Basic audiology for medical students

Abstract

Delay in the identification, diagnosis and intervention of hearing impairment and deafness is mainly linked to the lack of knowledge and commitment of medical doctors (MDs) towards this impairment. In 1997 and in 2006, a multicentre study on the status of prevention of hearing impairment (HI) and deafness in Mexico, directed towards the parents of deaf children, clearly showed this. Similar findings were obtained with a 10-item questionnaire designed to evaluate knowledge and attitudes towards hearing loss (HL) and used with those MDs selected in the annual national examination for the selection of candidates for residencies. From 23,482 applicants, 5464 MDs – the elite of general practitioners (GPs) who had graduated from more than 70 medical schools all over the country – were selected to start their specialization in 2007, and from these a total of 2727 completed questionnaires (49.9%) were obtained. These again showed a very low level of knowledge and misguided attitudes towards hearing, deafness and its consequences. In addition to efforts centred upon the postgraduate four-year residency in ‘Audiology, Otoneurology and Phoniatrics’ (Faculty of Medicine, National University of Mexico), we proposed inclusion of an audiology module in medical students’ clinical training and the undergraduate rotatory internship. In 2008, 20 multiple-choice questions were administered to 151 students at the beginning and end of the module. The comparison of these evaluations showed an initial average of correct responses of 33.4% and a final one of 77.9%, with a clear improvement of 44.5%. It is proposed to disseminate the module from our university, the most important in the country, to all the medical schools in Mexico, in order to improve the identification, diagnosis and intervention skills of future MDs.

Key words::

• deafness
• hearing loss
• prevention levels
• knowledge
• attitudes

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Appendix 1.

Hearing loss prevention levels multicentre study in Mexico and Latin America

All responses to this questionnaire will remain anonymous. We do not intend to evaluate each professional him/herself, nor medical schools in particular, but the medical community as a group. Please mark the response you consider to be appropriate or fill in the blanks where asked.

Speciality___________________

1. Hearing loss is a condition that can become extremely disabling

   a. Strongly disagree

   b. Disagree

   c. Don't know

   d. Agree

   e. Strongly agree

2. The fact that parents suspect that their child presents a hearing loss is reason enough to refer an infant or child to a specialist so that hearing assessment is performed

   a. Strongly disagree

   b. Disagree

   c. Neither agree nor disagree

   d. Agree

   e. Strongly agree

3. If you believe that an infant has a hearing loss, which specialist would you refer him to?

4. Several hearing loss risk factors have been determined for congenital or early developed hearing loss or deafness. Please write down the ones you can remember

5. Hearing assessment tests:

   a. Are not invasive and can be performed at any age

   b. Are reliable and precise at the time central nervous system reaches maturation

   c. Are invasive, but they give precise information at any age

   d. Can be performed once the child can answer to what he hears

6. There are several tests for assessing hearing function. Could you name them?

7. Whenever hearing aids are necessary they can be fitted to babies at any age

   a. Strongly disagree

   b. Disagree

   c. Neither agree nor disagree

   d. Agree

   e. Strongly agree

8. There are many conditions that can be screened or detected in newborns. Write down with numbers 1 to 6 the order of importance that you think corresponds to each one, giving 1 to the most prevalent and 6 to the least prevalent

   a. PKU ___________________

   b. Hypothyroidism __________

   c. Down's syndrome _________

   d. Spina bifida _____________

   e. Cleft palate _____________

   f. Hearing loss ____________

9. Children with a severe hearing loss who have been fitted with hearing aids, should always receive speech therapy

   a. Strongly disagree

   b. Disagree

   c. Neither agree nor disagree

   d. Agree

   e. Strongly agree

10. Learning to read and to write depends more on hearing than sight

    a. Strongly disagree

    b. Disagree

    c. Neither

    d. Agree

    e. Strongly agree