The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Observation of workplace performance is essential for assessment of this unit

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment:

Access to appropriate workplace, equipment and instruments where assessment can take place or the simulation of realistic workplace setting, including access to equipment for assessments

Relevant organisation policy, guidelines, procedures and protocols

Relevant professional bodies policies and guidelines on the conduct of screening hearing tests

Relevant legislative and regulatory documents

Relevant publications of the National Acoustic Laboratories

Access to professional library for accurate and current relevant information

Manufacturers' specifications for the use and storage of equipment

Method of assessment

Observation in the work place (if possible)

Written assignments/projects or questioning should be used to assess knowledge

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.

Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision.

Practical case presentation

Case studies and scenarios

Interviews/Questioning

Role plays

Related units:

This unit can be assessed independently, however holistic assessment practice with other audiometry units of competency is encouraged

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Anatomy of the ear, including peripheral auditory system

Appropriate physical environment for audiometric assessments of all types

Appropriate practices to ensure efficient use of power and other resources

Australian and international standards that apply to the conduct of a hearing assessment

Causes and types of hearing loss

Hearing aids and their functioning

Temporary Threshold Shift and Permanent Threshold Shift and their implications for assessment

The characteristics of speech tests (e.g. carrier phrase versus no carrier phrase, recorded versus live voice, open versus closed set tests)

The common physical abnormalities of the peripheral auditory system

The interrelationships with other professions

The materials that can be used for speech testing, particularly in relation to what the test is designed to assess, who the test is appropriate for and the reliability/validity of particular tests

Essential skills:

It is critical that the candidate demonstrate the ability to:

Compare assessment results across and within assessments to ensure they are cohesive

Conduct the full range of hearing assessments accurately and reliably

Correctly select required hearing assessment

Establish effective working relationships with external agencies

Interpret and record results accurately and identify options available to clients

Interpret pure tone audiometry and impedance audiometry test results accurately

Meet client needs and establish realistic goals through effective communication with client

Operate audiometry equipment and instruments correctly and in accordance with manufacturers' specifications

Perform hearing assessments, including otoscopy, accurately

Recognise and respond correctly when a client is not giving true thresholds

Select and use appropriate equipment and instruments

Use test results to determine type of hearing loss

Write comprehensive and accurate reports

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Use interpersonal skills to relate to people from a range of social, cultural and religious backgrounds and physical and mental abilities

Use numeracy skills including the ability to interpret data and record client results

Use oral communication skills-language competence required to fulfil job role in a safe manner and as specified by the organisation. Assessors should look for skills in asking systematic questions, providing clear information, listening to and understanding client areas of concern, and demonstrating ethical practice and procedures in dealing with clients. Effective verbal and non verbal communication skills with a range of internal and external persons are essential together with competence in English or a community language, depending on the client group

Use problem solving skills including an ability to use available resources and determine accuracy of test results

Use reading and writing skills-literacy competence required to fulfil job roles safely and effectively. The level of skill required involves reading and documenting clinical information and understanding procedure manuals

Work with others

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Information may include:

Client medical history

Referral letter

Correspondence

Consent forms

Current standards

Information for clients

Environment may include:

Consulting room

Acoustically treated assessment room

Equipment and instruments may include:

Audiometer (clinical, screening and diagnostic)

Headphones

Otoscope (hand held and video)

Screening tympanometer

Recorded speech sources

Sound field audiometer

Impedance audiometer

Computer

Equipment checking must include:

Acoustic calibration and integrity check of an audiometer

All parts are correctly assembled

Personal protective equipment may include:

Gloves

Masks

Eye protection

Clients may include:

Adults

Aged persons

Informed consent may include:

Written

Verbal

Implied

Confidentiality of client information may include:

Legal and ethical requirements

Secure location for written records

Telephone conversations

Offering a private location for discussions

Information disclosed to an appropriate person consistent with the responsibility of this position

Adherence to the Privacy Act

Personal hygiene/infection control procedures may include:

Washing hands

Current National Health and Medical Research Council (NHMRC) guidelines for infection control in health care settings

Standard Precautions and Additional Precautions as defined by the NHMRC

Current Australian Standards

Local Government ordinances

Other legislative requirements

Relevant policies and procedures may include:

Organisation

Industry standards (state and national)

Office of Hearing Services

Contract requirements

relevant Commonwealth and state/territory privacy legislation

Research organisations e.g. National Acoustic Laboratory (NAL)

Relevant state/territory OHS bodies

Industry professional bodies

Relevant Australian standards

Abnormalities of the ear canal may include:

Excessive cerumen

Foreign body

Discharge from the ear

Signs of inflammation/infection

Atresia

Exostosis

Collapsed ear canals

Presence of grommets

Otitis externa

Perforated tympanic membrane

Contraindications for proceeding with further tests include:

Excessive cerumen

Foreign body

Discharge from the ear

Signs of inflammation/infection

Atresia

Exostosis

Collapsed ear canals

Presence of grommets

Otitis externa

Perforated tympanic membrane

Referral agencies may include:

Audiologist

Medical practitioner

Medical facilities

Rehabilitation centres

Self help organisations

Hearing assessments must include:

Pure tone audiometry assessments ie air conduction screening and threshold assessments, threshold air and bone conduction assessments with masking as required, Stenger

Impedance audiometry assessments ie screening tympanometry and contralteral stapedius reflex recording, stapedial reflex delay

Speech audiometry assessments using at least two levels, one being at least 10dB above PB max ie phonetically balanced monosyllables, AB words, spondees

Results of hearing assessments may include:

Sensori-neural hearing loss

Conductive hearing loss

Mixed hearing loss

Identification of non-organic hearing loss

Options for client may include:

Fitting of a hearing aid or assistive listening device

Referral to a general practitioner

Referral to a local support group for training in communication strategies

Indications for medical referral include:

Visible evidence of cerumen accumulation or the presence of a foreign body which precludes assessment or taking an impression

Previously unreported apparent or confirmed perforation

Reported pain, discomfort or tenderness in the ear

Any history of active drainage from the ear during the past 3 months and/or apparent infection

A hearing loss associated with a traumatic insult to the ear

Chronic dizziness or vertigo

Reported facial numbness, weakness or asymmetrical facial movements

A hearing loss of sudden or recent onset

Unilateral hearing loss

Unilateral tinnitus

Sudden onset of tinnitus

Reported feeling of blockage or fullness in ear(s)

Rapid deterioration in audiometric thresholds

Indications for audiological referral include:

An air bone gap of 20dB or greater at 500, 1000 or 2000Hz

An asymmetrical sensory-neural loss (a difference of >20dB at 500, 1000 or 2000Hz and/or30dB at 3000, 4000 or 6000HZ)

A significant difference in speech discrimination scores between ears

Evidence of fluctuations in audiometric thresholds