Acceptability/Applicability

When developing measurement tools for use it is imperative that suitability for clinical application is considered. The acceptability/applicability section of the questionnaire to evaluate the UWO PedAMP consisted of 19 items. The items aimed to evaluate the UWO PedAMP documentation, training materials as well as the clinical application of UWO PedAMP components. Results are shown in Table 5-6. The majority of pediatric

audiologists (93%) agreed that, overall, the UWO PedAMP was suitable as the ‘norm’ or standard of care for clinical use, was acceptable and beneficial to families in their care, and improved the clinical treatment for children with hearing loss aged birth to 6 years of age.

The UWO PedAMP training materials include written documentation accompanied by case examples and a training DVD/CD. The inclusion of a training DVD/CD was requested by Network audiologists during their initial evaluation of the UWO PedAMP (Moodie, Bagatto et al., 2011). The training DVD/CD was developed based on successful training sessions of the UWO PedAMP provided to the Ontario Infant Hearing Program audiologists. Results indicated that most audiologist respondents (86%) agreed that the UWO PedAMP manual in combination with the DVD/CD training video were produced in such a way that novice and experienced pediatric audiologists should be able to implement the UWO PedAMP into clinical practice after reviewing them. An equal number of respondents (79%) agreed that the case examples provided in the training materials facilitated development of the knowledge and skills required for use of the UWO PedAMP in practice and that the training materials along with the DVD/CD could be used in place of in-person training. There were several respondents (14%) who

indicated that from their perspective in-person training was important for learning how to implement the UWO PedAMP.

Several respondents noted that although the training video presented valuable information to move the UWO PedAMP into practice, it was lengthy to watch and was delivered at “too slow of a pace.”

As reported above, from an overall perspective, the UWO PedAMP was suitable for use as the standard of care, however, based on the number of respondents selecting the ‘neutral’ category (neither agree nor disagree) respondents are less sure of its suitability as the ‘norm’ / standard from a time (36% chose the neutral category) perspective and/or whether it would receive widespread acceptance by their colleagues (43% chose the neutral category). Approximately one-third of respondents (29%) also chose the neutral category when asked for their perspective on whether or not the UWO PedAMP was too rigid to apply to individual patients.

Table 5-6: Level of agreement with statements related to the suitability or use of the UWO PedAMP as the ‘norm’ or standard in clinical practice.

Item Level of Agreement (n=14)

Agree to Agree Strongly (%) Neither Agree nor Disagree (%) Disagree to Disagree Strongly (%)

The training manual is acceptable on its own (without the DVD/CD) for learning how to incorporate the UWO PedAMP into clinical practice

57 21 21

The training DVD/CD is a beneficial addition along with the written training manual for learning how to incorporate the UWO PedAMP into clinical practice

86 14 0

The training manual + training DVD/CD can be used in place of in-person training

79 7 14

The training manual + training DVD/CD are best used together for learning how to incorporate the UWO PedAMP into clinical practice

57 36 7

The training manual + training DVD/CD are produced in such a way that even inexperienced or novice pediatric audiologists should be able to implement the UWO PedAMP into clinical practice after reviewing them

Table 5-6 continued: Level of agreement with statements related to the suitability or use of the UWO PedAMP as the ‘norm’ or standard in clinical practice.

Item Level of Agreement

Agree to Agree Strongly (%) Neither Agree nor Disagree (%) Disagree to Disagree Strongly (%)

The environment in which I work will make it difficult to use the UWO PedAMP

7 21 71

The time that it takes to administer the components of the UWO PedAMP will negatively affect other areas of pediatric audiological practice

14 36 50

The UWO PedAMP is too rigid to

apply to individual patients 0 29 71

The training manual + training DVD/CD help build my confidence about initiating the UWO PedAMP in my clinical practice

57 29 14

The case examples provided within the UWO PedAMP manual will facilitate development of

knowledge and skills for use of the UWO PedAMP in clinical practice

79 21 0

5.4.4.1

Select comments by Network audiologists regarding

acceptability/applicability of the UWO PedAMP

• At my site (numerous audiologists and support staff) it is not so much an issue of time/feasibility; it is a matter of convincing the team that the tools are appropriate for use on ALL hearing losses. There have been some concerns that using the

questionnaires on certain types of hearing loss (e.g., mild, unilateral, high-frequency) might actually hinder the family's acceptance of amplification (e.g., if the family doesn't see any problems when the child is unaided, it may be harder to convince them of the importance of amplification). The general consensus is that it's an excellent tool, in most cases. … I do not feel that, at this time, management would require all staff to incorporate it....

• The present protocol is a good place to start. … it will become important to review the protocol and tools as clinical experience with various 'difficult to assess' children improves. I would anticipate that tools may need to be modified or different 'norms' developed for children with multiple challenges.