AuD Clinical Requirements and Dress Code

SDSU School of Speech, Language, and Hearing Sciences

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CLINICAL EXPERIENCES AND DRESS CODE

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Clinical Experiences and Dress Code

Clinical Component

During the four-year AuD Program, students receive intensive and broad based clinical training in a variety of clinical settings. Students are exposed to a diverse group of clients across the life span with diverse ethnic, cultural, linguistic and multiple disabilities. Major emphasis is on learning state of the art techniques, grounded in evidence-based practice, to meet the current challenges and standards in diagnostic, treatment, and rehabilitative care of patients with auditory and vestibular disorders. Through the clinical practicum experience and externship, students learn to apply much of what they have learned in classes, as well as develop additional skills and levels of clinical independence.

Students learn to:

Identify, assess, diagnose, interpret, and manage test results related to disorders of hearing, balance, and other neural systems.
Conduct and interpret behavioral, electro-acoustic, and electrophysiological tests used to assess hearing, balance, and neural system function.
Perform otoscopic examinations for cerumen in order to evaluate its effects on hearing test results, hearing aid use, and/or making ear impressions, and to make appropriate referrals if needed.
Perform tinnitus evaluations and make appropriate recommendations regarding its treatment.
Select, evaluate, fit, and facilitate adjustments to hearing aids and other assistive hearing devices.
Evaluate and manage children and adults with central auditory processing.
Conduct newborn hearing screenings.
Observe/participate in electrodiagnostic tests for the purposes of neurophysiologic intraoperative monitoring and cranial nerve assessment.
Assess candidacy of clients with hearing loss for cochlear implants, perform CI programming and audiologic rehabilitation to optimize device use.
Counsel clients for psychosocial adjustment to hearing loss for persons with hearing loss and their families/caregivers.
Identify practice patterns in educational audiology, classroom acoustics, and use of FM systems and other assistive devices with school age populations.

Each clinical practicum experience is designed to be commensurate with the level of training. Students are only allowed to perform specific clinical tasks after a period of observation and demonstration by their preceptor. As the student progresses from one semester to another, the intensity of the clinical experiences and the demands of the setting develop into more challenging experiences and a greater degree of independence. The clinical portion of the AuD Program is designed to begin with 100% supervision and progressively builds toward more independence. However, for all clinical experiences, there is to be a supervisor on-site and readily available to provide direction and to approve clinical reports. All supervisors are aware of the need to be able to adjust the amount and quality of supervision based upon the demonstrated skills and experiences of each student. The Audiology Clinic Director monitors this process to ensure adequate supervision, based on feedback obtained from the student and the supervisor. Preceptoring is done by persons holding ASHA certification (CCC-A) for at least 1,820 hours of clinical practicum (the minimum number of hours required for CCC-A); however, some experiences, e.g., intra-operative monitoring, facial nerve monitoring, cerumen management, vestibular assessments, and some off-campus settings may be supervised by non-ASHA certified professionals and will not count towards certification.

Essentially there are four stages of clinical preparation in the Program:

Stage I (Sept Year 1-Aug Year 1): Basic Level (100% direct supervision).
Students spend approximately 8 hours per week in the SDSU Audiology Clinic, all three semesters. They gain experience in basic diagnostics and hearing aid fittings. Ample time is allowed for each patient (1-2 hours). Students learn; a) appropriate safety and infection control procedures, b) how to review patient charts/relevant information and obtain a case history, c) diagnostic equipment operation and how to perform the basic audiometric tests, d) electro-acoustic hearing aid checks, ear mold impressions, hearing aid selections and fittings, including real-ear probe measurements, e) report writing, and f) recommendations (generally made by the preceptor). Students attend a Clinical Cases Studies and Staffing Course (AUD 721) in the fall and summer academic sessions to discuss some of their cases and clinic issues (there is no staffing course in spring because of time devoted to research practicum course). Students should increase in their level of independence and efficiency across the three semesters, so that a complete evaluation is completed in less than 1 hour (at least 80% of the time). Students obtain approximately 150 clinical hours of experience.
Stage II (Sept Year 2-June Year 2): Intermediate Level (100% direct supervision).
Students spend approximately 8-10 hours per week in clinic at the UCSD School of Medicine's Otology and Audiology Clinic (at the Perlman Center) each of the three academic year quarters (fall, winter, spring). In addition, they spend one quarter in Otology Preceptorship where they shadow an otologist during otology clinics and surgeries. The foci in Year 2 are to get exposure to a wide variety of interesting medical cases, review and write in medical charts, and increase speed of evaluations. Extensive hands-on exposure provided in the following areas: tinnitus assessment/treatment, evoked potential testing, balance assessment, hearing aid fitting, medical audiological assessments. Students also spend time in the Neurophysiology Clinic participating in ABR, OAE, vestibular assessment, and facial nerve monitoring, and rotate through a Cystic Fibrosis (CF) clinic. All students attend a Clinical Case Studies and Staffing Course (AUD 291) each quarter and may attend the Chairman's Conference and Neurotology Conference, whenever relevant cases are discussed among residents, staff, and community physicians. Students obtain approximately 250 hours of clinical experience.
Stage III (June Year 2-May Year 3): Intermediate Level (25-100% direct supervision).
Beginning in the summer of Year 2 and continuing through May of the third year, qualified students are assigned to off-campus clinic sites where they receive at least 25% supervision. Students spend about 15-24 hours per week in off-campus agencies. Students demonstrate more independence on basic and advanced audiometric assessments and hearing aid fittings, and develop more skills in areas such as cochlear implants, pediatrics, electrophysiological assessment, and/or vestibular assessments. All students enroll in a Clinical Case Studies and Staffing Course (AUD 821) each term where they are required to present some of their cases for discussion. Students will also consult with SLP students for case management of hearing impaired speech-language clients. Students obtain approximately 750 hours of clinical experience.
Stage IV (July Year 3-June Year 4): Advanced Level (5-25% supervision direct supervision) from preceptor with CCC-A.
The amount of direct supervision can be adjusted based on demonstrated competencies and progress. Students compete for a full-time clinical placement (Clinical Externship) for 12 months (July-June) at a variety of interested sites associated with the program or at an approved site selected by the student with approval by the AuD Program's Audiology Clinic Director. Students are expected to gain full independence and confidence in a wide variety of clinical skills by the end of the externship. All students will participate in an On-line Integrative Seminar (AUD 891) in fall and spring semesters, where interesting cases and issues are discussed. Students must obtain a minimum of 1,850 hours of clinical experience during their 12 month externship.

Audiology Clinic Dress Code

THE DRESS CODE APPLIES TO ANYTIME YOU ARE IN THE CLINIC FOR MORE THAN 10 MINUTES WHETHER OR NOT YOU ARE SEEING PATIENTS. THIS INCLUDES STAFFINGS, LABS, RESEARCH, MEETINGS, ETC.

THIS DRESS CODE IS ALSO THE MINIMUM REQUIRED FOR OFF-CAMPUS CLINICAL PLACEMENTS. INDIVIDUAL PLACEMENTS MAY HAVE MORE STRINGENT RULES.

Shoes worn during clinic should look nice. Open-back shoes such as clogs and mules are acceptable. No flip-flops or athletic shoes are allowed during the provision of clinical services. Hose are optional for women. Off-campus sites may have different dress code requirements.
Any pants/skirt/shirt combination must cover the midriff when your arms are raised and also cover the back when bending over. No excessively baggy pants (crotch of pants to the knees, or riding excessively low on the hips).
Skirts should be of reasonable length, e.g., no more than 4 inches above the knee.
No denim jeans, shorts or jackets. All pants must be in good condition
Low-cut tops, tube tops, or shirts that show-through are not allowed. All tops must have straps that are at least 3" wide. Tops should not be too tight so as to gap in the front.
Shirts for men must have collars. No Hawaiian or other "loud prints. Ties are recommended when seeing patients. Shirts must be tucked in.
Any visible or potentially visible body art needs to be removed or covered. Oral or facial piercing (tongue, lip, eyebrow, and nose) must be removed. Any arm/shoulder/neck tattoos must be covered with long sleeves or a high collar. Any leg and/or ankle and/or foot tattoos must be covered with dark tights or pants. Using Band-Aids to cover tattoos is unacceptable.
Clinicians must wear their identification badge while providing services to patients.

As needed, your supervisor will help you to appear professional in the clinic environment.

last updated: 8/18/08