Type in keyword below and hit enter
Search Become a member
Home Log book for Tinnitus and hyperacusis

Log book for Tinnitus and hyperacusis

Logbook | Tinnitus and hyperacusis

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

plus 3 Add row minus3 Delete row

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

plus 3 Add row minus3 Delete row

Tutorial Subjects

plus 3 Add row minus3 Delete row

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
plus 3 Add minus3 Remove

Placements

plus 3 Add row minus3 Delete row

Part A: Direct observation of clinical skills

Section

1. Preparation for appointment to include collation of appropriate counselling tools, patient information, preparation of clinical facilities & equipment, to include daily calibration checks of equipment if to be used, and room set up

Section

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

Section

2. For patients with tinnitus:
a. Take a full and relevant history for a patient with a main complaint of tinnitus, to include history taking to cover the main areas defined below (unless justifiably omitted):
• Initial onset, quality, intensity, location, immediate impact
• Present quality, intensity, location, immediate impact
• Sudden/insidious
• Action
• Gaze modulation
• Somatic modulation
• Exacerbating and ameliorating factors
• Sleep
• Mood
• Medication
• Hearing: Extent of handicap, hearing aid use
• Past medical history – general/specific
• Anxiety/depression/psychological crisis
• Presence of any tinnitus
• Previous interventions (details and outcomes)
• Previous clinical input: GP, Otology, Diagnosis?
• Identifying patients concerns/anxieties
b. Use of validated questionnaires, for example: Tinnitus Handicap Inventory, Tinnitus Functional Index (TFI), Mini TQ.
c. Use of tools to aid assessment, for example the Tinnitus Thermometer
d. Identification of intervention options to include information counselling, sound therapy, hearing aids, relaxation / sleep / stress management and referral to other professionals and agencies
e. Diagnosis giving and information counselling, to include:
• Placing history in the context of an appropriate tinnitus responding to concerns and anxieties
• Discussing management options
• Goal setting
f. Identification of candidacy for and delivery of sound therapy, and fitting/adjustment of device, which may include
• environmental sound generator
• ear level sound generator
g. Identification of candidacy for and provision of hearing aids, and fitting/adjustment of device including
• applicability of open fit technology
• tinnitus specific programming parameters
h. Identification of need for onward referral, and respect for professional boundaries, e.g. GP, otolaryngology, psychology, bereavement/abuse support agencies, Social Services. In particular, recognition of when cognitive behavioural therapy (CBT) may be appropriate and onward referral to an appropriately qualified professional.
i. Assess changes in situation or symptoms though history taking and the use of validated questionnaires, review progress and modify intervention as needed
j. Observe a group tinnitus session

Section

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

Section

3. For patients with hyperacusis
a. Take a full and relevant history for a patient with a main complaint of tinnitus, to include history taking to cover the main areas defined below (unless justifiably omitted):
i. Onset, Severity, Limitation of activities
ii. Immediate impact
iii. Action
iv. Changes over time
v. Exacerbating and ameliorating factors
vi. Sleep
vii. Mood
viii. Medication
ix. Hearing: extent of handicap, hearing aid use,
x. Past medical history – general/specific
xi. Anxiety/depression/psychological crisis
xii. Presence of any hyperacusis
xiii. Previous interventions (details and outcomes)
xiv. Previous clinical input: GP, Otology, Diagnosis?
xv. Identifying patients concerns/anxieties.
b. Use of questionnaires, for example: Hyperacusis Questionnaire (HQ) , Inventory of Hyperacusis Symptoms (IHS).
c. Use of validated questionnaires to assess the impact of the condition on wellbeing, e.g. hearing abilities, co-morbidities
d. Identification of intervention options to include sound therapy, hearing aids, relaxation / sleep / stress management and referral to other professionals and agencies
e. Diagnosis giving and information counselling, to include:
i. Placing history in the context of an appropriate hyperacusis model
ii. responding to concerns and anxieties
iii. Discussing management options
iv. Goal setting
f. Identification of need for onward referral, and respect for professional boundaries, e.g. GP, otolaryngology, psychology, bereavement/abuse support agencies, Social Services
g. Assess changes in situation or symptoms though history taking and the use of validated questionnaires, review progress and modify intervention as needed

Section

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

Section

4. Use of validated questionnaires to assess the impact of the condition on wellbeing, e.g. hearing abilities, co-morbidities such as anxiety and depression. e.g. GAD-7, PHQ-9, HAD.

Section

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

Section

5. Identification of any further assessments required and appropriate priority of these, e.g. hearing tests, further diagnostic investigations, referring on to the appropriate discipline as required

Section

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

Section

6. Advice giving regarding stress management

Section

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

Section

7. Advice giving regarding relaxation & mindfulness

Section

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

Section

8. Advice giving regarding sleep management

Section

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

Section

9. Engaging in shared decision making, and agreeing priorities for interventions

Section

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

Section

10. Advice giving regarding the availability of information, devices, apps / websites and other sources of support

Section

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

Section

11. Collate, and prepare resource materials (including patient information) including signposting to online resources
Using appropriate communication skills throughout:
• Responds to questions from patients in an appropriate way, showing sensitivity and rephrasing / re-explaining as necessary to ensure understanding
• Back up information given with information leaflets where possible
• Uses appropriate methods to break difficult news to patients
• Shows sensitivity to the patient’s concerns both in questioning and information giving
• Records relevant information whilst maintaining a rapport with the patient and being aware of their concerns

Section

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

Section

12. Demonstrates good listening and reflection skills

Section

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

Section

13. Keep appropriate clinical records: record findings and interventions delivered clearly, in a consistent format, all of which must be dated and named.

Section

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

Section

14. 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.

Section

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

Part B - Periodic Appraisals of Competencies

New patient assessment with a primary complaint of tinnitus and associated hearing loss

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

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment, to include daily calibration checks any equipment to be used, and room set up
Competency 2:
Plan clinical approaches, using clinical reasoning strategies and evidence based practice, liaising with the relevant professionals to co-ordinate assessments & care, as appropriate  
Competency 3:
Carry out a person-centred assessment, to include a full and relevant case history, and using tools and validated questionnaires as appropriate, in a safe and effective manner adapting as required to ensure information gained is maximised within the time available.
Competency 4:
Show creativity, initiative and originality of thinking in tackling and solving practical problems
Competency 5:
Collate relevant information and make an informed decision concerning the diagnosis and management of individual cases
Competency 6:
Develop person-centred treatment plans incorporating the needs, preferences and values of the patient and their family, and use shared decision making to choose between options.
Competency 7:

Deliver person-centred treatment plans, using counselling skills and appropriate techniques as required, and adapt as required depending on progress. Specifically this should include:
a. Information counselling
b. Habituation based therapy
c. Use of sound therapy
d. Hearing aid fitting/re-programming (including combination devices)
e. Advice and information regarding stress, relaxation techniques and sleep management
Competency 8:
Collate, and prepare resource materials (including patient information) including signposting to online resources, to complement their own interventions and those of colleagues.
Competency 9:
Recognise the need for and arrange onward referral to appropriate colleagues to relevant professionals considering the holistic needs of the patient, such as ENT, Psychology, Psychiatry, GP, social services. This should include recognition of when cognitive behavioural therapy (CBT) may be appropriate and onward referral to an appropriately qualified professional.
Competency 10:
Communicate effectively with patients giving clear information on the plan for the session, results, recommendations and management using appropriate language, communication skills and strategies throughout.
Competency 11:
Keep appropriate clinical records
Competency 12:
Write reports on assessment findings and recommendations and / or outcome of management as required, suitable for the intended audience, to include a range of professionals.
Competency 13:
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 tinnitus and hyperacusis 
d. Critically evaluate and reflect on their own actions 
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

New patient assessment with a primary complaint of tinnitus and no associated hearing loss

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

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment, to include daily calibration checks any equipment to be used, and room set up
Competency 2:
Plan clinical approaches, using clinical reasoning strategies and evidence based practice, liaising with the relevant professionals to co-ordinate assessments & care, as appropriate  
Competency 3:
Carry out a person-centred assessment, to include a full and relevant case history, and using tools and validated questionnaires as appropriate, in a safe and effective manner adapting as required to ensure information gained is maximised within the time available.
Competency 4:
Show creativity, initiative and originality of thinking in tackling and solving practical problems
Competency 5:
Collate relevant information and make an informed decision concerning the diagnosis and management of individual cases
Competency 6:
Develop person-centred treatment plans incorporating the needs, preferences and values of the patient and their family, and use shared decision making to choose between options.
Competency 7:

Deliver person-centred treatment plans, using counselling skills and appropriate techniques as required, and adapt as required depending on progress. Specifically this should include:
a. Information counselling
b. Habituation based therapy
c. Use of sound therapy
d. Hearing aid fitting/re-programming (including combination devices)
e. Advice and information regarding stress, relaxation techniques and sleep management
Competency 8:
Collate, and prepare resource materials (including patient information) including signposting to online resources, to complement their own interventions and those of colleagues.
Competency 9:
Recognise the need for and arrange onward referral to appropriate colleagues to relevant professionals considering the holistic needs of the patient, such as ENT, Psychology, Psychiatry, GP, social services. This should include recognition of when cognitive behavioural therapy (CBT) may be appropriate and onward referral to an appropriately qualified professional.
Competency 10:
Communicate effectively with patients giving clear information on the plan for the session, results, recommendations and management using appropriate language, communication skills and strategies throughout.
Competency 11:
Keep appropriate clinical records
Competency 12:
Write reports on assessment findings and recommendations and / or outcome of management as required, suitable for the intended audience, to include a range of professionals.
Competency 13:
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 tinnitus and hyperacusis 
d. Critically evaluate and reflect on their own actions 
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

New patient assessment with a primary complaint of hyperacusus

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

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment, to include daily calibration checks any equipment to be used, and room set up
Competency 2:
Plan clinical approaches, using clinical reasoning strategies and evidence based practice, liaising with the relevant professionals to co-ordinate assessments & care, as appropriate  
Competency 3:
Carry out a person-centred assessment, to include a full and relevant case history, and using tools and validated questionnaires as appropriate, in a safe and effective manner adapting as required to ensure information gained is maximised within the time available.
Competency 4:
Show creativity, initiative and originality of thinking in tackling and solving practical problems
Competency 5:
Collate relevant information and make an informed decision concerning the diagnosis and management of individual cases
Competency 6:
Develop person-centred treatment plans incorporating the needs, preferences and values of the patient and their family, and use shared decision making to choose between options.
Competency 7:

Deliver person-centred treatment plans, using counselling skills and appropriate techniques as required, and adapt as required depending on progress. Specifically this should include:
a. Information counselling
b. Habituation based therapy
c. Use of sound therapy
d. Hearing aid fitting/re-programming (including combination devices)
e. Advice and information regarding stress, relaxation techniques and sleep management
Competency 8:
Collate, and prepare resource materials (including patient information) including signposting to online resources, to complement their own interventions and those of colleagues.
Competency 9:
Recognise the need for and arrange onward referral to appropriate colleagues to relevant professionals considering the holistic needs of the patient, such as ENT, Psychology, Psychiatry, GP, social services. This should include recognition of when cognitive behavioural therapy (CBT) may be appropriate and onward referral to an appropriately qualified professional.
Competency 10:
Communicate effectively with patients giving clear information on the plan for the session, results, recommendations and management using appropriate language, communication skills and strategies throughout.
Competency 11:
Keep appropriate clinical records
Competency 12:
Write reports on assessment findings and recommendations and / or outcome of management as required, suitable for the intended audience, to include a range of professionals.
Competency 13:
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 tinnitus and hyperacusis 
d. Critically evaluate and reflect on their own actions 
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

Review appointment for a patient with a primary complaint of tinnitus

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

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment, to include daily calibration checks any equipment to be used, and room set up
Competency 2:
Plan clinical approaches, using clinical reasoning strategies and evidence based practice, liaising with the relevant professionals to co-ordinate assessments & care, as appropriate  
Competency 3:
Carry out a person-centred assessment, to include a full and relevant case history, and using tools and validated questionnaires as appropriate, in a safe and effective manner adapting as required to ensure information gained is maximised within the time available.
Competency 4:
Show creativity, initiative and originality of thinking in tackling and solving practical problems
Competency 5:
Collate relevant information and make an informed decision concerning the diagnosis and management of individual cases
Competency 6:
Develop person-centred treatment plans incorporating the needs, preferences and values of the patient and their family, and use shared decision making to choose between options.
Competency 7:

Deliver person-centred treatment plans, using counselling skills and appropriate techniques as required, and adapt as required depending on progress. Specifically this should include:
a. Information counselling
b. Habituation based therapy
c. Use of sound therapy
d. Hearing aid fitting/re-programming (including combination devices)
e. Advice and information regarding stress, relaxation techniques and sleep management
Competency 8:
Collate, and prepare resource materials (including patient information) including signposting to online resources, to complement their own interventions and those of colleagues.
Competency 9:
Recognise the need for and arrange onward referral to appropriate colleagues to relevant professionals considering the holistic needs of the patient, such as ENT, Psychology, Psychiatry, GP, social services. This should include recognition of when cognitive behavioural therapy (CBT) may be appropriate and onward referral to an appropriately qualified professional.
Competency 10:
Communicate effectively with patients giving clear information on the plan for the session, results, recommendations and management using appropriate language, communication skills and strategies throughout.
Competency 11:
Keep appropriate clinical records
Competency 12:
Write reports on assessment findings and recommendations and / or outcome of management as required, suitable for the intended audience, to include a range of professionals.
Competency 13:
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 tinnitus and hyperacusis 
d. Critically evaluate and reflect on their own actions 
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

Review appointment for a patient with a primary complaint of hyperacusis

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

Please leave blank if not applicable

Competency 1:

Prepare clinical facilities & equipment, to include daily calibration checks any equipment to be used, and room set up
Competency 2:
Plan clinical approaches, using clinical reasoning strategies and evidence based practice, liaising with the relevant professionals to co-ordinate assessments & care, as appropriate  
Competency 3:
Carry out a person-centred assessment, to include a full and relevant case history, and using tools and validated questionnaires as appropriate, in a safe and effective manner adapting as required to ensure information gained is maximised within the time available.
Competency 4:
Show creativity, initiative and originality of thinking in tackling and solving practical problems
Competency 5:
Collate relevant information and make an informed decision concerning the diagnosis and management of individual cases
Competency 6:
Develop person-centred treatment plans incorporating the needs, preferences and values of the patient and their family, and use shared decision making to choose between options.
Competency 7:

Deliver person-centred treatment plans, using counselling skills and appropriate techniques as required, and adapt as required depending on progress. Specifically this should include:
a. Information counselling
b. Habituation based therapy
c. Use of sound therapy
d. Hearing aid fitting/re-programming (including combination devices)
e. Advice and information regarding stress, relaxation techniques and sleep management
Competency 8:
Collate, and prepare resource materials (including patient information) including signposting to online resources, to complement their own interventions and those of colleagues.
Competency 9:
Recognise the need for and arrange onward referral to appropriate colleagues to relevant professionals considering the holistic needs of the patient, such as ENT, Psychology, Psychiatry, GP, social services. This should include recognition of when cognitive behavioural therapy (CBT) may be appropriate and onward referral to an appropriately qualified professional.
Competency 10:
Communicate effectively with patients giving clear information on the plan for the session, results, recommendations and management using appropriate language, communication skills and strategies throughout.
Competency 11:
Keep appropriate clinical records
Competency 12:
Write reports on assessment findings and recommendations and / or outcome of management as required, suitable for the intended audience, to include a range of professionals.
Competency 13:
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 tinnitus and hyperacusis 
d. Critically evaluate and reflect on their own actions 
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.

Maximum file size: 73.4MB

Please tick if resit is required

Resit information

Area below only for use when applying to resit the practical examination.

I confirm that I am satisfied the candidate is now ready to resit exam

Save / submit

If you have completed this module and are ready to submit this logbook check the box below, otherwise you can save your progress and come back to this later.

Assessors

Approval action