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Home Log book for Cochlear implants

Cochlear implants

Logbook | Cochlear implants

Candidate details

Contact Address
Contact Address
City
County
Post code

Supervisor details

Record of training

Clinical sessions

All of these sessions must be supervised by an appropriate staff member who meets all the requirements as required in the HTS regulations, and should be recorded in the table below. Additional sessions which do not meet the supervision requirements as outlined in the regulations cannot be counted towards the total number of minimum sessions for this module, and should not be include in this table.

Please note, these are sessions of approximately 3.5 hours, not individual patients.

Clinical sessions

Date

Supervisor
Supervision level
Direct / Indirect
Direct / Indirect
Direct / Indirect
Direct / Indirect
Direct / Indirect

Time spent on session

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Summary of HEI M level credits completed relevant to this module

Completion certificates award should be submitted with this portfolio insert when requesting examination.

Summary of HEI M level credits

Maximum file size: 73.4MB

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Tutorial Subjects

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Case Studies

Maximum file size: 73.4MB

Secondments

duration (in days) of the secondment

Maximum file size: 73.4MB

Maximum file size: 73.4MB

Clear
Signature only required if report not uploaded and signed already
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Placements

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Part A: Direct observation of clinical skills

Section

  1. Facilities & Equipment:
  2. a) Stage A / daily checks to include equipment related to cochlear implant assessments such as soundfield and speech discrimination systems.
  3. b) Room preparation and set-up, including collation of appropriate written resources.

Section

(Staff name /date)
(Staff name/date)

Section

2. Assessment Case History:
a. Independently and succinctly, obtain a relevant case history in a logical but flexible progression. (Competence in adult and/or paediatric assessment (as applicable to your service), including history taking is a pre-requisite for this module). Within a full case history, the following areas that are more specific to cochlear implant patients should be included:
i. aetiology, syndromes, type and duration of hearing loss, progression, preferred ear
ii. General medical health and fitness for surgery
iii. History of hearing aid usage and rehabilitation, including reasons for non-use
iv. Communication ability and preferred mode of communication
v. Understanding and attitude to cochlear implants
vi. Goals and expectations from cochlear implantion

b. Demonstrate strategies to communicate with patients with severe/ profound hearing loss, including need for text transcription, lip-reading, repetition/rephrasing, sign language or use of interpreters, checking for understanding and written support materials.

Section

(Staff name /date)
(Staff name/date)

Section

3. Expectations Counselling Regarding Outcomes:
a. Detailed and individualised expectations counselling regarding the range of possible and likely outcomes to patients/parents and significant others (as applicable), including acclimatisation period.
b. Specific and individualised information regarding cochlear implant devices available and suitability for the individual patient.
c. Information about risks of cochlear implantation including loss of residual hearing and device failure
d. Discussion about the choice of ear for CI
e. Check understanding and repeating/rephrasing as necessary, provision of supporting written information, appropriate use of interpreters.
f. Shared decision-making and patient/parent/carer involvement in choice and informed consent.
g. Respond to questions from patients and significant others in an appropriate way, showing sensitivity to concerns.
h. Discuss proposed individual management plan and agree appropriate goals with the patient/ Parent/Carer (as applicable).
i. Discuss and agree management options for patients currently outside of CI criteria or unwilling/unable to proceed with CI.

Section

(Staff name /date)
(Staff name/date)

Section

4. Clinical Procedures – Assessment - in addition to the pre-requisite competence in adult and/or paediatric audiology assessment, specific clinical procedures that should be demonstrated in cochlear implant assessments are
a. Objective hearing assessment to include:
i. OAEs
ii. Acoustic reflexes
b. Behavioural hearing assessment to include ear specific testing of:
i. Aided speech discrimination in quiet and noise (where applicable)
c. Comparison of hearing assessment outcomes and informal observations to identify signs of non-organic presentations and/or neural / central processing issues.
d. Explain results to the patient/ parents/carers to include:
i. Hearing level and implications for speech communication
ii. Audiological suitability for a cochlear implant
e. Informal assessment of candidate’s speech intelligibility and the need for onward referral to speech and language therapy as required
f. Adaption of the cochlear implant assessment for more complex patients e.g. deaf blindness, dementia, learning difficulty or non-English speaking.

Section

(Staff name /date)
(Staff name/date)

Section

5. Multidisciplinary Team Meeting
a) Attend a MDT meeting and understand the role of the multidisciplinary team in patient management and decision-making.

Section

(Staff name /date)
(Staff name/date)

Section

6. Clinical Procedures – CI Programming
a. Review session files or surgical reports for relevant information.
b. Measure and assess electrode impedances, include identification of faults.
c. View and interpret datalogging where relevant.
d. Measure and/or verify Threshold and Comfort (MCL) levels as appropriate for device, including global adjustments, sweep and balancing, and interpolation of settings
e. Select and adjust programme parameters as required, to include as appropriate:
i. Pulse width
ii. Rate
iii. Maxima
iv. Frequency allocation
v. Gains
vi. Map strategy
vii. Mode of stimulation
viii. Disabling or enabling electrodes
ix. Adjustments for electro-acoustic (hybrid) hearing and bimodal hearing.
f. Management of non-auditory sensations.
g. Measurement and application of neural responses.
h. Choice of user settings in context of individual user circumstances, for a particular device such as noise reduction or directional programmes.
i. Choice and set-up of remote control, apps, FM systems and wireless accessory options, in context of individual user circumstances.

Section

(Staff name /date)
(Staff name/date)

Section

7. Clinical procedures – rehabilitation
a. Use of validated questionnaires and patient / Parent/carer/ (as applicable) reported outcome measures (PROMs) to assess the outcome of cochlear implantation
b. Identify further assessments required and appropriate priority of these, e.g. further diagnostic investigations, referring on to another discipline as required.
c. Engage in shared decision-making, and agree goals and priorities for interventions.
d. Advise on techniques for maximising hearing outcome in relation to music, telephone use and hearing in noise.
e. Liaise with specialist rehabilitationists/ speech and language therapists (as applicable)

Section

(Staff name /date)
(Staff name/date)

Section

8. Troubleshooting:
a. Identify and manage common processor and coil faults, including testing of microphones.
b. Identify and manage programming issues – such as compliance levels required for remapping.
c. Identify and manage impedance/electrode issues, including requirement for integrity testing and manufacturer input.
d. Identify and manage issues requiring rehabilitation strategies e.g. by use of data-logging.
e. Manage problems with power and battery life issues.
f. Refer for further support e.g. from ENT, speech and language therapy, teachers of the deaf and education (as applicable).

Section

(Staff name /date)
(Staff name/date)

Part B - Periodic Appraisals of Competencies

Assessment for suitability for a cochlear implant

Internal Assessor/External Assessor in Home Department/External Assessor On Secondment

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment used in CI assessment, to include daily calibration checks and room set up.
Competency 2:
Formulate assessment and treatment plans, liaising with relevant professionals to co-ordinate cochlear implant assessments & care, as appropriate.
Competency 3:
Plan clinical approaches, using clinical reasoning strategies and evidence-based practice.
Competency 4:
Take a full and relevant history.
Competency 5:
Carry out assessments in a safe and effective manner adapting as required to ensure information gained is maximised within the time available. This includes the use of validated questionnaires as appropriate.
Competency 6:
Show creativity, initiative and originality of thinking in tackling and solving practical problems 
Competency 7:

Collate relevant information from other members of the team and make an informed decision concerning the suitability of individual cases for implantation from an audiological perspective.
Competency 8:
Give clear information on results of hearing tests, advice and recommendation for follow-up actions/interventions using appropriate language and communication strategies.
Competency 9:
Ensure that patients/ parents/carers (as applicable) have accurate expectations with regard to potential outcomes from cochlear implantation and that they are part of the decision making,
Competency 10:
Develop and deliver individual management plans to include follow-up and adaptation of treatment as required liaising with therapy colleagues, as applicable.
Competency 11:
Work with patients post surgery to optimise outcomes by:
a. Applying knowledge of advanced technological features of cochlear implants to programme sound processors as required.
b. Setting up cochlear implant sound processors for electro-acoustic (hybrid) hearing and bimodal hearing where appropriate.
c. Setting up and demonstrate the use of remote controls, mobile phone apps, assistive devices, wireless streaming or other optional technological features.
d. Evaluating outcomes of treatments using a range of subjective and objective outcome measures.
Competency 12:
Keep appropriate clinical records.
Competency 13:
Write reports on assessment sessions, recommended treatment plans and / or outcome of treatment as required, suitable for the intended audience, to include a range of professionals, patient/ parents/carers (as applicable).
Competency 14:
Understand own role and those of other professionals in the team including surgeons, speech and language therapists, teachers of the deaf, hearing therapists, psychologists, social services and other agencies who contribute to the management and welfare of the patient and their family.

Competency 15:
Demonstrate the ability to, and articulate clearly through presentation and constructive discussion with colleagues:
a. Relate their own practice to a supporting knowledge base – including reference to evidence based and/or recognised good practice
b. Clearly justify any of their own clinical decisions made in the assessment or management of patients
c. Critically appraise the context of individual assessments within national and local structures/processes for assessment and diagnosis of balance disorders
d. Critically evaluate and reflect on their own actions 4
e. Show independent thought through evaluation and presentation of alternative (and justified) approaches to existing local practice

0: Does not currently meet examination requirements
1: Meets examination requirements
2: Exceeds examination requirements

Agreed to reassess inweeks
plus 3 Add table minus3 Delete

Part B - Periodic Appraisals of Competencies

Initial programming of device (switch-on) 

Internal Assessor/External Assessor in Home Department/External Assessor On Secondment

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment used in CI assessment, to include daily calibration checks and room set up.
Competency 2:
Formulate assessment and treatment plans, liaising with relevant professionals to co-ordinate cochlear implant assessments & care, as appropriate.
Competency 3:
Plan clinical approaches, using clinical reasoning strategies and evidence-based practice.
Competency 4:
Take a full and relevant history.
Competency 5:
Carry out assessments in a safe and effective manner adapting as required to ensure information gained is maximised within the time available. This includes the use of validated questionnaires as appropriate.
Competency 6:
Show creativity, initiative and originality of thinking in tackling and solving practical problems 
Competency 7:

Collate relevant information from other members of the team and make an informed decision concerning the suitability of individual cases for implantation from an audiological perspective.
Competency 8:
Give clear information on results of hearing tests, advice and recommendation for follow-up actions/interventions using appropriate language and communication strategies.
Competency 9:
Ensure that patients/ parents/carers (as applicable) have accurate expectations with regard to potential outcomes from cochlear implantation and that they are part of the decision making,
Competency 10:
Develop and deliver individual management plans to include follow-up and adaptation of treatment as required liaising with therapy colleagues, as applicable.
Competency 11:
Work with patients post surgery to optimise outcomes by:
a. Applying knowledge of advanced technological features of cochlear implants to programme sound processors as required.
b. Setting up cochlear implant sound processors for electro-acoustic (hybrid) hearing and bimodal hearing where appropriate.
c. Setting up and demonstrate the use of remote controls, mobile phone apps, assistive devices, wireless streaming or other optional technological features.
d. Evaluating outcomes of treatments using a range of subjective and objective outcome measures.
Competency 12:
Keep appropriate clinical records.
Competency 13:
Write reports on assessment sessions, recommended treatment plans and / or outcome of treatment as required, suitable for the intended audience, to include a range of professionals, patient/ parents/carers (as applicable).
Competency 14:
Understand own role and those of other professionals in the team including surgeons, speech and language therapists, teachers of the deaf, hearing therapists, psychologists, social services and other agencies who contribute to the management and welfare of the patient and their family.

Competency 15:
Demonstrate the ability to, and articulate clearly through presentation and constructive discussion with colleagues:
a. Relate their own practice to a supporting knowledge base – including reference to evidence based and/or recognised good practice
b. Clearly justify any of their own clinical decisions made in the assessment or management of patients
c. Critically appraise the context of individual assessments within national and local structures/processes for assessment and diagnosis of balance disorders
d. Critically evaluate and reflect on their own actions 4
e. Show independent thought through evaluation and presentation of alternative (and justified) approaches to existing local practice

0: Does not currently meet examination requirements
1: Meets examination requirements
2: Exceeds examination requirements

Agreed to reassess inweeks
plus 3 Add table minus3 Delete

Part B - Periodic Appraisals of Competencies

Ongoing review and programming of device/s

Internal Assessor/External Assessor in Home Department/External Assessor On Secondment

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment used in CI assessment, to include daily calibration checks and room set up.
Competency 2:
Formulate assessment and treatment plans, liaising with relevant professionals to co-ordinate cochlear implant assessments & care, as appropriate.
Competency 3:
Plan clinical approaches, using clinical reasoning strategies and evidence-based practice.
Competency 4:
Take a full and relevant history.
Competency 5:
Carry out assessments in a safe and effective manner adapting as required to ensure information gained is maximised within the time available. This includes the use of validated questionnaires as appropriate.
Competency 6:
Show creativity, initiative and originality of thinking in tackling and solving practical problems 
Competency 7:

Collate relevant information from other members of the team and make an informed decision concerning the suitability of individual cases for implantation from an audiological perspective.
Competency 8:
Give clear information on results of hearing tests, advice and recommendation for follow-up actions/interventions using appropriate language and communication strategies.
Competency 9:
Ensure that patients/ parents/carers (as applicable) have accurate expectations with regard to potential outcomes from cochlear implantation and that they are part of the decision making,
Competency 10:
Develop and deliver individual management plans to include follow-up and adaptation of treatment as required liaising with therapy colleagues, as applicable.
Competency 11:
Work with patients post surgery to optimise outcomes by:
a. Applying knowledge of advanced technological features of cochlear implants to programme sound processors as required.
b. Setting up cochlear implant sound processors for electro-acoustic (hybrid) hearing and bimodal hearing where appropriate.
c. Setting up and demonstrate the use of remote controls, mobile phone apps, assistive devices, wireless streaming or other optional technological features.
d. Evaluating outcomes of treatments using a range of subjective and objective outcome measures.
Competency 12:
Keep appropriate clinical records.
Competency 13:
Write reports on assessment sessions, recommended treatment plans and / or outcome of treatment as required, suitable for the intended audience, to include a range of professionals, patient/ parents/carers (as applicable).
Competency 14:
Understand own role and those of other professionals in the team including surgeons, speech and language therapists, teachers of the deaf, hearing therapists, psychologists, social services and other agencies who contribute to the management and welfare of the patient and their family.

Competency 15:
Demonstrate the ability to, and articulate clearly through presentation and constructive discussion with colleagues:
a. Relate their own practice to a supporting knowledge base – including reference to evidence based and/or recognised good practice
b. Clearly justify any of their own clinical decisions made in the assessment or management of patients
c. Critically appraise the context of individual assessments within national and local structures/processes for assessment and diagnosis of balance disorders
d. Critically evaluate and reflect on their own actions 4
e. Show independent thought through evaluation and presentation of alternative (and justified) approaches to existing local practice

0: Does not currently meet examination requirements
1: Meets examination requirements
2: Exceeds examination requirements

Agreed to reassess inweeks
plus 3 Add table minus3 Delete

Part B - Periodic Appraisals of Competencies

Trouble-shooting case

Internal Assessor/External Assessor in Home Department/External Assessor On Secondment

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment used in CI assessment, to include daily calibration checks and room set up.
Competency 2:
Formulate assessment and treatment plans, liaising with relevant professionals to co-ordinate cochlear implant assessments & care, as appropriate.
Competency 3:
Plan clinical approaches, using clinical reasoning strategies and evidence-based practice.
Competency 4:
Take a full and relevant history.
Competency 5:
Carry out assessments in a safe and effective manner adapting as required to ensure information gained is maximised within the time available. This includes the use of validated questionnaires as appropriate.
Competency 6:
Show creativity, initiative and originality of thinking in tackling and solving practical problems 
Competency 7:

Collate relevant information from other members of the team and make an informed decision concerning the suitability of individual cases for implantation from an audiological perspective.
Competency 8:
Give clear information on results of hearing tests, advice and recommendation for follow-up actions/interventions using appropriate language and communication strategies.
Competency 9:
Ensure that patients/ parents/carers (as applicable) have accurate expectations with regard to potential outcomes from cochlear implantation and that they are part of the decision making,
Competency 10:
Develop and deliver individual management plans to include follow-up and adaptation of treatment as required liaising with therapy colleagues, as applicable.
Competency 11:
Work with patients post surgery to optimise outcomes by:
a. Applying knowledge of advanced technological features of cochlear implants to programme sound processors as required.
b. Setting up cochlear implant sound processors for electro-acoustic (hybrid) hearing and bimodal hearing where appropriate.
c. Setting up and demonstrate the use of remote controls, mobile phone apps, assistive devices, wireless streaming or other optional technological features.
d. Evaluating outcomes of treatments using a range of subjective and objective outcome measures.
Competency 12:
Keep appropriate clinical records.
Competency 13:
Write reports on assessment sessions, recommended treatment plans and / or outcome of treatment as required, suitable for the intended audience, to include a range of professionals, patient/ parents/carers (as applicable).
Competency 14:
Understand own role and those of other professionals in the team including surgeons, speech and language therapists, teachers of the deaf, hearing therapists, psychologists, social services and other agencies who contribute to the management and welfare of the patient and their family.

Competency 15:
Demonstrate the ability to, and articulate clearly through presentation and constructive discussion with colleagues:
a. Relate their own practice to a supporting knowledge base – including reference to evidence based and/or recognised good practice
b. Clearly justify any of their own clinical decisions made in the assessment or management of patients
c. Critically appraise the context of individual assessments within national and local structures/processes for assessment and diagnosis of balance disorders
d. Critically evaluate and reflect on their own actions 4
e. Show independent thought through evaluation and presentation of alternative (and justified) approaches to existing local practice

0: Does not currently meet examination requirements
1: Meets examination requirements
2: Exceeds examination requirements

Agreed to reassess inweeks
plus 3 Add table minus3 Delete

Supervisor’s Final Report and Sign-off

I confirm that this candidates training has been completed as per the module specification. I would like an exam to be arranged.

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