Big Ten Consensus Statement Regarding the Future of Audiology Education As of July 4, 2003, the consensus statement was unanimously ratified by the faculties of audiology and speech-language pathology (communicative disorders) programs at Arizona State University, Boston University, Howard University, Indiana University, Michigan State University, Ohio State University, Pennsylvania State University, Purdue University, San Diego State University/University of California San ... Academic Edge
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Academic Edge  |   September 01, 2003
Big Ten Consensus Statement Regarding the Future of Audiology Education
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Hearing Disorders / Professional Issues & Training / Academic Edge
Academic Edge   |   September 01, 2003
Big Ten Consensus Statement Regarding the Future of Audiology Education
The ASHA Leader, September 2003, Vol. 8, 11-12. doi:10.1044/leader.AE.08162003.11
The ASHA Leader, September 2003, Vol. 8, 11-12. doi:10.1044/leader.AE.08162003.11
As of July 4, 2003, the consensus statement was unanimously ratified by the faculties of audiology and speech-language pathology (communicative disorders) programs at Arizona State University, Boston University, Howard University, Indiana University, Michigan State University, Ohio State University, Pennsylvania State University, Purdue University, San Diego State University/University of California San Diego, Seton Hall University, University of Arizona, University of Illinois, University of Iowa, University of Kansas Intercampus Program in Communicative Disorders, University of Massachusetts, University of Minnesota, University of Wisconsin, Washington State University, and Wichita State University.
July 2003
Introduction
The profession of audiology has experienced tremendous evolutionary changes as a result of at least four factors. These include:
  • an expansion in the scope of audiology practice over the past two decades

  • an expansion of hard of hearing populations in need of audiologic services

  • the evolution of multiple organizations that have laid claim to the representation of the profession, with the disparity of their visions for the profession of audiology creating a significant and often divisive political environment

  • the adoption of a doctoral degree as the required degree for entry into clinical practice

This has all occurred over a period of time characterized by wide fluctuations in the global economy with a dramatic shift toward an emphasis on cost accountability and doing more with less in the delivery of health care services and in meeting the missions of academic programs across the United States.
These changes have had serious repercussions on academic audiology programs, resulting in the permanent closings of 33 long-standing master’s programs over the past decade (Council of Academic Programs in Communication Sciences and Disorders 2000–2001 Demographics Survey). At least 29 new clinical doctoral programs (AAA Web site, July 2003) currently exist. The majority of these are converted master’s programs, with the minority being new programs that were initiated primarily as distance education programs targeted toward practicing audiologists with their master’s degrees. Several of the latter programs are now also developing residential post-bachelor’s AuD programs. The distance education programs emerged in the absence of any accreditation criteria that applied to them. The new clinical doctoral degree programs have various degree designators, including doctor of audiology (AuD), doctor of science (ScD), clinical PhD, etc.
As the cultures of Doctoral/Research–Intensive and Extensive universities are similar, with similar concerns and shared values, a seminal meeting of a convenience sample of audiology programs from these universities, including representatives from the Big Ten universities and all Indiana universities with graduate audiology programs, was hosted at Purdue University Oct. 4, 2002.
The purpose of this meeting was to:
  • discuss issues and concerns that relate to the rapid evolution of the audiology profession in the context of the unique visions and values shared by audiology education programs in Doctoral/Research-Intensive and Extensive universities

  • come to consensus on those issues/beliefs that are believed foundational to the maintenance of rigor in the preparation of clinical audiologists and to the development of the future of the audiology profession

  • initiate a discussion of visions for the future evolution of the profession based on cross-disciplinary cooperation and the foundational principles of using the principles and precepts of good science to better understand the auditory system and serve the many populations of people with auditory disorders

  • create a mechanism for the continuation of the momentum of this group at an annual Audiology Summit meeting for all Doctoral/Research-Intensive and Extensive university programs held at future conference meetings of the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD)

Shared Values
The Big Ten universities, which gave birth to the field of audiology and have had strong programs in audiology and hearing science throughout the more than 50-year history of the profession, share the mission of undergraduate and graduate education culminating in the preparation of clinical practitioners and research scientists. These programs advocate using qualified faculty in adequate numbers with sufficient infrastructure support to effectively deliver a curriculum that represents the full scope of practice in the discipline. These universities also share the commitment to scholarship through the contributions of their faculty to the body of knowledge across disciplines via their research and the dissemination of research findings via appropriate juried venues.
The Big Ten universities advocate for the education of audiologists and hearing scientists by experts both from within the discipline and across academic disciplines whenever appropriate. This philosophy is consistent across both didactic and clinical education, emphasizing the relevance of clinical experiences supervised by the most qualified practitioner. It is also the shared belief that the most comprehensive preparation of clinical audiologists is accomplished when academic programs have consistent and reciprocal relationships with medical centers and other clinical venues such as schools and industry that provide access to experiences that both represent the full scope of audiology practice and are responsive to each program’s supervision requirements and desired student learning outcomes.
Consensus Statements
As these universities look to the current and future education of doctorally prepared audiologists and hearing research scientists in academic programs across the United States, we are in agreement on the fundamental and critical importance of the following statements:
  1. We support the doctoral degree as the entry level to the clinical practice of audiology and the freedom of university programs to select the doctoral degree designator (e.g., AuD, ScD, PhD, etc.) that they deem most appropriate to the mission and culture of their institution.

  2. We reaffirm that the depth and breadth of clinical preparation in audiology qualifies the audiologist to be the primary hearing health care provider.

  3. We believe that the integrity of the discipline of audiology depends on a continuing and strong research base, which is synergistic with clinical practice and tended by appropriately educated PhD (or other research-emphasis doctorate) research scientists and clinical scientists.

  4. We agree that the PhD (or other research-emphasis doctorate) is the degree that is necessary for the preparation of research scientists who have the knowledge and skills to maintain the research standards of the academy and most rigorously contribute to the body of knowledge.

  5. As unanimously resolved by the members in attendance at the CAPCSD April 2002 conference in Palm Springs, CA, and voted on and passed by the CAPCSD membership in the summer of 2002, we also are: “1)…opposed to the recognition by either the Office of Education or CHEA of any new accreditation entities for speech-language pathology or audiology programs…” and support the CAPCSD recommendation that “2)…the Council of Academic Programs in Communication Sciences and Disorders will entreat the Council of Academic Accreditation (CAA) to insure that all professional organizations with vested interests in the quality of professional education in either speech-language pathology or audiology are provided equitable opportunity for input to the standards review and implementation process, and the Council of Academic Programs in Communication Sciences and Disorders will exercise whatever influence and leadership opportunities it may have toward the goals articulated in (1) & (2) above.” Note: The CAA, as of Oct. 15, 2002, has already accredited 18 clinical doctoral programs (AuD, ScD, and PhD) based on the new competency-based certification standards of ASHA’s Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC).

  6. We believe that the profession of audiology will be best served through the cooperation of the organizations that have the representation of the audiology profession as part, or all, of their mission. The smooth and issue-focused trajectory of the future development of the audiology profession must not be compromised by the conflict created by disparate political agendas of these organizations.

  7. We agree that there should be a single certifying body that should never link certification to a specific degree designator. We also acknowledge that, with the advent of state licensure or title registration being mandatory for the practice of audiology in most states, certification is voluntary. For this reason, master audiologists may be licensed or have title registration without having certification. It is a concern shared by the group that under the current ASHA program accreditation guidelines, master audiologists who are able to legally practice the profession of audiology in their states but who do not have certification are unavailable to accredited programs as supervisors of our audiology students. There is need for resolution of this dilemma.

  8. We believe that in response to the outcomes/learning-focused CFCC standards for competency in the knowledge and skills that represent the full scope of audiology practice, academic programs must establish levels of expected competency (e.g., taught, emerging/learning, mastered) with accompanying methods of formative assessment.

  9. We agree that the areas of knowledge and skills identified in the certification standards (effective Jan. 1, 2007) should be weighted according to their commonality across practice settings. Those that are judged to be more specialized or practice-setting specific should have a lesser weighting, allowing programs greater flexibility in defining the level of competency their students are expected to achieve and the alternative pathways that they may use to achieve those competencies.

  10. We agree that although competence across the scope of audiology practice is the primary mission of clinical programs, exposure to research must be an integral part of the curriculum with the breadth and depth of this exposure defined by the mission and values of each program. We agree that, at a minimum, graduates of accredited clinical doctoral programs in audiology must have a level of exposure to research methodology that is sufficient enough to allow them to be critical consumers of research. To this end, we believe that clinical audiologists must have a level of research exposure that enables them to view their clinical practice as clinical science and to modify their delivery of clinical services based on the outcomes of their practice and evidence-based scientific research.

  11. We agree that a doctoral program in audiology must have a core faculty that is sufficient in number, breadth, and depth to present a curriculum that represents the majority of the scope of practice of the profession. Adequacy of the number of faculty is objectified through such metrics as accessibility to students, national visibility through publications and presentations, breadth of expertise recognized by members of peer institutions, and participation in activities that define “the cutting edge” in clinical practice. We agree that shared resources such as distance participation in clinical grand rounds, didactic lectures, virtual experiences, etc. should be used only to enhance the program being delivered by an adequate number of core faculty and never in place of them.

  12. We recognize that in the current academic environment of Doctoral/Research-Intensive and Extensive universities, if an audiology program is to survive and flourish, the following activities must be well-represented among the faculty: productive research (discovery) programs; active involvement in teaching (learning) with an expectation that these faculty, and all faculty within the academy, will be teaching at both the graduate and undergraduate levels; and productive service (engagement) activities that include the expectation for revenue generation through the delivery of clinical services, traditional department, college, university, and community service activities including administration, and a new emphasis on development activities to address the fiscal needs of programs through the establishment of endowed scholarships, professorships/chairs, and named infrastructures. We agree that these expectations cannot be met using a model that defines full-time “faculty” using only the traditional tenure-track designation. We therefore encourage all audiology programs in Doctoral/Research-Intensive and Extensive universities to work with their university administrators and governing boards to establish a dual faculty track model that includes and equally values both tenure-track and clinical faculty (e.g., assistant through full professors).

  13. We agree that the “12 months’ full-time equivalent of supervised clinical practicum sufficient in depth and breadth to achieve the knowledge and skills outcomes” (ASHA certification standards effective Jan. 1, 2007) should be an integral part of the clinical education program and that clinical experiences can be acquired using a variety of models (e.g., fewer long-term or multiple short-term experiences spaced throughout the program). The concept of a “clinical matching program in the final year of a clinical doctoral program” may be inconsistent with the letter and intent of these new certification standards.

  14. We agree that specific guidelines for inclusion of practicum sites in a program must be created and address issues such as accreditation by appropriate bodies (e.g., Board of Health, JCAHO, etc.), number and adequacy of preparation of site supervisors, consistency of amount of supervision and willingness of supervisors to use university program-approved metrics for formative assessment of student competencies acquired at the site, responsiveness of the site to the needs of the academic program, scope of practice represented within the site, approval of site supervisors by the academic program, etc.

Authors: Nancy Barlow, Ruth Bentler, Ingrid Blood, Arlene Carney, Ron Chambers, Phil Connell, Allan Diefendorf, Robert Fox, Joyce Hawkins, Tom Hemeyer, Larry Humes, Lata Krishnan, Ravi Krishnan, Robert Novak, Mike Pachuilo, Jennifer Simpson, Elizabeth Strickland, Terry Wiley, Michael Wynne
Editor’s note: An accredited program may utilize clinical supervisors that the program deems qualified to supervise its students to obtain specific knowledge or skills. Such supervision can be used only for clinical hours in excess of those required of an applicant for certification.
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September 2003
Volume 8, Issue 16