Counseling Training for Audiology Students: Using Standardized Patients

Author's School

Graduate School of Arts and Sciences

Author's Department/Program

Speech and Hearing Sciences


English (en)

Date of Award

Summer 8-15-2015

Degree Type


Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

William W Clark

Committee Members

Brian Carpenter, Lisa S Davidson, Dehra Glueck, L. Maureen Valente


The implementation of Universal Newborn Hearing Screening (UNHS) has resulted in earlier diagnosis of hearing loss in children. Research shows that early diagnosis of hearing loss results in better outcomes in speech and language, socio-emotional, and cognitive development. Early diagnosis, however, often comes as a surprise to parents of newborns. When parents are told their child has a hearing loss, it is often before they have been able to observe behaviors that would lead to the suspicion of hearing loss. Parents are usually told about the hearing loss diagnosis by an audiologist and are often dissatisfied with how the news is delivered. Parents want someone who is compassionate, empathetic, and who will listen to them and spend time with them after the diagnosis. Audiologists often do not receive the proper training in how to deliver this news in graduate school either through coursework or practical experience. This leads to professionals who are ill-prepared to help parents with this difficult diagnosis. Medical students and other healthcare students utilize standardized patient (SP) encounters to practice counseling skills as well as clinical skills in a safe environment rich in feedback. SPs are actors trained to realistically portray a patient with varying physical symptoms and emotional reactions. The purpose of this thesis was to examine the efficacy of using SPs to train students enrolled in the Washington University Program in Audiology and Communication Sciences (PACS) Doctor of Audiology (Au.D.) program. Eight Au.D. students completed five SP encounters in which they delivered an initial diagnosis of hearing loss to a parent of a six-week old son who was referred based on his UNHS. Each encounter consisted of a parent who expressed a different emotional response to the diagnosis (tearful, contesting, guilty, and overwhelmed), with both the first and last encounters consisting of a tearful response. Students received feedback directly from the SPs following three of the encounters, as well as completed a de-briefing session with other participating students and an audiologist to discuss their experiences. Encounters were rated by two SPs and three pediatric audiologists using the Audiology Counseling Evaluation (ACE) Questionnaire. Ratings of the students as well as measurements made of video recordings of the encounters were analyzed to determine changes in behavior from the first encounter to the final encounter. Results indicated that although results were variable across and within students, improvements were made in several areas and students felt the training was worthwhile and valuable. Based on these improvements and observations made, the use of SPs could be helpful in training Au.D. students in counseling skills. Further research is necessary to quantify further these preliminary results and expand the areas in which SP encounters could be used.