Now more than ever, infection control is one of the most widely discussed topics in any health-care environment. Infection control guidelines are changing rapidly, affecting the student clinician experience. 

In accordance with the Centers for Disease Control and Infection (CDC) guidelines, perhaps the most influential way to slow the spread of COVID-19 is minimizing the number of people in a space at a given time. Many medical settings have reduced the quantity of individuals allowed in the facility at once which often means fewer, if any, students. 

Student clinicians face restrictions because of the pandemic, resulting in decreased practicum hours and fewer opportunities for hands-on learning experiences. While remote learning resources and networking opportunities have evolved to fill in this gap, many clinicians and students in our profession continue to adapt to the impact that limited in-person exposure has presented.

What Do Academic and Clinic Modifications Entail for AuD Students? 

The most predominant advice as students are allowed back into the clinic is to develop, implement, and maintain a plan of action (Centers for Disease and Control Intervention, 2020). However, as audiology programs prepare for the fall semester, there is not one cohesive national strategy for reopening. Many programs will opt for either a combination of in-person and remote instruction, solely remote learning, or limited in-person learning. 

Although maintaining social distance continues to be one of the most easily implemented and medically proven ways to stop the spread of COVID-19 (Delen et al, 2020), this strains the student clinician experience as students are commonly the first ones to be removed from a practicum site to accommodate social distancing. In effect, this limits direct patient interactions and professional observation hours, two essential components of gaining competency as a student clinician. 

Even when a site can accommodate a student and still meet CDC guidelines for social distancing, their patient interactions may remain restricted because the number of patients in the clinic is also limited. Restrictions on daily patient load are increasingly common to allow more time for cleaning between appointments and less crowding in waiting rooms. 

Furthermore, some patients are simply avoiding the clinic due to concern of contracting the coronavirus, amongst other recommendations that medically fragile patients and those over the age of 60 only attend appointments if absolutely necessary (Academy of Doctors of Audiology, 2020). Many clinics have adapted hybrid or rotating schedules, altering the number of audiologists and preceptors in the clinic on a given day. With a decreased volume of patients, students who do receive a practicum rotation remain limited in their hands-on opportunities with patients. 

Where Do We Go from Here?

With student practicum hours either reduced or eliminated, it is important that AuD programs adapt their curriculum to incorporate new modalities for patient care and building clinical skillsets. Per CDC guidelines recommended by the Academy (COVID-19 and Clinical Recommendations, 2020), non-essential healthcare appointments should be conducted online via telehealth to limit person-to-person interaction. Non-essential appointments commonly include hearing device appointments, annual audiograms, and hearing screenings. For many students, these non-essential appointments offer some of the greatest benefit for continual practice and skill improvement. As audiologists transition to increased demand for telehealth services, AuD programs have adopted simulated clinic opportunities and web-based learning of telehealth practices. However, due to limited classroom and clinical opportunities because of the COVID-19 pandemic, students may still perceive a regression in their audiology skillset. The following are recommendations for both students and preceptors to fill the gap in practicum experience.

  • Be patient and forgiving with yourself and/or with your student. 

If you feel that you are no longer in the audiology mindset or finding it difficult to commit time to the profession after quarantine, be patient with yourself. The COVID-19 pandemic has been a trying time for everyone and you are not alone. 

  • Be flexible and maintain a dynamic mentality.

CDC guidelines and clinic closures are changing rapidly. Be prepared to implement new protocols and be understanding of patients who are unwilling to return until circumstances improve. The Academy is tracking changes and posting updates on the impact of CDC guidelines on audiology. 

  • If you are a student or a clinician who is out of practice due to COVID-19, use the extra time to learn about audiology topics that interest you, seek continuing education opportunities, or review recent audiology literature. 

The Academy has many online resources and webinars to learn about various topics within the profession. 

  • AuD students can use this time to study for competency and licensure exams. 

It is never too early to begin studying for competency examinations. Additional downtime from the lack of practicum hours is a great opportunity to review and study. This will also keep you in the audiology mindset and prepare you for your next practicum rotation. 

  • Educate yourself on infection control practices for your return to the clinic. 

CDC guidelines are changing daily as medical experts discover more about the novel coronavirus. Keeping up to date with infection control protocol will help you feel more confident as clinical sites reopen for students. 

  • Embrace virtual learning. 

Like classroom education, virtual learning will likely prove beneficial for the student clinician if later supplemented with in-person supervision. Additionally, increased access to online courses and resources may help reach students in more remote locations. Virtual resources are easy to promote and share amongst colleagues or friends. Sharing your favorite resources on social media can help bring awareness to our profession and to the growing availability of online education materials. 

  • Volunteer and help through community service. 

Find local activities or campaigns shared through social media or any news outlets. Now more than ever, it is important as future healthcare providers to be engaged in the community. 

  • Become a voice; advocate and promote social distancing activities through social media. 

The sooner everyone adheres to social distancing and other CDC recommendations to flatten the curve, the quicker students and clinicians can get back to business as usual in the clinic.

What Does the Future Hold for Clinical Education within the Audiology Curriculum? 

Within the past 20 years, audiology licensure was adapted from a two-year master’s degree to a four-year clinical doctorate because of the clinical experiences obtained throughout the audiology student curriculum. Clinical engagement remains a fundamental component of AuD curricula to prepare students for professional patient practice. 

Nationwide, AuD students have been asked to adjust and continually adapt to the changing infection control protocols imposed by the COVID-19 pandemic. While AuD curricula and student clinician experiences continue to evolve because of the pandemic, the rapid adoption of telehealth practices and availability of online simulations for students shows the resilience of our profession. Although clinical experience will likely remain limited in-person or virtual for the foreseeable future, there are many opportunities to help students develop their skills for licensure. 

Educating and fostering proper infection control practices amongst AuD students will make the future of our profession more equipped for potential disruptions. While the COVID-19 pandemic has presented numerous challenges to audiology students and clinicians, it has also created opportunities for professional development and mindfulness with infection control practices. We encourage students to view these challenges as learning opportunities to better the future of our profession.