Placement year feedback from students placed 2007/08

1. Dr Gary Farrell Placement year feedbackfrom students placed 2007/08

2. Overview • Course changes • Student integration • Sharing best practice • Deviation from BSA procedures • Variation in service provision/structure • Student projects • Student comments • Student projects • Unusual student experiences • Accreditation –service feedback and curriculum input

3. Course changes • Nothing major last year • Proposed • Analogue aids – less • Digital aid programme and modification – more • Occulomotor testing – less • Communication skills and dealing with difficult/challenging patients • Aurical audiometry? • Effective masking? • What else is missing – curriculum review later

4. Student integration 1 • Talk from year 3 student really useful • We expect contact from the student even a visit to you prior to placement • All students re-familiarise themselves with BSA recommended procedures prior to starting • A welcome pack with basic information is very useful to the student • Location of clinic protocols is also useful • Induction –earlier the better • Manual Handling? • Disabled, Dix-Hallpike, elderly frail – balance testing • 2nd Induction – how different – can it be tailored?

5. Student integration 2 • Time at start to re-familiarise themselves with Practice Navigator/Auditbase and the aids used in the department – less so on second placement • We teach Auditbase and Spirit aids • Shadowing other staff was excellent ToD, HT, speech therapist ENT doctor etc • Visit to ENT surgery – great but not for the squeamish • They enjoy being part of the team • Journal clubs • Staff lunches • Staff meetings • Staff socials • Xmas party etc

6. Sharing best practice • Most students see two different departments and compare and contrast • Courtesy telephone calls to reduce DNA rates • Effective timetabling of slots – admin staff induction into type of slot i.e. re-tube or re-assess • Noisy busy waiting rooms not a good first impression for hearing impaired • A tidy workplace is an efficient workplace • Quality of rooms and privacy of patients in shared rooms – ie storeroom in a patient interview room

7. Deviation from BSA procedures or best practice • Some testing carried out in non-soundproof booths • Not using otostop for impressions and also undertaken when excessive wax and infection? • Doing open fit in last 5 mins of appointment without complete verification due to time constraints • Free field warble tones used on 4 year old when can possibly use headphones • NAL NL1 or DSL i/o – which is best for kids and why – YOU decide • Fully masked PTA in 5 mins! • Paediatricians cleanliness – a lot to be desired and lack of communication (hand washing)

8. Variation in service provision • Routinely testing 3 and 6 kHz in PTA • Variable use of GHAB • REMs – when used and justification • REMs used for open fit? • Just fitting unilateral hearing aids – no option for patient to have bilateral aids • High proportion of click fits in a number of departments – is this the future or convenient • Management structure and style variable – this is good

9. Variations from the students point • Students are not an imposition they are an asset • Students should not be talked down to in front of patients • Some departments could do with a lick of paint • Protocols varied and some out of date • “Clinical guidelines reduce unacceptable or undesirable variations in practice and provide a focus for discussion among health professions” • Availability of mentor and Head of Department • Time to enter or discuss logbook entries and achievements • 2nd placement – they are ready to go from the start

10. Student comments • Overlap with inductions • Open door policy very useful • Cover at outstations not as good as central location • Lack of panic buttons • Whistleblowing policy • Support from University and tension! • Being with another student is much more settling – a buddy

11. Student projects • Designing leaflets, poster displays or patient information sheets • Equipment operating instructions • Academic talk to staff or patient interest groups, audit guidelines, protocols and protocol updates • Essay on BAHAs, localisation (unilateral or bilateral aids), open fits, VEMPs, earmould modifications etc • Talk in a village Hall • Talk to Journal Club

12. Unusual student experiences comments • Brighton Bells • Nurse arrested for child molestation • Arson attack and break in next door • “Do hospitals normally have shootings” • “Does audiometry affect pacemakers” • Dementia patients are a real challenge • I had to counsel the patients wife as she was more frustrated • The letters to PALS really show patient appreciation • What is CHARGE syndrome • Finding a mastoid cavity not spotted by the audiologis • Patient falling asleep during REMs • Kids love bubbles • Looking for toys in childrens ears – transformers and potatoes? • Testing the King of Tonga’s hearing

13. Accreditation and curriculum • 5 year accreditation • 2 advocates • Student experience • Improvements over the years • Changes required • Curriculum development • Analogue aids – less • Digital aid programme and modification – more • Occulomotor testing – less • Communication skills and dealing with difficult/challenging patients • Aurical audiometry? • Effective masking?

14. Final comment • When they come back from their placement year they are buzzing with confidence and enthusiasm. • They have matured and are more engaging and certainly have more clinical knowledge • That is primarily up to you and your staff • Thank you from us all

15. Contact details • Dr Gary Farrell - Room 4087 ISVR • Tel 023 80594942 • E:mail gf@isvr.soton.ac.uk