Summary of procedures for which professionals identified a need for improvement

The survey revealed several specific procedures where professionals considered that improvements were desirable.

Information for family members:

Only Dutch and German participants were asked about this procedure. A moderate proportion (12 of 72) would wish to improve the procedure even given the present time constraints of the “real world”. In the “ideal world”, 50% of the respondents wanted improvements in this procedure. Our interpretation is that they would like to have more time to speak to family members.

MCL/ULL measures:

There was some interest in improvement in the ULL procedures from Dutch and UK professionals, but mainly in the “ideal” rather than the “real” world. German professionals routinely use ULL procedures and only one noted a need for improvement. However German professionals did want to see improvements in MCL measurements.

Questionnaires:

Even in the “real” world situation, some 20% of professionals expressed interest in improved questionnaire procedures for users before fitting of hearing aids. There was a smaller level of interest in the “real” world for improvements to questionnaires used to evaluate hearing aid benefit. In the “ideal” world situation, some 50% of professionals were interested in improvements in questionnaire procedures, both before and after fitting hearing aids.

Proprietary and generic methods of hearing aid fitting and interactive methods of fitting:

In the “real” world, few professionals expressed a need for improvements in fitting methods, but there was significant interest in improvements in the “ideal” situation (from 20 out of 86 respondents).

Fitting and comparison of alternative hearing aids:

This was clearly signalled as an issue for UK professionals, who already make more use of such comparisons than would be expected from the NHS recommendations, which stipulate the fitting of only one hearing aid (to each ear).

Tuning fork test:

The survey indicates that this test is rather little used, and while there is no demand for improvements to the procedure itself, we could well consider the removal of this procedure from an overall set of recommendations for good practice.

In summary, most of the call for improved procedures applied to the “ideal” rather than the “real” world situation. There are two conclusions that can be taken from this. Firstly, for procedures that are in common use, professionals are for the most part happy with the procedures that they use. Secondly, for those procedures that are not in common use, professionals cannot foresee any improvements that would make them more likely to use these procedures. This is clearly an area where well-targeted education could encourage change of practice.

Implications of sampling

Where we find evidence that professionals involved in hearing aid fitting are open to changes in their practice, any conclusions must be tempered by a consideration of the relatively low numbers responding, and by the likelihood that those who have responded are likely those who are more interested in and open to change. If similar detailed surveys of professionals are to be performed in the future, it would be worthwhile to enlist the support of the national organisations of professionals, although this would undoubtedly require a considerably longer timescale of preparation for data collection.