending day care centers, children with Down syndrome, low-income and minority children, and homeless children.
The Service-Learning Model
Prior studies indicate that programs with service-learning courses provide students with in-depth knowledge of course content, concepts, and applications in communication sciences and disorders at both undergraduate (Peters, 2011) and graduate levels (e.g., Cokely & Thibodeau, 2011; Kaf et al., 2011).
Inspired by such findings, my co-author Elizabeth Strong and I sought to integrate a service-learning project into my pediatric audiology course with help from Missouri State University’s Citizenship and Service Learning office. In 2005, we developed a course that met the university’s criteria for integrated service learning—a minimum of 15 hours of experiential education for each student that includes personal reflection, assessment, and interaction with community partners.
Next, we identified four community partners from Springfield, Missouri: a support group for children with Down syndrome, the University Child Care Center, Missouri State University’s Child Development Center, and The Kitchen Clinic, Inc., a local organization that provides services with the support and cooperation of the professional health care community. We recently added the Women, Infants, and Children (WIC) center and the Rivendale Center for Autism. Our service-learning pediatric audiology course presented an opportunity to bridge the gap between pediatric training, knowledge and skills acquisition (KASA) standards, and ASHA recommendations that audiology students be prepared with extensive academic and clinical training with pediatric populations—and take steps toward overcoming the shortage of pediatric audiologists (ASHA, 2007; Madell, 2009).
We hypothesized that experience-based learning would significantly enhance students’ clinical skills and increase their civic engagement and interest in pediatric audiology (Kaf & Strong, 2011). We sought to determine if service learning would affect AuD students’ clinical competency with children, their interest in pediatric audiology as a career, levels of community engagement, and impact on the community. Forty-eight AuD students enrolled in the service-learning pediatric audiology course, and 10 non-service-learning AuD students from a traditional pediatric audiology class served as controls.
Student Activities
Our pediatric audiology course was the students’ first exposure to the subject. The class was designed to help students use classroom knowledge in practical situations, teach them how to communicate with and evaluate young children, cultivate their interest in pediatric audiology, and address social issues pertinent to hearing loss and otitis media in children.
First, the 48 service-learning students learned course material on otoscopic examination, behavioral hearing evaluations, and middle-ear function testing in children. Each then provided a minimum of 15 hours of supervised, unpaid hearing and middle-ear testing to children in the community, resulting in a total of 720 hours of community service over four semesters. The service-learning group tested both ears of 292 children (163 boys) aged 6 months to 5 years.
Students explained the test results to parents, and gave each a written report with recommendations for rescreening or referral for medical intervention. In contrast, for the purposes of this study the non-service-learning group was not required to provide audiological evaluation to young children. They learned about audiological evaluation of pediatric populations only through a didactic course.
Student Assessments
We administered two surveys to both student groups. The 19-item Student Attitude, Opinion, and Preference (Lewis & Seymour, 2005; Williams & Deci, 1996) gauged their perceived readiness and apprehension levels regarding work with children, their expectations for service learning, and their interest in pediatric audiology as a career. The 12-item Student Assessment of Learning Gains (Weston, Seymour, Lottridge, & Thiry, 2006) measured the impact of service learning on students’ clinical skills and interest in specializing in pediatric audiology.
Students wrote papers on how they perceived the value of service learning. We used these papers to assess students’ clinical skill development, interest in pediatric audiology as a career, and levels of community and civic engagement. Parents and community partner staff completed a separate survey to provide feedback on the students’ services to children. Results included:
  • Service-learning students were overall more positive (71%) about pediatric services than non-service-learning students (37%).

  • Service-learning students were significantly less apprehensive about testing children and showed gains in perceived competency and interest in working with children.

  • Assessment of students’ reflection papers suggested that the service-learning experience advanced students’ clinical skills with young children (87%), improved their level of civic and community engagement (85%), and increased their interest in becoming pediatric audiologists (42%).

  • All the staff and most parents indicated that audiology students were knowledgeable, respectful, professional, confident, and friendly when evaluating children. Ninety-two percent of parents—including all parents of children with Down syndrome—were willing to receive student services again.

Overall, the service-learning experience led to positive and desirable outcomes for students, such as the opportunity to gain early clinical experience with adequate practice, increased comfort levels when working with children, and increased motivation to give something back to the community. These characteristics align with JCIH recommendations (JCIH, 2007) and KASA standards stating that audiologists should be knowledgeable, be sensitive to cultural differences, and interact effectively with children and their parents.
Sources
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Bringle, R. G., Philips, M. A., & Hudson, M. (2004). The measure of service learning: Research scale to assess students’ experiences. Washington, DC: American Psychological Association.
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Cokely, C.G., & Thibodeau, L.M. (2011). Service learning in auditory rehabilitation courses: The University of Texas at Dallas. American Journal of Audiology, 20, S233–S240. [Article] [PubMed]
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Fink, L. D. (2010). The joy and responsibility of teaching well. ASHA Leader, August 31, 10–13.
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Joint Committee on Infant Hearing. (2007). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention. Available from www.asha.org/policy.
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March 2012
Volume 17, Issue 3