Part 2 of the Certificate Holder–Tinnitus Management (CH-TM) program began in July 2018, providing the final step for audiologists wishing to earn a credential that reflects the requisite knowledge necessary for the management of tinnitus patients. The CH-TM is an assessment-based certificate program that uses evidence-based instructional design principles to ensure efficient learning and retention of the information presented in the course. This online self-study course offers a learning program supplemented with a toolbox of resources.

The American Board of Audiology (ABA) conceptualized the CH-TM to (1) bridge the gap between formal audiology education and tinnitus-focused training, (2) create a comprehensive and unbiased tinnitus-management program, and (3) develop a greater pool of audiologists trained to treat the significant number of individuals who suffer from tinnitus. 

This program reflects current scientific research, along with the combined years of practice and diverse experiences of a group of renowned experts in the specialty. 

Part 1 of the CH-TM provides the foundational knowledge needed to assess and manage patients with tinnitus and/or decreased sound tolerance (DST). Part 2 expands on this knowledge base to provide advanced intervention and management techniques for audiologists who treat patients with tinnitus and/or decreased tolerance to sound. 

Tinnitus in America

Tinnitus affects a significant percentage of the U.S. population. One in 10 adults in the United States are affected by tinnitus, according to research by Bhatt et al (2016). A total of 14.6 percent of the respondents to the 2011–2012 National Health and Nutrition Examination Survey from the National Center for Health Statistics reported suffering from tinnitus. In 2007, 9.8 percent of adults 18 years of age and older responding to the National Health Interview Survey by the U.S. Census Bureau and the Centers for Disease Control and Prevention said they had been “bothered by ringing, roaring, or buzzing in your ears or head that lasts for five minutes or more” within the 12 months preceding the survey.

Research indicates that 85 percent of tinnitus sufferers never received any form of treatment (Bhatt J et al, 2016). Approximately one in 12 young people experience significant challenges from tinnitus and tinnitus increases with age, according to the Hearing Health Foundation (2017). A growing area of research investigates the relationship between noise exposure and tinnitus among youth (Mahboubi et al, 2013; Park et al, 2014). This is of particular concern, given the use of personal music devices, earbuds, and exposure to loud music among members of the millennial generation.  

The CH-TM Program

The clinical practice guideline for tinnitus published by the American Academy of Otolaryngology Head and Neck Surgery Foundation (Tunkel et al, 2014) is considered the essential and overarching reference for tinnitus treatment. This is the only tinnitus-management guideline that exists in the literature today. It is based on a systematic review of the literature, and is the foundational document on which the CH-TM program is built. The CH-TM program takes this foundation to the next level by presenting a standardized approach to assessment and reviewing the current evidence supporting the use of various management and therapy options available to today’s tinnitus specialist.   

The program includes two parts, each containing multiple modules of web-based content developed by the subject matter expert (SME) work group and validation panel. The SME work group and validation panel included distinguished researchers and clinicians whose collective experience in tinnitus management is represented in the comprehensiveness of the program. Unlike other programs on the market, the CH-TM offers a diversity of perspectives in the content and is an affordable option for audiologists seeking additional training in tinnitus management. Each module in the program is worth 0.2 AAA/Tier 1 CEUs.

Part 1: Foundations of Tinnitus Management

Module 1, Tinnitus Definitions and Theoretical Foundations: Identifies the different types and characteristics of tinnitus, the prevalence of the condition in the United States and globally, and different theories of the etiology of tinnitus.

Module 2, Management of the Patient with Tinnitus: Provides a snapshot of the experience of tinnitus, along with a broad synopsis of assessment approaches, intervention techniques, and practice management considerations.

Module 3, Business Management Considerations: Discusses the unique demands and business factors associated with integrating tinnitus and decreased sound tolerance services into an audiology practice.

Part 2: Tinnitus Management Principles in Practice

Module 4, Audiological Evaluation of the Patient with Tinnitus: Teaches how to assess the results of a comprehensive audiological evaluation as a basis for clinical decision-making for a patient with tinnitus.

Module 5, Tinnitus Intervention Techniques: Reviews varied approaches that may be used as interventions for patients with tinnitus, including indications for use, benefits, and limitations of each technique.

Module 6, Management Plan for the Patient with Tinnitus: Teaches how to educate and collaborate with patients and other providers to develop a management plan for a patient with tinnitus

Module 7, Management of the Patient with Decreased Sound Tolerance: Summarizes the characteristics and prevalence of DST, along with assessment approaches, treatment techniques, and practice-management considerations for these patients.

Unique Program Features

The format of CH-TM allows for full engagement of the learner throughout the modules and beyond the program. As learners move through the modules, they find additional tips and tools that augment and enhance the instructional content.

Case Studies: The modules include case studies that illustrate applications of presented content.  The interactive component of the program enables the learner to engage in the diagnosis and management of the patients.

Words to the Wise: Practical tips are provided from audiologists who have experience working with patients with tinnitus.

Terminology Alerts: Terms are clarified that have nuances or may vary from one audiology program to another.

Think About It icon: The program offers questions that challenge learners to stop and reflect about what they are learning. 

Check Your Knowledge: Questions help learners self-assess as they progress through the program.

Toolbox: The toolbox links to additional information, resources, tools, and other practical aids to expand knowledge or support work with patients with tinnitus. The toolbox also contains a full reference list related to the citations seen throughout the modules.

Participant Response

Within days of the release of Part 2 of the CH-TM, many of those who had completed Part 1 were already well underway in Part 2. The completion of Part 2 will earn these individuals the CH-TM designation.

In Part 1 postcompletion evaluations, many learners identified strengths of the program, including the following:

  • The review of the basics of tinnitus and the general rehabilitative techniques.
  • Great knowledge base. Unbiased.
  • Excellent visual diagrams—excellent content.
  • This is the only tinnitus specialist training available.
  • Delivery format, additional resources, easy-to-understand explanations.
  • Helping to move audiology forward to accept tinnitus care as viable in practice. 


Acknowledgments

The American Board of Audiology recognizes that the CH-TM program would not have been possible without the exceptional volunteers who devoted their time as SMEs or members of the validation panel. In addition, the instructional designer, Laurie Posey, EdD, of George Washington University, brought her expertise to the translation of the learning objectives into fully-developed, evidence-based storyboards for each module. Katy Sidwell provided outstanding project management at the staff level to sustain volunteer engagement and uphold the quality of the program from conception through production. 


References

Bhatt J, Lin H, Bhattacharyya N. (2016) Prevalence, severity, exposures, and treatment patterns of tinnitus in the United States. JAMA Otolaryngol Head Neck Surg 142(10):959–965. 

Hearing Health Foundation. (2017) Tinnitus in childhood. http://hearinghealthfoundation.org/childhood_tinnitus (accessed April 7, 2017).

Mahboubi H, Oliaei S, Kiumehr S, Dwabe S, Djalilian H. (2013) The prevalence and characteristics of tinnitus in the youth population of the United States. Laryng 123(8):2001–2008. 

Park B, Choi H, Kim H et al. (2014) Analysis of the prevalence of and risk factors for tinnitus in a young population. Otol Neurotol 35(7):1218–1222. 

Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM et al. (2014) Clinical practice guideline:  tinnitus. Otolaryngol Head Neck Surg 151(2 Suppl):S1–40. www.ncbi.nlm.nih.gov/pubmed/25273878.

U.S. Centers for Disease Control. (2012) National Health and Nutrition Examination Survey. wwwn.cdc.gov/nchs/nhanes/ContinuousNhanes/Overview.aspx?BeginYear=2011 (accessed July 2018). 

U.S. Centers for Disease Control. (2007) National Health Interview Survey. www.cdc.gov/nchs/nhis/index.htm (accessed July 2018).

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