audiology profession demands universal and comprehensive training … · 2017-12-22 · demands...

AUDIOLOGY TODAY Jan/Feb 2015 Vol 27 No 132

AUDIOLOGY PROFESSION DEMANDS UNIVERSAL AND COMPREHENSIVE TRAINING FOR PRECEPTORSBY TORRYN P. BRAZELL AND LILI TAYLOR

The September/October issue of AT featured an article on Part 1 of the ABA’s Preceptor Training Needs Gap Analysis, which examined the need for improved access to high-quality preceptor training from the perspective of experienced, practicing preceptors. This article presents findings from Parts 2 and 3 of that gap analysis, in which input from clinical education coordinators and recently graduated students round out the profile of preceptor training needs from the vantage point of key stakeholders.

33Vol 27 No 1 Jan/Feb 2015 AUDIOLOGY TODAY

(ABA) has found through its Preceptor Training Needs Gap Analysis studies that today’s preparation methods for the audiologists of tomorrow needs to be more uniform, comprehensive, robust, and uni-versally available. Results from the ABA’s gap analysis, Part 2—Clinical Education Coordinators and Part 3—Recently Graduated Students, reinforce and expand upon findings from Part 1—Experienced Preceptors. Each part of the study offered a robust and richly detailed picture of the complexities of the preceptor role, and revealed the depth and breadth of knowl-edge and competencies required to do the job well. Clinical education coordinators and recently graduated audiologists who contributed to Parts 2 and 3 of the gap analysis shared a strong consensus that significant gaps currently exist in the quality, consistency, and availability of preceptor training.

“Strengthening the skills of experienced preceptors and preparing new preceptors to be effective clinical educators is an imperative for our industry,” said John A. Coverstone, AuD, chair of the ABA Board of Governors. “As a profession, we must take responsibility for ensuring that preceptors currently supervising students are consis-tently well prepared.”

“We also must introduce clear path-ways to training for audiologists who are interested in serving as preceptors,” he continued. “The ABA is committed to developing a standards-driven, assess-ment-based preceptor training program to meet this profoundly important need.”

Dr. Coverstone said the ABA will seek ongoing stakeholder guidance as findings from the gap analysis are integrated into the first-ever standards-driven, assess-ment-based Preceptor Training Program for the audiology profession.

The ABA Preceptor Training Program will be a voluntary professional develop-ment program designed to

� support preceptors and prospective pre-ceptors in developing their full potential as outstanding clinical educators;

� broaden opportunities for students to engage in high-quality clinical learning experiences that will prepare them for their audiology careers; and

� enhance patient services and advance the audiology profession by promot-ing best practices across the scope of practice.

“The clinical education coordinators and recently graduated audiologists who participated in our gap analysis had many positive things to say about the training experience in our profession. However, they agreed across the board that a more rigorous, uniform approach to preparing preceptors as clinical educators would yield broad benefits,” said Dr. Coverstone.

Part 2—Clinical Education CoordinatorsPart 2 explored the perspective of the faculty representatives charged with establishing and coordinating the clinical placement sites. Beyond developing placement opportuni-ties, clinical education coordinators also are responsible for monitoring and managing student/preceptor expectations and prepa-ration, to ensure that clinical placements provide students with beneficial, positive learning experiences.

“Clinical education coordinators are often in the best position to articulate a student’s needs for clinical learning experiences and provide front-line support during the transition from the classroom to the independent clinical setting,” said Dr. Coverstone. “Feedback collected from clin-ical coordinators will assist us in designing training that equips preceptors to work with clinical education coordinators to assess student competencies

THE AMERICAN BOARD OF AUDIOLOGY®


Comprehensive Training for Preceptors

“Findings from Part 2 of the gap analysis gave us a fas-cinating window into the variety of requirements used by clinical programs,” Dr. Coverstone continued. “We wanted to gain a sense of typical levels of student exposure to clinical settings over the course of the full educational experience. Therefore we asked clinical education coor-dinators to describe how their programs introduced and integrated clinical placements.”

The majority of clinical education coordinators repre-sented audiology programs with on-site clinics. Students typically acquired foundational clinical experiences during the first year and progressively transitioned to off-site placements during the second or third program years. Students in most programs were working part-time in off-site placements in their third year while continuing to attend classes. Most students moved to full-time off-site assignments for their final year.

Against this backdrop of commonalities were varia-tions in the number of clinical hours required at specific points in different programs. For example, one program did not require students to be on-site every week but, rather, required 25 hours of clinical observation during a 16-week period. Another program required one full day in the general clinic per week along with a half day in either the clinic’s adult teaching center (fall semester) or pediat-ric teaching clinic (spring semester).

As students advanced through their programs, the concentration of clinical exposure and independence increased across programs. Students worked with a range of patients, from pediatric to geriatric, and they prac-ticed both observation and hands-on clinical laboratory experiences. These included assessment of patients for hearing aids, earmold impressions, vestibular evaluations, hearing aid fittings and dispensing, aural rehabilitation, and other types of care.

“While we were pleased to find that the programs offered a wide range of experiences, we were particularly interested to find out how clinical education coordinators identify, recruit, and determine the qualifications of the audiologists who serve as preceptors for their students,” said Dr. Coverstone.

The clinical educators in Part 2 of the gap analysis reported employing a mixture of strategies to develop clinical placement sites:

� Several relied on professional networks to identify and recruit audiologists to serve as preceptors.

� Some reported being approached by audiologists inter-ested in hosting students.

� Others received referrals from current preceptors working within their programs.

Only one clinical education coordinator in the gap analysis indicated that her program provided a formal training program for preceptors. Topics addressed in this preceptor training program include

� matching preceptor style to student skill,

� setting goals and providing appropriate feedback,

� handling difficult conversations, and

� reviewing documentation requirements.

The balance of the respondents did not have a formal training program in place for preceptors but did offer a range of informal supports, including informational pack-ets, ongoing communications, preceptor meetings, and/or monthly “preceptor tips” sent via e-mail.

It is interesting to note that the responses of clinical educators tracked closely with those of experienced pre-ceptors in Part 1 of the gap analysis across several issues. Both stakeholder groups expressed the conviction that the connection between coursework and student clinical

ONLY ONE CLINICAL EDUCATION COORDINATOR IN THE GAP ANALYSIS INDICATED THAT HER PROGRAM PROVIDED A FORMAL TRAINING PROGRAM FOR PRECEPTORS.

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PRECEPTOR QUALIFYING CRITERIAWhen determining whether an audiologist is qualified to serve as the preceptor for a field placement, survey respondents collectively applied one or some combination of the following selection/qualifying criteria.

PRECEPTOR TRAINING NEEDSWhere do you see the greatest gaps in the skills of preceptors as clinical educators that could be addressed with training? Multiple respondents expressed the conviction that the connection between coursework and student clinical assignments should be strengthened and better coordinated to facilitate the best learning experience for students. The following specific skills gaps were identified as topical areas on which preceptor training should focus.

Teaching Skills Communication and Interpersonal Skills

Management Skills

9 Task analysis

9 Assessing student skill level

9 Developing learning objectives

9 Goal setting

9 Setting expectations

9 Formative and summative evaluations

9 Assessing learning styles

9 Observation

9 Fostering critical thinking and clinical decision making

9 The underperforming student

9 Fostering reflective practices

9 Providing written and verbal feedback

9 Dealing with challenging/difficult students

9 Generational issues

9 Cultural sensitivity

9 Dealing with ambiguity

9 One Minute Manager

9 WWW (What?, So What?, What Next?)

9 Understanding FERPA

A desire to be clinical educator

Three years of experience

A clinical focus on an area of expertise of interest to students

A formal interview with the clinical education coordinator

Positive references/background

A site visit



CLINICAL EXPERIENCES OF RECENT AUDIOLOGY GRADUATESPopulations Activities

Adults � Hearing device fittings and evaluations � Balance testing

Veterans � Hearing device fittings and evaluations � Rehabilitation

Pediatrics � Neonatal hearing evaluations � Hearing diagnostics � Cochlear implants � Deaf school assignment

EFFECTIVE PRECEPTOR QUALITIESClinical Skills

9 Has a well-rounded clinical background

9 Is a lifelong learner

9 Has a strong understanding of the science that underpins clinical practices

9 Applies evidence-based practice

9 Is willing to continue learning new and better ways to do our job

9 Is interested in improving as a clinician; stays current on new research

Teaching Skills

9 Enjoys and wants to teach

9 Allows students to try things

9 Provides positive reinforcement

9 Can teach to a variety of learning styles (visual, auditory, kinesthetic learners)

9 Treats students with respect

9 Fosters intellectual curiosity

9 Provides a challenging learning environment

9 Provides students with routine evaluations of their performance

9 Can provide constructive criticism

9 Can let go and give students independence when appropriate

9 Acts as a mentor

Professional Leadership Skills

9 Leads by example

9 Behaves professionally with the student and with patients

9 Serves as a professional role model

Interpersonal Skills

9 Is a good listener

9 Values the student’s input

9 Engages in constant communication with student

9 Demonstrates patience and understanding with students and patients

9 Exhibits humility as a clinician

Management Skills

9 Has good time management skills



assignments should be strengthened and better coordi-nated to facilitate student learning experiences. Similarly, clinical education coordinators agreed that a precep-tor training program should focus on building skills in communication and interpersonal dynamics, as well as management skills.

The following specific skills gaps also were identified as areas on which preceptor training should focus (see Preceptor Training Needs sidebar for complete results):

� assessing student skill level

� developing learning objectives

� goal setting

� generational issues

� cultural sensitivity

� dealing with ambiguity

� understanding the Family Educational Rights and Privacy Act (FERPA)

Part 3—Recent Audiology GraduatesThe majority of audiologists who participated in Part 3 graduated from audiology programs within the last three years, bringing a fresh and immediate stakeholder per-spective to the preceptor preparation issues under review. Their educational experience came from universities across the United States, including Gallaudet University, Lamar University, Nova Southeastern University, The Graduate Center—City University of New York, University of Florida, University of South Florida, University of Utah, Vanderbilt University, and Wichita State University.

Participants in Part 3 completed clinical education placements in a variety of settings, from a Veterans Administration clinic and a cochlear implant clinic to hos-pitals and educational settings. A majority of respondents completed early clinical rotations in on-site assignments at university clinics, working with adults and children. Most were progressively transitioned to off-site place-ments as they advanced through their programs.

While in their student clinical placements, Part 3 partic-ipants reported being assigned to a wide range of clinical placements in which they gained experience working with diverse populations and issues. Clinical experiences listed by respondents are included in the sidebar.

“The audiologists who participated in Part 3 of the gap analysis clearly valued their clinical placement

experiences as formative professional development opportunities,” said Dr. Coverstone. “They all reported gaining important clinical skills that prepared them for practicing independently in the profession, which is of paramount importance for the future of audiology.”

As one respondent said, “It was important to me to go to a site where I was treated like a student and NOT another set of hands in the office. I wanted to be at a place where I would be challenged and educated every day. I wanted to be somewhere that would prepare me to be competent in the entire scope of practice and allow me to be confident in my clinical abilities postgraduation.”

Part 3 focused on four major topic areas, including the following:

� Student Background—Respondents identified their audiology programs, their year of graduation, and the types and duration of clinical placements in which they worked.

� The Preceptor Selection Process—Respondents provided information on how they located clinical placement opportunities and selected placements aligned with their needs and interests.

� Externship Experiences—Respondents described their externship experiences, including information as to how they were paid, their preceptors’ work styles, per-formance expectations for the placement, and what a typical day included. Respondents also provided feedback about their satisfaction with their placement experiences.

� Exploring Training Needs—Respondents offered their perspectives on the attributes of a good preceptor.

“Students put in long days learning alongside practicing professionals,” said Dr. Coverstone. “In most cases, they were exposed to every aspect of the profession, from managing a business and a patient caseload to interacting with and assessing treatment options for a wide variety of patients. Where we see the gap is with the structure of training and feedback, as well as in how prepared some preceptors are to effectively teach and mentor students.”

For example, several respondents described engag-ing in regular, structured feedback sessions during which their preceptors provided evaluations of their work. Other students did not feel they received adequate feedback. Students shared a list of qualities to describe a

“less-than-adequate” preceptor:



� has poor communications skills—can’t or won’t explain things

� does not provide performance feedback or openly crit-icizes mistakes

� is reluctant to appropriately grant independence to students as their skills mature

� seems unapproachable or is dismissive of student questions or concerns (condescending, unprofessional, angry, or just too busy)

� throws students into unfamiliar situations for which they have not been prepared

However, the list of qualities student respondents shared as characteristic of good preceptors was extensive. The wide range of attributes the respondents associated with good preceptors included the following:

� teaches to a variety of learning styles (visual, auditory, kinesthetic learners)

� provides a challenging learning environment and con-structive criticism

� provides students with routine evaluations of their performance

� engages in constant communication with student

� demonstrates patience and understanding with stu-dents and patients

� has good time-management skills

� is a lifelong learner; is interested in improving as a clinician; stays current on new research

Taking it a step further, the ABA asked respondents to describe the qualities they would most value in a preceptor. The following themes were observed in responses to the question, “If you could create a ‘dream preceptor’ who could provide students with the optimum learning experience and clinical exposure, what knowledge, skills and abilities/competencies would this perfect person possess?”:

� strong communication and organizational skills

� the ability to challenge students to constantly grow and strive to keep their skills and knowledge current;

� a sense of when to let students learn on their own and when to step in with support

� an understanding of how to serve as a guide in the learning process, rather than as a boss or drill sergeant

� patience, understanding, and an open mind—a will-ingness to learn and share knowledge

� a good attitude toward the profession and a desire to help students

As one respondent noted in her survey comments, “I strongly believe that not every audiologist makes a good preceptor. Graduating from an audiology program and becoming a practicing audiologist does NOT give you the ability to be an effective preceptor.”

The Next StepAccording to Dr. Coverstone, now that Parts 1, 2, and 3 of the ABA Preceptor Training Needs Gap Analysis have been completed, results will be compiled and reviewed by a focus group of leading audiologists and educators, who will make recommendations on the ABA Preceptor Training Program.

If you are interested in helping to develop or assist in underwriting the ABA Preceptor Training Program, please contact Torryn P. Brazell at [email protected].



“There are many components that contribute to cre-ating a positive, valuable clinical placement experience, and it really takes commitment, understanding, and good communication skills from every party involved,” said Dr. Coverstone. “The underlying theme in these gap analy-ses is that there is a distinct need for uniform training of audiology preceptors to ensure that future doctors are learning alongside the best available teachers.

“We believe that the ABA Preceptor Training Program will become industry standard,” he continued. “It will demonstrate that the preceptor is the best possible educator and mentor, will reassure universities that stu-dents are placed with skilled preceptors, and will assure students they are receiving precepting from highly qualified mentors.”

The program’s curriculum will focus on a broad spec-trum of clinical student experiences, ranging from first year practicums to final-year externships. The ABA aims to create a new cohort of highly skilled, technically excellent preceptors prepared to lead today’s audiology students into their future careers, having gained maximum value from their formative field placement experiences.

Torryn P. Brazell, MS, CAE, is the managing director of the American Board of Audiology®. She is a credentialing practitioner with extensive experience in association management, including the development and implementation of professional certification and assessment-based certificate programs: initial concept, practice analyses, subject matter expert facilitation, program delivery, item writing, and recertification.

LiLi Taylor, MA, is the program director and consulting instructional designer for the American Board of Audiology’s Preceptor Training Program. She holds degrees in communication sciences and disorders and instructional systems design. She has conducted cross-industry training needs analyses and produced curriculum for professional development initiatives in the public and private sectors.

An autonomous organization, the American Board of Audiology (ABA) is dedicated to enhancing audiological services to the public by promulgating universally recognized standards in professional practice. The ABA encourages audiologists to exceed these prescribed standards, thereby promoting a high level of professional development and ethical practice. To help meet that goal, the ABA administers the Board Certified in Audiology® credential, the Pediatric Audiology Specialty Certification (PASC®), and the Cochlear Implant Specialty Certification (CISC®), all of which are voluntary certifications.

audiology profession demands universal and comprehensive training … · 2017-12-22 · demands...

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