I have a cochlear implant and do quite well with it.
Early on, before I had any confidence and had not
completely figured out how to deal with my hearing
loss in clinic, it was hard going to offsites and not
exactly knowing what I needed and how to make the
adjustments I needed, and not quite having the
confidence in myself to work assertively with the
supervisors. I learned how to hook up CD players to
audiometers and now carry one with me to offsites as I
need to. I always do SRT and word rec on CD. I'm
still sorting out a bit the ins and outs of doing
pediatric testing as doing speech testing from a CD
works fine for adults but can be a bit inflexible with
kids and kids can generally be a bit harder to
understand than adults (word rec, that is- SAT is not
an issue). However, I'm more interested in working
with adults than with kids anyway. With pediatrics
some supervisors have been fine; others were really
concerned about my being able to do word rec for kids
MLV to make it more "interesting" for the kids.

I made arrangements to spend a week working full-time
at the VA in Memphis focusing on word rec testing with
adults, and figured out that I need a certain amount
of lighting in a certain configuration and need to
instruct patients to speak clearly in order for me to
be accurate in scoring. Some offsite supervisors have
been more open to the CD than others; some have the
perception that it takes too long. Some supervisors
were far more concerned about my accuracy in scoring
than others (typically before I put the extra time in
at the VA). I think a lot of it has just been having
to learn as I go along how to do things in a way that
work for me, while still being a student and learning
the concepts as well- I've had a couple of offsite
supervisors who were enthusiastic and willing to spend
the extra minute or two initially to figure stuff out.
Some places just have terrible soundbooths with poor
lighting- and I learned at the VA that certain things
were critical to my being accurate- but once I get to
a 4th year, I figure that I can drag in some lamps and
set it up in a way that works. I can think of one
place I was at, though, where the physical layout of
things was such that it would just be hard to fix the
physical soundbooth situation. Of course I'll go to
the places and check things out before agreeing to any
placement. (So much for my soundbooth rant- while at
the VA we found out that, by lipreading, I would at
times be more accurate than a normal-hearing clinician
who wasn't watching the patient, which is why it
drives me crazy that people think they can get away
with visually terrible soundbooths.) For a while I
tried to do word rec by having patients write down
words, because my in-house supervisors were strongly
suggesting it, but offsite supervisors were not too
open to that because it would take too long. Once I
spent the extra time at the VA, though, and worked
alongside a VA audiologist to sort things out, I felt
comfortable scoring spoken responses as long as the
patient does not have too much in the way of
articulation problems.

Some of it has been learning how to learn in a
clinical setting, which poses a different set of
challenges than classroom settings. I'm very much
used to handling a classroom and do well there; a
clinical education setting can be quite fast-paced and
a challenge dealing with the large amount of
information thrown at me at once. I've had a couple
of clinical supervisors suggest to me that they feel
that with my hearing loss, I have to concentrate, and
that I sometimes miss things because of the processing
demands or don't pick up on things quite as quickly.
As I've improved in my clinical skills and have gotten
more experience, I find that it gets easier because I
just know the stuff better and it's not as much new
information. I've learned to be more intentional
about trying to retain what I learn during each clinic
session and get the supervisors in a habit of
regularly giving me feedback and reviewing each day's
activities.

So... in short, just a lot of having to learn by trial
and error how to make things work, and going through a
roller-coaster ride with my confidence in the process.
Some places were more helpful than others to my
clinical growth at the stage I was at, when I was
there, with consideration to the challenges of dealing
with my hearing loss at the same time. I've dealt with
some personal challenges at the same time during my
graduate school career that added a bit of an
emotional load and made it harder to cope at times.
Gaining confidence has been a very slow process.
However, I've managed to learn something from every
place, and pull it all together over time.

I'm thinking of steering towards the VA and private
practices, where the focus would be on rehabilitation
and my hearing loss would be an asset. ENTs and the
medical setting seem to be more interested in whether
I can do a test in 10 minutes or less, and I just
can't speed up word recognition beyond a certain point
without losing accuracy (the CD player goes at a
certain speed). I think I've needed to spend time at
ENT places as part of my training to see more
complicated stuff, but I've also learned that it's
probably not the best kind of place for my long-term
career.

The person in my department who is coordinating fourth
years has heard from one place that was really
concerned about their fast pace and they weren't as
open to the idea of working with a student who has a
cochlear implant. So I've been more in favor of not
emphasizing my hearing loss, at least initially. On
the other hand, as you say, some might see it as a
positive.

I mostly was just throwing the topic of 4th years out
there for discussion... to see if anyone had things to
say or comments to make about their experiences or
thoughts they have about the process.

Julie


--- K Bretz <bretzk@...> wrote:

>
> Julie,
>
> What kinds of problems have you run into in your
> clinical placements? I found most places are very
> receptive to it - you need to use your hearing loss
> as a positive thing. it is a HUGE advantage for you
> in gaining rapport with patients. I would just
> advise to let them know up front what kind of
> accommodations you have found you need, or if you
> don't need any stress that you have done well in
> your previous sites without any accomodations. I
> suggest making some sort of statement about your
> loss in your cover letter. It will help you stand
> out from other applicants. For example here is the
> statement I had for my job applications "I feel I
> would bring a fresh point of view into your facility
> as a new graduate experienced with the latest
> technology and as a hearing impaired individual."
>
> If you are interested in a placement in southern
> california email me (bretzk@...) and I can
> get you in touch with the people at my company who
> are recruiting for up to 4 placements.
>
> Good Luck!
>
> Kristen Bretz
>
>
>
> To: HOHAudiologists@...:
> fitzerjulie@...: Tue, 4 Dec 2007 23:50:49
> +0000Subject: [HOHAudiologists] 4th year externships
>
>
>
>
> I'm currently in the process of looking at 4th year
> externships and finding a place that will match me
> well and will be open minded regarding my hearing
> loss (I've run into a real mixed bag in my offsite
> placements). I was wondering if anyone wanted to
> share their experiences with 4th year applications
> placements, any tips, etc. Julie
>
>
>
>
>
>
>
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