Introduction and Methods

In September 2018, the Student Academy of Audiology (SAA) conducted a national survey of current graduate students, externs, and recent graduates in order to evaluate the state of audiology education. With more than 1,000 responses, the results from the SAA 2018 Education and Externship Survey provide a good look at a number of the strengths and the potential areas for improvement in audiology training.

Part 1 of this article, published in the July/August 2019 issue of Audiology Today, presents results from the SAA survey and discusses disparities in the AuD externship. This article, a continuation of that piece, provides an examination of the current state of AuD education, excluding the externship. 

Content of Education

The audiological scope of practice requires the teaching of a variety of topics in graduate education programs. Standard content in audiology curricula includes education and experience with diagnostics (including for adult, pediatric, vestibular, tinnitus, electrophysiology, and central auditory processing disorder (CAPD) testing) and rehabilitation (including aural rehabilitation, assistive listening devices, hearing aids, osseointegrated devices, cochlear implants, verification, tinnitus and cerumen management, vestibular rehabilitation, educational audiology, and CAPD intervention). 

While this is not an exhaustive list, the survey results revealed that students reported differences across programs in the amount of experience received in areas such as assistive listening devices, tinnitus diagnostics and management, and pediatric diagnostics. 

These results suggest that the dissimilarities across programs could lead to inconsistently trained audiology graduates, as well as graduates who are inadequately prepared to provide the full scope of practice.

In addition to topic areas considered standard, other areas such as cognitive decline, medical imaging, and pharmacology have recently gained attention. According to the survey findings, students’ satisfaction with their knowledge in these areas depended on their AuD program. For each of the above-mentioned topics, students whose AuD programs have dedicated classes in those areas reported having more knowledge than students from AuD programs that do not have those classes, even if the subject was addressed in other coursework. 

This result again emphasizes that graduates are unequally prepared, even in areas related to the expanding scope of audiology. Knowledge of cognitive decline, medical imaging, and pharmacology will prove useful as health care continues to become more collaborative. 

Length of Education

The length of the AuD education program has been an ongoing conversation since the unveiling of the doctoral degree, with many pros and cons identified. Three-year, or accelerated, programs may be attractive to undergraduates who are concerned for social and financial reasons about committing four years to graduate education. 

While comparing academic performance, clinical hours, and assessments of content mastery is outside of this survey’s scope, the responses about preparedness and experiences among students in three-year and traditional four-year programs were evaluated. Students in three-year programs felt as prepared for their externships as those in four-year programs, though students from three-year programs were less likely to report knowledge and experience in niche areas such as cochlear implants, pediatric diagnostics, and educational audiology than students in four-year programs.

Feedback to AuD Programs

Feedback from students directly to their school programs serves as an important means to elicit beneficial changes for future students. The ASHA Council on Academic Accreditation requires programs to “systematically collect evaluations of the academic and clinical aspects of the program from students…” (ASHA, 2017). However, it remains unclear what specific mechanisms colleges and universities use to collect feedback, how many hold exit interviews, and how this requirement is enforced.

The SAA survey focused on a national sample of audiology graduate students. When asked if they would feel comfortable providing feedback to their AuD programs, the survey respondents overall agreed that they would. On-campus students more strongly agreed that they feel comfortable providing feedback to their programs than externs and recent graduates. 

According to the survey results, first-year students were the most comfortable in providing feedback. The level of comfort declined each year in graduate school, with recent graduates being the least comfortable in providing feedback. 

These results may be due to inherent challenges for externs and recent graduates in providing genuine feedback, including a perceived lack of anonymity due to small cohort sizes, skepticism that the program will act based on their feedback, or apathy once they have left the university. This perception of feedback is of particular concern because externs and recent graduates can provide valuable feedback based on real-world experiences outside of their own universities.

Future work should investigate how to best motivate AuD programs, externship sites, and AuD students to actively engage in this evaluation process and how to mitigate the specific barriers that exist in current systems.

Conclusions

As mentioned in the previous Audiology Today article, “Say the Word ‘Survey’: Inspiring Data-Driven Change for Externships” (Lewis, Camera, DeBacker, 2019), audiology students indicate that addressing differences in education among AuD programs is a top priority to many SAA members. The perceived lack of uniformity in AuD education, despite similar accreditation standards, suggests that there is an urgent need to examine the differences between academic curricula and pedagogical foci among accredited AuD programs. Additionally, future efforts should focus on how the audiology community can help externs and recent graduates feel more comfortable providing program feedback. SAA hopes to work together with the American Academy of Audiology and the Accreditation Commission for Audiology Education (ACAE) in these pressing endeavors.