This document discusses the development of a questionnaire to investigate common errors made by audiology students during clinical training. The questionnaire was developed based on a review of clinical protocols and rubrics. It contains statements in 8 areas of clinical testing that were validated by clinical preceptors. The questionnaire aims to identify errors related to knowledge, practical skills, professionalism, and communication in order to develop feedback modules for simulated learning environments in audiology education. In the future, the validated questionnaire will be administered to audiologists to identify the most common errors made by students during clinical training.

1. 1st Allied Health Scientific Colloquium (AHSC) 2016 in conjunction with the 2nd KAHS Research Week 2016
Theme: “Enhancing Academic and Research Quality” | 21st – 25th November 2016 | KAHS Examination Hall, Ground Floor
1st Allied Health Scientific Colloquium
(AHSC) 2016
1st Allied Health Scientific Colloquium (AHSC) 2016 in conjunction with the 2nd KAHS Research Week 2016
Theme: “Enhancing Academic and Research Quality” | 21st – 25th November 2016 | KAHS Examination Hall, Ground Floor
1st Allied Health Scientific Colloquium
(AHSC) 2016
KRW2016/POSTER/AHSC/05
TITLE: INVESTIGATION ON COMMON ERRORS MADE BY AUDIOLOGY
STUDENTS DURING CLINICAL TRAINING
Authors: Nur ‘Ain Fathanah Mohd. Puzi1, Ahmad Aidil Arafat Dzulkarnain1, Sarah
Rahmat1
Correspondence: ahmadaidil@iium.edu.my, sarahrahmat@iium.edu.my
INTRODUCTION
The use of Simulated learning environment (SLE) training is aimed to fully or partially substitute the real clinical working environments and
have been reported to provide positive outcome to students in various fields (Butter et al, 2010; Cook, 2014). The SLE is categorized
according to the degree of fidelity (low, medium and high). In Audiology, most of the SLE training reported in the literature consist of either
low-fidelity or medium fidelity (Dzulkarnain et al, 2015). Only few of the SLEs are of high-fidelity in nature, however the focus of the
training is limited to only one or few specific testing (does not consist of all routine testing) (Wilson et al, 2011). This gap suggests the need
of developing a high-fidelity comprehensive SLE module, which also requires inclusion of feedback components. In any training
methodology including SLE, feedback is important for ensuring that students can determine whether or not they are fulfilling the
requirements of the respective learning task (Issenberg and Scalese, 2008). To develop a feedback module in SLE training module, the
knowledge of the typical errors made by the students in a specific task need to be systematically determined. This study therefore aims to
investigate the common errors regularly made by audiology students in the clinic during routine-audiology assessments.
QUESTIONNAIRE DEVELOPMENT
1. IIUM audiology clinic protocol and IIUM audiology clinical
rubric were reviewed to identify any sentence highlighting possible
errors made by the students during clinical placement.
2. The questionnaire was reviewed by two audiology clinical
preceptors (2nd and 3rd authors) based on; i) their experience in
supervising students in the clinic, ii) the learning outcome (LO) for
audiology clinic courses (basic to advance courses)
3. The survey questionnaire were divided into 8 areas of testing
(case history, otoscopic examination, pure tone audiometry,
tympanometry, acoustic reflex, management and plan, case note, and
professionalism):
•In general, all of the 8 areas pointed towards four general themes:
(i) error because of lack of knowledge e.g. from the cognitive
learning domains; (ii) error because of the incompetency in the
practical skill involving psychomotor and cognitive domains; (iii)
errors involving professionalism involving cognitive, psychomotor
and affective learning domains; (iv) errors involving communication
skills.
•Four categories of Likert scale consist of ‘not at all’, ‘rarely’,
‘occasionally’ and ‘frequently’ were provided at the end of each
statements for evaluation by clinical preceptor.
•In addition to that, one blank section is added in each of the areas to
allow feedback from audiology preceptors on additional possible
common error that are not listed in the close ended statement.
•Table 1 shows the example of common errors from some of the 8
sections of the questionnaire.
Development of questionnaire Validation of questionnaire Actual survey
Section Statement Not at all Rarely Occasionally Frequently
Case history Use of jargon when
conversing with
patient
Pure tone
audiometry
Unable to perform
masking procedure
Tympanometry Unable to determine
tympanogram type
Table 1 shows example of the statement for some of the section
Figure 1: Stages of collection of the common errors made by audiology students
1Department of Audiology & Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic
University Malaysia, Kuantan, Pahang
FACE VALIDITY
1. Face validation was performed by language experts (one
professional proofreader who is an English native speaker and one
linguist).
2. Some of the amendments were made based on the opinions from
the two evaluators:
•Deletion of repetitive words across statements (e.g. ‘Student’ that
was originally spell out in each sentence).
•Re-arrangement of section according to audiology clinic session’s
flow
•Correction of sentence structure and grammar check
3. The questionnaire will be further validated and piloted in future
study.
CONTENT VALIDITY
1. Content validation of the finalized survey of the questionnaire
have been distributed among 7 audiologists and pending for
collection.
2. The relevancy of each item in pointing towards the common
errors, and in assessing four domains (communication technique,
clinical skill, knowledge, and professionalism) will be evaluated
by the audiologists.
3. One audiologist has performed the content validation procedure.
All questions are considered as relevant (100%) and a few
suggestions of common errors were also given.
4. Upon collecting the response from the other 6 audiologists, the
relevancy score will be statistically evaluated using content
validity ratio (CVR) and Fleiss’ kappa statistics. Items that does
not meet statistical accepted value will be removed from the
questionnaire to produce final version of the questionnaire.
FUTURE DIRECTION: ACTUAL SURVEY
1. 30 audiologists will be recruited to answer the final version of
the questionnaire to identify the common errors made by the
student during clinical training.
2. Identification of errors from the least to most common based on
the agreement towards statements from the questionnaire and any
subjective feedback will also be conducted.
REFERENCE
1. Butter J. , Mcgaghie W.C., Cohen E.R., Kaye M. & Wayne D.B. 2010. Simulation-based mastery learning
improves cardiac auscultation skills in medical students . J Gen Intern Med , 25 , 780 – 85.
2. Cook D.A . 2014. How much evidence does it take? A cumulative meta-analysis of outcomes of simulation-based
education. Medical Education , 48, 750– 760.
3. Dzulkarnain, A. A. A., Wan Mhd Pandi, W. M., Rahmat, S. & Zakaria, N. 2015. Simulated learning environment
(SLE) in audiology education: A systematic review. Int Audiol J, 22: 1-8.
4. Scalese, R. J., Obeso, V. T. & Issenberg, S. B. (2008). Simulation technology for skills training and competency
assessment in medical education. Journal of General Internal Medicine, 23(1): 46-49.
5. Wilson W.J. , Goulios H. , Kapadia S. , Patuzzi R. , Kei J. et al . 2011. A national approach for the integration of
simulated learning environments into audiology education . Australia: Health WorkforceAustralia.
ACKNOWLEDGEMENT
The authors wish to acknowledge the Ministry of Higher Education through the Fundamental Research Grant
Scheme (FRGS) (Grant numbers: FRGS15-236-0477) for their financial support in conducting this study. The
authors declare there is no conflict of interest.