The core courses consist of seven modules, each module composed of two courses worth 3.0 credits for each module, with a total of 21 credits.
Module on Auditory Systems
Course 1: Auditory Physiology & Psychoacoustics
This course will review our understanding of sound, i.e. the nature of acoustic signals, how we measure them, and important aspects of how sounds are transmitted to the ears. We will examine the structure and function of the auditory system from the ear to auditory cortex. The course will cover the basic mechanics and physiology of the middle ear and cochlea. We will examine in some detail hair cell mechanisms and the coding of sound signals by the cochlea. We will describe key features of central auditory processing, including brainstem mechanisms involved in sound localization and cortical processing of complex sounds including speech-related signals. We will discuss both physiological and behavioral measures of auditory function. Behavioral measures will include basic clinical tests of hearing (e.g. the audiogram) as well as more complex psychophysical assessments. These psychophysical tests include investigations of auditory function in the frequency (spectral) domain, in the temporal domain (timing information in sounds) and in the intensity domain (e.g. loudness measures). In all cases the behavioral measures will be considered for the normal auditory system and for subjects with various types and degrees of hearing problem.
Course 2: Auditory System Disorders and Diseases
This course is designed to instruct students on important etiologies of hearing loss and related disorders affecting children and adults. Auditory disorders and diseases are reviewed following an anatomical sequence from the external ear to the central auditory system with an emphasis on those etiologies encountered most often in clinical audiology. Coverage of each disorder or disease includes information on prevalence, risk factors, mechanism(s), pathophysiology, medical management, patterns of auditory findings, and implications for general and hearing health. Importantly, a lecture in the course is entirely devoted to medical referral indications and guidelines. The final segment of the course provides an overview of the topic of clinical pharmacology. The course includes a guest lecture from an otolaryngologist.
Module on Basic Clinical Assessments
Course 3: Diagnostic Clinical Procedures & Clinical Skills
This course is designed to provide a systematic, critical and practical review of current principles, procedures, and protocols for behavioral hearing assessment of children and adults. A substantial portion of the course is devoted to pure tone audiometry with air- and bone conduction stimulation and to speech audiometry. This discussion also includes the important topic of proper masking techniques to assure ear specific test findings. Valuable but less used techniques such as the audiometric Weber test and the sensorineural acuity level (SAL) test are also covered. The final segment of the course includes lectures on effective and efficient strategies for combining procedures into an evidence-based test battery for diagnosis of peripheral hearing loss and detection of central auditory nervous system dysfunction. An important topic covered in the course is the cross check principle. The discussion also includes special patient populations such as children and adults with false or exaggerated hearing loss.
Course 4: Electro-acoustic Measurements in Audiology & Clinical Skills
This course is designed to review principles underlying electroacoustic measurements, specifically aural immittance measures and otoacoustic emissions, and their clinical applications. The course begins with a brief historical perspective emphasizing the long-tradition of research evidence supporting clinical application of aural immittance measurements. Important terms and relevant anatomy and physiology are defined. Measurement of aural immittance procedures is then explained in the context of clinical practice guidelines including multi-component and multiple-probe tone tympanometry, Eustachian tube dysfunction tests, and acoustic reflexes. Special attention is given to the diagnostic value of analysis of acoustic reflex threshold, latency, amplitude, and patterns for ipsilateral and contralateral conditions. Wideband absorbance/reflectance is also covered with emphasis on advantages in measurement of middle ear function in children. The remainder of the course focuses on otoacoustic emissions, including current thinking on mechanisms of generators, guidelines for measurement and analysis, and clinical applications in children and adults.
Module on Advanced Clinical Assessments
Course 5: Electro-physiologic Measurements in Audiology & Clinical Skills
This course is designed to provide a systematic and practical review of current principles, procedures, and protocols for the application of auditory evoked responses in the assessment of children and adults. A substantial portion of the course is devoted to the auditory brainstem response (ABR) and its application in frequency-specific estimation of auditory thresholds in infants and young children. This discussion also includes an explanation of different stimulus options and the calibration of stimuli used in in auditory electrophysiological measurement. The course also covers other auditory evoked responses applied clinically in audiology, including electrocochleography (ECochG) and cortical responses.
Course 6: Introduction to Vestibular Function & Clinical Skills
This course is designed to introduce students to the vestibular system, related disorders, and basic evaluation techniques. Following an anatomical sequence from the peripheral to central vestibular systems, a few common disorders are reviewed. Coverage of each disorder or disease includes information on prevalence, risk factors, mechanism(s), pathophysiology, medical management, patterns of symptomatology. The final segment of the course provides an overview of the bedside evaluations of the Vestibular Ocular Reflex and Vestibular Spinal Reflex, and Videonystagmography overview
Course 7: Pediatric Audiology
Hearing assessment and management for infants, young children and people with developmental delays is crucial for minimize the developmental effects of hearing loss in these populations. This course will provide students with an understanding of the development of auditory behavior, overview of Early Hearing Detection and Intervention programs, developmentally-appropriate physiological and behavioral test techniques, and provision of amplification. Case studies and video examples will be used to reinforce key concepts.
Course 8: Auditory Processing and Disorders
The general objective of this course is to provide students with an understanding of acoustic cues for perception, speech perception, theories of perception and how these relate to Auditory Processing Disorders. This course will review in detail diagnostic procedures and management strategies for auditory processing disorders (APD). The emphasis will be on the neurobiological basis of APD, differential diagnosis, and management. After successful completion of this course, students should be able to use their skills and knowledge to develop auditory processing services to children and adults.
Course 9: Hearing Technologies & Clinical Skills
This course is designed to introduce students to theoretical and practical information regarding modern hearing aids, develop an understanding of the mechanisms, advantages, and disadvantages of different hearing aid features, the selection, assessment, programming and fitting strategies consistent with evidence based methods. New developments in hearing aid technologies signal processing strategies, verification, validation and outcome measures will be examined. Modern pre-fitting measures will be reviewed and related to the selection and application of advanced hearing aid technology.
Course 10: Implant Technologies and Sensory Aids & Clinical Skills
This course will review cochlear implants and other implantable technologies for clinical audiologists. The course will cover the basic issues related to cochlear implant candidacy criteria, cochlear implant design, surgery, habilitative and rehabilitative issues and strategies. Candidacy, fitting, and verification issues will be addressed.
Course 11: Auditory Rehabilitation
This course is designed to instruct students on the principles and implementation of audiologic rehabilitation across the human lifespan. The successful management of hearing loss involves more than technology-related solutions. The nature of hearing loss and the limitations associated with current technology require an understanding of the impact of hearing loss on the individual, caregivers, communication partners, and family members in order to prescribe appropriate and effective non-technology intervention strategies that minimize the psychosocial consequences of hearing loss and maximize the benefits of prescribed technology.
Course 12: Counseling in Audiology
Audiologists are quite familiar with the range of psychological and emotional difficulties associated with living with hearing loss. For instance, parents often “shop around” for a preferred diagnosis, or find it hard to act upon recommendations, likely because they are overwhelmed and confused about their child’s hearing loss. Children with hearing loss often lack support in developing emotional self-awareness and important social skills. Teens may choose to forsake amplification to fit in with peers. Adults often wait for years before addressing their hearing problems and even after they make an initial appointment, they may resist hearing help. Such patients can be said to be “stuck” in the helping-seeking process.
Audiologists often report being unfamiliar with the help-seeking process and therefore feel under-prepared to provide support in this vital area of patient care. “Counseling in Audiology” is designed to provide support to audiologists interested in expanding their counseling skills. The course will afford an opportunity not only to learn and understand a set of basic counseling strategies, but also apply, discuss, and evaluate the effectiveness of these strategies. Research supporting counseling as an evidence-based practice will be fully explored.
Module on Best Practices
Course 13: Clinical Decision Making in Audiology
This course is designed to explore the important topic of clinical decision making in audiology. Clinical decision making is the process of organizing, collecting, and analyzing evidence from a single patient encounter, with the goal of developing a rational and effective treatment plan. Clinical decisions are often made with incomplete or imperfect information. Understanding how to evaluate the accuracy and limitations of clinical data and the risks associated with clinical errors is an important discipline for the clinician to master. Clinical decision-making involves analytical skills and the ability of an audiologist to “think on his or her feet.” The course begins with a review of evidence-based practice, including principles and examples relevant to audiology, plus clinical practice guidelines. The review includes topics such as performance of tests used in audiology (sensitivity and specificity), statistical principles in decision-making and clinical application of signal detection theory. This course incorporates “patient based learning” with case studies of patients with auditory and related disorders (e.g., tinnitus and autophonia) to achieve educational course objectives. It also covers elements of report writing as a culmination of clinical decision-making.
Course 14: Public Health & Humanitarian Audiology
This course is designed to review public health issues in audiology and determinants of hearing health status including cross-cultural differences in prevalence, racial and ethnic distribution of major forms of hearing loss and auditory dysfunction, the impact of hearing loss and auditory dysfunction on quality of life, preventive measures, and changing demographics over time within society. Portions of the course deal with public health implications and determinants of hearing health to include: 1) early hearing loss detection and intervention (EHDI) in children, 2) ototoxicity and diet, 3) personal and societal impact of sound induced hearing loss, 4) personal and societal impact of age-related hearing loss, and 4) tinnitus plus disorders of reduced sound tolerance. The course also addresses psychosocial aspects of hearing loss for persons with hearing loss and their families in the context of public health. The latter segment of the course focuses on humanitarian audiology efforts to expand and improve the quality of hearing care globally with a special series of lectures on audiology applications of tele-health (tele-audiology). The course includes guest lectures from audiologists and other health professionals who specialize in public health issues and humanitarian audiology.
Fellowship Course Descriptions