Creative Destruction in Hearing Care
from Hearing Tests to Smartphones
modern society. Pager salesmen,
typists, and video store clerks are
three quick examples from the past
30 years of once relatively prevalent
occupations that currently barely exist.
By Brian Taylor, AuD
14
I
Learn how hearing
healthcare professionals
can adapt to more
effectively meet the
changing demands of
the marketplace
f you were living 100 years ago,
there is a good chance you knew
more than a few coopers. Coopers,
sometimes fondly referred to as barrel
makers, were among the most popular
skilled professions in the early 1900s.
By 1930, however, coopering was a
marginalized profession, nearly nonexistent, unless of course, you live in
the states of Tennessee or Kentucky,
where it thrives as an artisanal craft.
Read this article and take the
quiz on page 55 for continuing
education credit.
The virtual elimination of a once
thriving profession is an example of
creative destruction, and there are
many examples of it throughout our
“Creative destruction” is a paradoxical
term introduced to economics in the
1940s by the Austrian economist and
Nobel laureate Joseph Schumpeter
(1883–1950). He used the term to
describe the special form of economic
growth that entrepreneurs bring
to capitalism. Schumpeter argued
that it was the entrepreneur’s
introduction of radical innovation
into the capitalist system that was
the real force sustaining long-term
economic growth, even as it destroyed
the economic value of established
enterprises that may have previously
enjoyed a substantial degree of
unchallenged power. The questions
for hearing care professionals are
twofold: What forces at work in
today’s economy have the potential
to creatively destroy audiology and
hearing instrument dispensing? And,
how will audiologists and hearing aid
specialists adapt to more effectively
meet the changing demands of the
marketplace? No one can predict the
future, but we can be relatively certain
there will be significant changes
in the way the two established
professions of audiology and hearing
aid specialists create value for the
hearing impaired population over
the next decade. The objective of this
article is to review many of the forces
that could lead to creative destruction
and offer an antidote for overcoming
them.
Tablet-based Audiometer Apps
Over the past few years, tablet-based
audiometry apps have emerged
as viable options for completing
portions of the diagnostic battery.
According to Sanchez et al (2015)
one such tablet-based audiometer
(iAudiometer Pro) is accurate enough
for clinical use, as the researchers
compared the iAudiometer Pro app
to a professionally calibrated GSI16
audiometer, using three different
transducers and found no significant
differences in thresholds compared
to the GSI 10 audiometer. The
iAudiometer apps allows for air and
bone conduction testing. Additionally,
other versions of the iAudiometer
have speech tests as well as special
audiometric tests for the pediatric
population.
These results, while promising,
warrant further investigation, but they
do suggest table-based audiometry,
given its portability, allows hearing
care professionals to more easily
provide services in remote areas
or they cannot travel to the clinic.
Interestingly, Sanchez and colleagues
found that while 63% of participants
believed that a table-based hearing
test yields accurate results, 86%
preferred obtaining a hearing test from
a hearing care professional.
Self-guided Hearing Screening Apps
In addition to tablet-based
audiometry, there are a variety of
hearing screening apps allowing
individuals to monitor their own
hearing without seeing a hearing
care professional. Although there
is a paucity of data supporting their
validity, there is significant potential
for self-guided hearing testing
apps to allow younger patients to
engage in the process of checking
their hearing from the convenience
of home without the hassle of
making an appointment. Similar to
automated blood pressure tests,
automated hearing screening might
be an effective approach to facilitate
more active patient involvement at
a younger age when hearing loss is
milder and less debilitating.
Automated Hearing Aid Algorithms
A significant part of digital evolution
is the use of signal processing
strategies that automatically assess
the patient’s listening environment
and make adjustments to the signal
processing strategy based on the
listening needs of the individual.
Historically, hearing aids have
been programmed and adjusted
in the hearing care professional’s
office, mainly because considerable
expertise was needed to determine
the proper adjustments and to
effectively operate the programming
device. In the future, these timeheld procedures may be no longer
needed, as adjustments could be
made remotely and many of tweaking
of the hearing aids parameters could
be accomplished with intelligent,
automated algorithms. Arguably,
automated algorithms have been
in existence for several years, but
as their sophistication grows, the
ability to program and adjust them
may greatly reduce the need of the
expert guidance of the hearing care
professional.
PSAPs and Hearables* (See IHS
statement on PSAPs on page 24)
There are a variety of over-thecounter personal sound amplification
products (PSAPs) that are slowly
becoming known as “hearables.”
While PSAPs and hearables are not
allowed to be marketed as medical
devices for the remediation of hearing
loss, many of them are used for this
purpose. Also, given the uneven
sound quality of PSAPs and hearables,
hearing care professionals need to
be involved in the process of verifying
the quality of their coupling to the
individual’s ear. This is especially
important for patients with mild loss
who might chose to wear a PSAP
before transitioning to conventional
hearing aids over time. Hearing care
professionals would be wise for
developing a strategy around getting
directly involved in the verification of
PSAPs fittings with probe microphone
measures. A fee for service could be
charged to check the quality of the
fit, as a poorly fitting PSAP is likely to
result in poor benefit.
Smartphones Apps
The stigma associated with hearing
aids probably has some influence on
the uptake of PSAPs and hearables.
After all, if it looks like a hearing aid it
must be a hearing aid. Smartphones
Continued on page 16
15
apps, which there are dozens
available, are, like PSAPs, plagued with
uneven sound quality. However, they
do offer an alternative to traditional
hearing aids some individuals might
find appealing. Amlani et al (2013)
compared the performance of two
apps, which essentially turn the
smartphone into a body aid when
coupled to the ears with headphones
or earbuds, to hearing aids at the
basic level of technology. Results
indicated that on several measures of
outcome, including benefit, quality
of life improvements and audibility
there were not significant differences
between the “bare-bones” hearing
aids and smartphone apps. Amlani
et al (2013) demonstrated that
smartphone hearing aid applications
have similar electroacoustic
characteristics and perceived
performance when compared to a
traditional hearing aid, and could
be useful as a temporary or starter
solution to a hearing deficit.
Directed Audio Solutions
Directed audio solutions represent the
morphing of programmable hearing
aids and consumer electronics. One
such device, Hypersound (www.
hypersound hearing.com), allows
patients to enjoy television and
other home media activities without
disturbing others. These systems
work by using an ultra-high frequency
carrier signal to transmit audio in
a tight, narrow beam over several
feet without interference from noise
or reverberation. Utilizing the nonlinear properties of air, ultrasonic
transmission of audio allows listeners
situated in the 2-3 foot wide beam,
even several feet from the television,
to experience more audibility high
frequency sounds. For many listeners,
16
this results in a marked improvement
in speech intelligibility when watching
TV. They are programmable, so they
can be customized to the patient’s
hearing loss. Customizable directed
audio devices represent a new
product category in the industry
that patients, especially younger
patients with milder hearing loss
who might find it appealing because
they offer an effective solution
for a hearing problem and do not
have the unfortunate stigma of a
hearing aid. In that vein, devices like
hearables, directed audio solutions,
and smartphones might provide the
untapped mild to moderate high
frequency market with products they
find appealing. As shown in Figure 1
below, this segment of the hearing
impaired marketplace has been
largely underserviced by conventional
hearing aids.
Biotechnology
Hair cell regeneration and gene
therapy represent some of the future
innovations that may transform the
practice of audiology. Although still in
its infancy, in the future audiologists
and other hearing care professional
may be directly involved in the
regeneration of hair cells within
the cochlea. For more details on
the potential of biotechnology in
audiology, see Parker, 2011.
Interventional Hearing Care
As previously mentioned, no one
has a crystal ball, but all of us can
prepare for a future where audiology
and hearing aid dispensing are
practiced in a different way. One
way to prepare for a different future,
one that is likely to be creatively
disrupted by cheaper, faster and
smarter technology is to examine
Profound or Residual:
5%
70%
30%
Moderate to Severe:
20%
Mild to Moderate:
75%
50%
10%
Aided population
50%
90%
Unaided population
Figure 1. Hearing loss segmented by degree. Data compiled from Nash (2013), Lin et al (2011),
Lin (2011) and Wallhagen & Pettengill (2008)
existing gaps in the marketplace
and how our professions can add
additional value that may not be
centered on the selection, adjustment
and tweaking of hearing aids, or the
ability to conduct a basic hearing
assessment. Practicing in a different
way involves getting out from your test
booth and directly connecting with
the community, especially individuals
who are beginning to experience
difficulties with communication, but
remain reluctant to take action. The
key to long term professional survival
may rest on our ability to intervene
with patients at an earlier age when
hearing loss is typically milder and
easier to manage.
Let’s cut to the chase, here are four
pillars of an interventional audiology
strategy that are designed to keep
hearing care professionals actively
involved in the direct care of patients.
1. Exert more social pressure to get
non-consulters to act sooner, using
self-guiding hearing screening apps
to speed the journey to your office.
2. Engage younger patients, many
with milder hearing losses by
offering them products and services
that don’t carry the stigma of
hearing aids.
3. Leverage changes in U.S. healthcare
system to partner directly with
primary care physicians and other
medical gatekeepers in the early
management & intervention of
age-related hearing loss and its
co-morbid conditions.
4. Modify or update your clinic
approach to patient interaction
by focusing on patient-centered
communication and participatory
care.
Figure 2. An example of an advertising campaign using positive triggers to action.
Let’s briefly examine each of these
pillars of interventional hearing care
and how you can begin to bring them
to life in your practice. Using positive
triggers to action requires hearing care
professionals to use advertising that
highlights the hidden risk of hearing
loss while simultaneously empowering
the individual to take action to
seek help for a possible condition.
Curtis Alcock of Audira has written
and lectured extensively on positive
cues to action and how they can be
used in marketing. (Alcock’s articles
have appeared in prior THP editions
archived on the IHS website www.
ihsinfo.org.) Figure 2 is an example
of an advertising campaign utilizing
many of Alcock’s ideas.
The second pillar of interventional
hearing care is to systemically
Continued on page 18
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recommend alternative products and
services that do not have the stigma
of traditional hearing aids. These
offerings may include auditory training
apps and directed audio solutions
(e.g., Hypersound) that still need to
be customized by the professional,
while still being an attractive option
for patients, especially those with
milder losses in need of situational
help. In order to effectively educate
patients on their options, hearing
care providers are encouraged to
utilize decision aids, like the one
shown in Figure 3. A patient decision
aid is a structured tool designed to
facilitate knowledge transfer and
patient engagement. It can be used to
compare the pros and cons of more
than one treatment option with more
direct involvement from the patient in
the decision-making process.
The third pillar of interventional
hearing care necessitates the need
to directly interact and educate
primary care physicians. Given the
well-documented relationship agerelated hearing loss has to cognitive
decline, increased hospitalization
and social isolation, hearing care
professionals are obliged to adhere
to scientifically-defensible principles
in order to responsibly educate
medical gatekeepers and spur them
in to action. The consequence of
successfully educating medical
gatekeepers is likely to be a significant
uptick in the number of adults aged 55
and older who visit your practice for a
hearing screening appointment.
To make this appointment valuable
to consumers, and not simply a
hearing test that can be completed
with a self-guided app, hearing care
professionals are urged to practice
Listening to Television with a Hearing Loss:
TV Device or Hearing Aids?
An Interactive Decision Aid
Check all statements
that apply to you
If you like a statement, check
If you dislike a statement place an
My hearing problem causes
arguments with family members.
The TV is too loud!
I have difficulty understanding
dialog, especially fast
talkers, female talkers
or foriegn accents.
My difficulty with the TV is
affecting my personal and social
life. My spouse or other
family members can’t be in
the same room.
I have difficulty when the TV is
at normal volume. I can hear it,
but cannot understand what is
being said.
The speech is too soft but the
music is too loud. I can’t find
the right volume.
The more items you checked, the
more likely it is that you need
help listening to TV
If you feel ready to address
the difficulties, your audiologist
can help you decide on
the next step
✓ the box
✗ in the box
A TV device is less costly
than hearing aids
Hearing aids are expensive,
but they can be used in
all situations
No long clinic appointments
needed
Usually, 3–4 clinic visits are
needed, to fit, fine tune and
troubleshoot hearing aids
A TV device is easy to
install, use and maintain
I will have to learn how to
use hearing aids; regular
cleaning and care are
needed
Device only works for TV;
other listening situations
may still be difficult, indoor
use only
Hearing aids are designed
to enhance speech
understanding; they can be
used in all situations
Device overcomes distance
and background noise to
isolate the TV signal and
improve viewing experience
Hearing aids may not solve
my TV problem; I might
need to buy extra devices
that connect hearing aids to
the TV
Device does not disturb
others; family members can
view TV normally
Hearing aids do not disturb
others; family members can
view TV normally
TV Device
Total
Total
Hearing Aids
✓
✗
Total
Total
✓
✗
Do you responses appear to favor one over the other?
With your audiologist, explore your preferences and dislikes.
Discuss them together to aid your decision.
All rights reserved © 2015 Jennifer Gilligan
Figure 3. An infographic that compares directed audio to traditional hearing aids for television
watching. Reprinted with permission of Jennifer Gilligan of CUNY-Graduate Center
patient-centered, participatory care.
Ultimately, this change from productcentric to patient-centric care in which
providers are reimbursed for their
time helping patients cope with the
consequences of hearing loss may
provide our profession with a new
value proposition for consumers.
Continued on page 20
19
Shared-decision making (or
participatory care), on the other hand,
requires the professional to actively
guide patients through the stage
of health behavior change. (For an
introduction to the stages of change
model see Leplante-Levesque’s recent
article in The Hearing Journal.)
Figure 4. The six components of participatory care and five steps of patient-centric communication.
Known as participatory care, the six
steps listed in the center of Figure 4
comprise the foundational elements
of patient-centered communication.
Participatory care is a model of
healthcare in which patients take a
more active role in the generation and
implementation of treatment options.
It is thought that participatory care
may be an effective way to address
the needs of patients with chronic
conditions, such as age-related
hearing loss. Participatory care, also
commonly referred to as shared
decision making, falls in the middle of
the patient-provider decision making
continuum shown in Figure 5.
Traditionally, healthcare services
20
have been delivered in a paternalistic
manner whereby patients assume
a relatively passive role in their
relationship with the provider. As
patients have become more actively
involved in their healthcare choices,
and, as the internet and other forms
of social media have become more
ubiquitous, DIY care has become a
popular healthcare delivery model in
some circles. This is depicted in Figure
5 as the informative relationship,
which removes the provider from the
essential decision making duties, and
leaves the patient to fend for himself.
PSAPs in their current form are bought
under this informative model.
In today’s era of consumer-driven
healthcare, participatory care appears
to be popular among baby boomers,
especially those with chronic medical
conditions. Practicing participatory
care requires a relatively high degree
of healthcare literacy on the part
of the patient and involves the use
of shared decision making by both
the patient and hearing healthcare
professional. Shared decision making,
which is an essential component of
patient-centric communication, is
the process in which the patient and
the hearing healthcare professional
exchange information about the
scale and scope of the patient’s
condition, express the preferences
of intervention options and
collaborate on the implementation
and evaluation of a solution. Shared
decision making and participatory
care cannot be supported without
adequate information provision
(Poost-Faroosh, et al 2015). It requires
a hearing care professional, skillful
in motivational interviewing and
other interpersonal communication
abilities, to guide patients through
the process of behavior change.
To learn more about motivational
interviewing readers are encouraged
to visit www.motivationalinterviewing.
com and read the works of industry
experts Kris English, Jill Preminger,
Gaby Saunders, John Greer Clark and
Michael Harvey.
As the American healthcare system
evolves, moving toward a model
emphasizing preventive care and
management of chronic conditions,
there will be ample opportunities
for professionals to become more
actively involved in delivering care to
younger patients, many with milder
hearing losses. Practicing the six
steps of participatory care, shown
in the center of Figure 4, will require
less focus on technology and more
care professionals would be wise to
develop skills in these five areas.
• Ensure patient comfort. In addition
to providing physical comfort
through the use of ergonomically
correct chairs and providing an
inviting ambience, it is vital for
professionals to foster emotional
comfort too. Basic interpersonal
skills such as good eye contact,
an engaging smile and a warm,
Patient-Provider Relationship
Patemalistic:
1. Passive role for patient
2. Works well when patients
have limited information
and an acute problem
Informative:
Shared-decision:
1. Patient and professional
work together
2. Works well when patient
has long-term, chronic
condition
3. Collaboration on options,
goals and results
1. Professional provides
information and patient
makes decision
independently
2. Information can be
outsourced to call center
or website- direct-toconsumer example
Figure 5. The continuum of patient-provider relationships
emphasis on guiding patients through
the process of behavior change. It
will require professionals to become
less reliant on the crude tools such
as the audiogram and more adept at
using interactive practices, such as
goal setting when making important
treatment decisions with respect to
the individual.
The five attributes of patient centered
communication, summarized from
the work of Canadian audiologist
Laya Poost-Faroosh below, can be
utilized to optimize the individual’s
experience in your clinic. Of course
there are no guarantees, but hearing
authentic manner help establish
a safe and emotionally inviting
atmosphere where patients can
feel comfortable.
• Consider patient motivation and
readiness. Rather than using the
audiogram results as a guide,
professionals are encouraged
to ask patients simple scaling
questions to ascertain the degree
of readiness and motivation to
receive help. A scaling question
asks patients to self-rate on a 1
to 10 scale (1 is no problem, 10
is a great deal of problems) how
motivated or how ready they are
to receive help. Insights into the
patient’s perceptions of readiness
and motivation on a quantifiable
scale help hearing aid specialists
match the support, feedback
and guidance depending on the
patient’s self-rating. For example,
patient A with a low self-rating on
the readiness to accept treatment
would warrant a much different
set of tactics than patient B who
has a high self-rating and is read to
move ahead with treatment. In this
example, patient A would probably
benefit from much more exploration
around why treatment uptake
would be beneficial to him and his
family. The role of the hearing care
professional in this case is to help
the patient “paint the picture” of all
the potential benefits of help.
• Acknowledge and understand
the patient as an individual.
Using customizable, open-ended
assessment tools like the COSI or
TELEGRAM (Thibodeau, 2004) are an
effective approach to individualizing
the initial discovery of the scale and
scope of the patient’s challenges.
Additionally, it is helpful to focus
on specific behaviors, which are a
consequence of the hearing loss
that the patient may be willing
to change. For example, if the
patient expresses concern that he is
avoiding certain listening situations
because he cannot hear, devise
some goals and strategies that will
allow the patient to become more
actively involved in these places
with your guidance and support.
Taking a deeper dive into the
individual needs of the patient and
the associated behavior resulting
Continued on page 22
21
I don’t have any problems or concerns that need changing.
Pre-contemplation
It might be worth it to work on my problems and concerns.
Contemplation
I am very close to doing something about my problems and concerns.
Preparation
I am currently working on addressing my problemsand concerns—that’s
why I am here.
Action
Table 1. One question stages-of-change assessment
from untreated hearing loss takes
more time, but in the end that
added time is more likely to result
in a patient that feels they were
profoundly heard by their hearing
care provider.
• Provision of useful and actionable
information. As a general rule the
information you provide that patient
needs to be in alignment with their
stage of readiness. The Stage-ofChange (or Transtheoretical) Model
recently summarized by LaPlanteLesvesque (2015) suggests that
hearing impaired patients are likely
to be in one of the following stages:
pre-contemplation, contemplation,
preparation or action. Patients are
likely to progress through the stages
of change in the order listed above.
Currently, the University of Rhode
Island Change Assessment (URICA)
self-report has been used to identify
the individual’s stage of change,
however, given its 32-question
length, the URICA is probably
feasible to conduct clinically.
That doesn’t mean identifying a
patients stage of readiness cannot
be ascertained during the interview
process. One quick way to gather
some helpful information about a
22
patient’s stage of change is to use
the one question shown in Table 1.
By asking the patient to check
the box next to the statement
most accurately describing their
current status with respect to their
hearing, the hearing professional
can estimate how ready the patient
may be to take action resolving the
handicapping conditions caused by
their hearing loss.
“Which of the following statements
best describes your attitudes and
beliefs about your hearing ability
today”: (check one circle). Note that
the third, far right column is not
visible to patients.
The important consideration is that
the actions taken by the hearing care
professional to help the patient must
be congruent with the patient’s stage
of change. For example, if the patient
checks the top box placing him in
the pre-contemplation mode, it is
wise for the professional to avoid talk
about treatment options – even in the
event of a significant hearing loss of
the audiogram. Further, identifying
the patient stage of readiness is an
effective springboard into deeper
dialogue around behavior change.
Let’s say the patient checks the box
corresponding to the contemplation
mode, this could be a cue for the
professional to explore some of the
reasons why it might be important
to seek help for their hearing
impairment. More research is needed
on how this one-question approach
aligns with the URICA and the stagesof-change model, however, it does
provide useful information about the
patient’s self-perception of readiness
to seek help and take action.
• Facilitate shared decision making.
The final patient-centered attribute
is the ability to enable shared
decision making between the
patient and hearing aid specialist.
In addition to the previously
mentioned use of patient decision
aids, shared decision making
implies that you have an assortment
of treatment options from which to
choose. Putting shared decision
making into practice does not mean
scientifically-based principles are
abandoned. The science behind
fitting hearing aids and other
devices are more important than
ever before.
Baby boomers and others classifying
themselves as healthy agers take a
more active role in their healthcare
choices. Anecdotal reports are
consistent with this finding, as a
recent poll of A.T Still University
School of Health Sciences students
who are also active clinicians report a
substantial upswing in the number of
patients under the age of 60 seeking
help and information for their hearing.
If it is indeed the case that younger
individuals are seeking hearing
care services it is logical for many of
them to be in pre-contemplation or
contemplation stage, and therefore,
this requires the hearing care
professional guide them to the action
stage of change. Additionally, many
of these younger patients, seeking
first time help are likely to have milder
communication challenges, thus
traditional hearing aids may not be of
interest to them, at least in the earlier
stages of their loss. Rather than telling
these patients to wait, interventional
hearing care professionals (who put
patient-centered and participatory
care skills into practice) will be
providing treatment choices which
may not be traditional hearing aids.
Apps like the iAudiometer and devices
such as Hypersound that have an edgy
consumer electronic look and feel
may captivate the new, younger help
seeker. Alternative treatment choices
may be even involve the delivery of a
product and could be therapy-driven
approaches to behavior change. As
the healthcare landscape continues
to evolve, hearing care professionals
must continue to offer value to the
marketplace by offering a wider range
of treatment options. Introducing
Continued on page 24
23
these alternative options starts
with the consistent use of patientcentered communication skills and
participatory care. In today’s digital
age, the irony is that our future as
hearing care professional is predicated
on our ability to master the basic
human skills of communication
and trust. n
The views expressed in this article
are those of the author and do not
represent the opinions or advice of
the International Hearing Society.
According to the FDA, personal sound
amplifiers (PSAPs) are not medical
devices, nor are they to be marketed to
people with hearing loss. IHS advises
hearing aid dispensing professionals
to use caution in attempting to modify
or fit personal sound amplifiers
and to ensure they are following all
applicable state and federal laws.
Brian Taylor, AuD is the Senior Director of Clinical Affairs at Turtle Beach/
Hypersound. He is also the clinical audiology advisor for the Fuel Medical
Group. Brian is an adjunct professor for A.T. Still University Arizona School
of Health Sciences, and editor of Audiology Practices, the quarterly journal
of the Academy of Doctors of Audiology. He serves as the treasurer for the
Accreditation Commission for Audiology Education (ACAE) whose mission
is to assure the public that AuD programs graduate competent audiologists
trained to the highest standards. Over the past decade, Dr. Taylor has held
a variety of positions within in the industry, including stints with Unitron
and Amplifon. He can be contacted at [email protected]
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Hearing Journal. 57,11, 46-51.
Wallhagen, MI & Pettengill, E. (2008). Hearing impairment: Significant but underassessed in primary
care settings. J Gerontol Nurs. 34: 36-42.
Take the continuing
education quiz on
page 55.
24
IHS Continuing Education Test
1. An example of a profession that
has already undergone creative
destruction is
a.hearing aid specialist
b.cell phone sales person
c.audiologist
d.pager sales person
2. A client who states that they are very
close to doing something about their
hearing problems and concerns
would be considered to be in this
stage of readiness:
a.pre-contemplation
b.contemplation
c.preparation
d.action
3. A recent study by Sanchez revealed
that this percentage of people
prefer to obtain a hearing test
from a hearing care professional
a.36%
b.63%
c.68%
d.83%
5. Creative Destruction
a.is an economic term introduced in the 1880s
b.describes the economic growth that entrepreneurs bring to socialism
c. states that long-term economic growth is fueled by radical innovation
d.none of the above
6. As it relates to creative destruction,
hearing care professionals would
be wise for developing a strategy
around getting directly involved in
the verification of PSAPs fittings with
probe microphone measures.
a.true
b.false
7. Hearing healthcare professionals
will experience significant change in
how they create value for the hearing
impaired population over the next
decade.
a.true
b.false
4. Professionals who adopt a
participatory care methodology
of approaching patients will
a. become less reliant on the audiogram
b.place more emphasis on the behavioral change process
c. place less focus on technology
d.all of the above
8. Using self-guiding hearing screening
apps is likely to slow a prospective
client’s journey to your practice.
a.true
b.false
9. Participatory care is a model of
hearing healthcare where
a.patients take a more active role in the generation of treatment options
b.patients take a less active roll in the
implementation of treatment options
c. patients are guided in a
paternalistic manner in their treatment plan of action
d.none of the above
10. A patient decision aid is a structured
tool designed to
a.facilitate knowledge transfer
b.increase patient engagement
c. compare the pros and cons of more than one treatment option with more direct involvement from the patient
in the decision-making process
d.all of the above
For continuing education credit, complete this test and send the answer section to:
International Hearing Society • 16880 Middlebelt Rd., Ste. 4 • Livonia, MI 48154
• After your test has been graded, you will receive a certificate of completion.
• All questions regarding the examination must be in writing and directed to IHS.
• Credit: IHS designates this professional development activity for one (1) continuing education credit.
• Fees: $29.00 IHS member, $59.00 non-member. (Payment in U.S. funds only.)
#
CREATIVE DESTRUCTION IN HEARING CARE
Name _____________________________________________________________________________
Address ___________________________________________________________________________
City ___________________________________State/Province _____ Zip/Postal Code __________
Email _____________________________________________________________________________
Office Telephone ____________________________________________________________________
Last Four Digits of SS/SI # _____________________________________________________________
Professional and /or Academic Credentials _______________________________________________
Please check one: o $29.00 (IHS member) o $59.00 (non-member)
Payment:
o Check Enclosed (payable to IHS)
(PHOTOCOPY THIS
FORM AS NEEDED.)
Charge to: o American Express o Visa o MasterCard o Discover
Card Holder Name ___________________________________________________________________
Card Number _______________________________________________ Exp Date _______________
Signature __________________________________________________________________________
Answer Section
(Circle the correct response from the test questions above.)
1. a
b
c d
6.a b
2. a
b
c d
7.a b
3. a
b
c d
8.a b
4. a
b
c d
9. a
b
c d
5. a
b
c d
10. a
b
c d
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