ABSTRACT The Audiology profession in South Africa appears to be lacking direction. Many challenges to Audiology service delivery are said to exist. However, no official national investigation regarding the range of audiological services provided has been conducted. The purpose of this study was to investigate at a national level, the demographics of Audiologists in SA, to conduct an audit of service delivery, and to identify issues impacting on audiology service delivery. Respondents were requested to indicate reasons for non-provision of audiology services. Research participants included all South African qualified Speech-Language and Hearing Therapists, Audiologists, Speech Therapist and community service graduates currently registered with the Health Professional Council of South Africa. A cross-sectional ex post facto, descriptive survey research design within the quantitative paradigm was selected. Descriptive statistics were utilised to analyse the data and were presented to display service delivery provided by respondents employed in the private and public sectors. Results: A significant difference in professional registration and practice was evident. The audit of service delivery revealed that the provision of advanced diagnostic audiology procedures, paediatric audiology services as well as rehabilitation services was significantly lacking. Audiology service delivery in both the public and private sector were analogous. The lack of equipment was a central reason for the non-provision of services amongst all respondents. Key issues influencing service delivery included the lack of knowledge by associated professionals and the public, delayed referrals, limited budgets, lack of staffing, and restrictions regarding advertisements. Conclusion: The profession of audiology in SA is under transition. The scope of audiology service delivery is slowing moving towards the implementation of advanced diagnostic audiology services however support from associated professionals is lacking. To this end the Audiology profession in SA must focus on advertisement and marketing regarding the range and clinical relevance of audiological services available. Future directions for the profession include the development of unified test protocols and norms, forming data bases, equipping audiology departments, and hosting a forum to discuss a vision of audiology services in SA.

While the approaches for providing aural rehabilitation to the hearing impaired are well documented, no research and only a few articles addressed the comprehensive application of these approaches in the private sector. Therefore, a survey of audiologists was conducted to determine how extensively the approaches are being utilized in this setting and what, if any, unmet client needs may exist. Sixty certified, dispensing audiologists who work in the private sector and reside in Washington, Oregon, Idaho, Montana, and Wyoming participated in the study. Participants were identified from membership lists provided by the five states' Speech-Language and Hearing Associations. A questionnaire was constructed to determine the extent that 14 topics, 32 methods, and 18 barriers, which were identified in the literature, are being used or encountered when providing services to these clients. The survey results indicated that once the standard hearing aid evaluation has been completed, 45% of the respondents are spending less than 60 minutes in providing aural rehabilitation to each client. Only 5% of the respondents were dissatisfied with this amount of time, indicating that 40% believed that comprehensive aural rehabilitation services can be provided satisfactorily in less than one hour. Eighty-six percent of the topics listed in the questionnaire are being discussed with a majority of the respondents' clients. On an average, the respondents discussed topics relating to Audiogram Results, Hearing Aid Orientation, and Expectations for Hearing Aids with over 90% of their hearing impaired clients. They discussed Trouble Shooting and Communication Enhancement with 76-83% of their clients, and they also discussed Hearing Loss Information and Listening Devices with 58-60% of them. Community Resources was discussed with only 33% of this clientele. Only 25% of the methods listed in the questionnaire are being utilized with a majority of the respondents' hearing impaired clients. On an average, respondents utilized methods relating to Oral Instruction with 99% of these clients. They utilized Counseling, Skill Practice, and Support with between 49-64% of them. Respondents utilized the remainder of the methods, including Written Materials, Visual Aids, Referral, Audio-Visual Aids, Structured Classes, and Programmed Instruction, with less than 30% of this clientele. Sixty-three percent of the methods that respondents estimated using with a majority of their clients rely solely upon the ability to hear and comprehend the spoken word, and only 37% of these provide opportunities for repeated exposure to the educational concepts being conveyed. None of the barriers listed in the questionnaire were perceived by respondents as having a high degree of influence on the services they provide. Only 1/3 of the barriers were perceived as having a moderate degree of influence, including audiologists' lack of time to research or develop instructional materials and clients• a.) denial, b.) vanity or self-consciousness, c.) lack of interest, d.) reluctance to participate in an aural rehabilitation program, and e.) ability to afford a hearing aid.

This study explored the types and uses of informal, on-the-job learning occurring among American Speech-Language-Hearing (ASHA)-certified Speech-Language Pathologists (SLPs) working in medical settings as part of a rehabilitation team. In addressing this purpose, a qualitative, phenomenological approach to research methodology was used. Participants were selected through a process of purposeful sampling, each meeting the criteria of having earned the Certificate of Clinical Competence in Speech-Language Pathology from ASHA and working in a medical setting as part of a rehabilitation team. Twenty-four SLPs from varying demographic profiles took part in one of three online data collection methods. Nine participants completed a computer-mediated interview, 11 participants completed an online journal entry and 4 participants completed a virtual focus group method. All data collection methods were accomplished via internet technologies. Data analysis was performed through a process of thematic analysis and resulted in four significant findings. First, both internal and external forces triggered SLPs to learn informally in the medical workplace. Also, SLPs went through an individually-determined, goal-directed process when learning informally in the medical workplace. SLPs used a combination of collaboration, workplace experience and research to learn informally in the medical workplace. And finally, SLPs employed informal learning activities for the purpose of meeting personal, patient and organizational needs. / It was recommended that (a) the American Speech- Language-Hearing Association review its professional development policy and consider implementation of a process whereby clinicians can document their goal-directed workplace learning and receive professional development credit for these activities; (b) healthcare organizations recognize, support and reward the informal learning in which their SLPs are already engaging; and (c) SLPs enhance their informal learning in the medical workplace through proactivity, critical reflectivity (of their own and others' learning), and creativity. The significance of this research included the use and support of existing theory in both Adult Education and Human Resource Development. Further, this research represents the first of its kind in investigating informal learning in rehabilitative therapies, specifically Speech-Language Pathology. Peer professions such as Physical and Occupational Therapy may also benefit from this study's conclusions and recommendations, as these professionals work in similar medical contexts. / by Patrick Roy Walden. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.

The primary objective of the project was to survey audiologists in clinical practice setting to determine the amount of time taken to perform various audiologic tests using Current Procedural Terminology, (CPT) codes to define these tests and if these CPT codes were felt to be adequate. Audiologists were also asked to respond regarding possible impact and reimbursement changes in their clinical practices related to managed care. Responses of audiologists were analyzed to determine: a) adequacy of CPT codes; b)average time to perform various audiologic tests; c) impact managed care onclinical practice; and d) changes in reimbursement as a result of managed care. The survey was designed to determine the type of work setting, typical job duty, average monthly caseload and hours per day spent on patient care for each respondent. The survey with a cover letter explaining the purpose was mailed to 93 audiologists in clinical setting in the state of Florida. Five were returned undeliverable, and 39 of the remaining 88 were returned either completed or partially completed. The survey results revealed over 71% of the audiologists felt the current CPT codes were adequate. Time spent performing traditional audiologic tests, such as comprehensive audiometric evaluations and impedance testing, was fairly consistent. Greater time variability occurred in tests used to determine vestibular function. Over three-quarters of the respondents believed managed care has had a negative impact on their clinical practices, while 11% believe they have been positively impacted. Approximately 82% of the audiologists have had reductions in reimbursement as a result of managed care, while 10% have seen no change and 5% have enjoyed slightly greater reimbursement.

Professional research project (Au.D.)--University of South Florida, 2001. / Title from PDF of title page. / Document formatted into pages; contains 29 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The primary objective of the project was to survey audiologists in clinical practice setting to determine the amount of time taken to perform various audiologic tests using Current Procedural Terminology, (CPT) codes to define these tests and if these CPT codes were felt to be adequate. Audiologists were also asked to respond regarding possible impact and reimbursement changes in their clinical practices related to managed care. Responses of audiologists were analyzed to determine: a) adequacy of CPT codes; b)average time to perform various audiologic tests; c) impact managed care onclinical practice; and d) changes in reimbursement as a result of managed care. / The survey was designed to determine the type of work setting, typical job duty, average monthly caseload and hours per day spent on patient care for each respondent. The survey with a cover letter explaining the purpose was mailed to 93 audiologists in clinical setting in the state of Florida. Five were returned undeliverable, and 39 of the remaining 88 were returned either completed or partially completed. The survey results revealed over 71% of the audiologists felt the current CPT codes were adequate. Time spent performing traditional audiologic tests, such as comprehensive audiometric evaluations and impedance testing, was fairly consistent. / Greater time variability occurred in tests used to determine vestibular function. Over three-quarters of the respondents believed managed care has had a negative impact on their clinical practices, while 11% believe they have been positively impacted. Approximately 82% of the audiologists have had reductions in reimbursement as a result of managed care, while 10% have seen no change and 5% have enjoyed slightly greater reimbursement. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.