There is ongoing confusion regarding the professional roles in the diagnosing and treatment of hearing loss. This confusion is widespread amongst the public, physicians, and other health care providers.
At Sounds+ our mandate includes the desire to promote the importance of audiology through educating the public and other health professionals about the importance of hearing health care & audiology. Therefore, let us try to clarify this topic.
There are predominantly two health-care professions that provide services to conduct hearing tests for the purposes of selecting, fitting and dispensing hearing aids and other assistive listening devices. These two groups, audiologists and hearing instrument practitioners (also known as hearing instrument specialists, hearing aid dispensers, hearing aid practitioners and hearing aid dealers), have different scopes of practice, which are defined by their education and training and by regulatory distinctions.
Academic and Clinical Training
The academic and clinical training of audiologists and hearing instrument practitioners differs significantly. For audiologists, the minimum educational requirement in Canada is a master’s degree or equivalent; which typically consists of 2-3 years of education after achieving a 4 year bachelor’s degree. Depending on the type of bachelor’s degree earned, an applicant to a master’s program in audiology may be required to do additional university coursework prior to admission.
In addition to coursework, master’s students in Canadian audiology programs must also complete a minimum of 350 hours of supervised clinical practicum. This typical 5-7 years of baccalaureate and graduate degree university education prepares audiologists to exercise their profession using a high-level of independent clinical judgment and critical thinking based on evidence-informed practice when assessing and managing patients with audiological disorders.
Licensing and Practice
There is considerable variability within the educational and clinical training for hearing instrument practitioners across Canada. There is no standardized minimum educational requirement to practice across Canada and the credentials for hearing instrument practitioners vary significantly between provinces/territories.
There is also no agreed-upon standard across Canada in the areas of regulation/registration; requirements for post-secondary education related to hearing health and hearing-aid dispensing; on-the-job training or demonstration of competence prior to licensing. Depending on the province/territory, an individual considering a career as a hearing instrument practitioner may or may not be required to pursue formal education and may complete a self-study program (which can be achieved in a few months) or a college or university diploma or certificate program. Some programs require a high school diploma for admission, while others evaluate applicants on a case-by-case basis. The college or university diploma or certificate programs are typically 2-3 years in length and focus on hearing testing and hearing-aid technology.
Both audiologists and hearing instrument practitioners conduct hearing tests for the purposes of dispensing hearing aids and other assistive listening devices. Despite sharing this similarity, the hearing instrument practitioner’s scope of practice is narrower than the audiologist’s.
Hearing instrument practitioners test peripheral hearing for the purpose of selecting, fitting and dispensing hearing aids and other assistive listening devices. Hearing instrument practitioners are typically not permitted to provide services to children as their scope is generally limited to adults and is reflected as such in regulation, where it exists.
Audiologists are uniquely qualified to assess, identify, diagnose and manage individuals with peripheral or central hearing loss, hyperacusis, tinnitus and balance disorders; and to select, prescribe, fit and dispense hearing aids and other assistive listening devices. Audiologists also receive extensive training in counseling and (re)habilitation, which extends their practice beyond the selection and fitting of amplification. Audiologists are trained to perform these services for all ages – from newborns to adults.
In summary, there are significant differences in the scopes of practice and educational training levels between audiologists and hearing instrument practitioners. Audiologists bring a broad range of clinical skills and services to a patient’s hearing health care and hearing instrument practitioners have a narrower scope of practice. Though differences exist, there are work environments where audiologists and hearing instrument practitioners work collaboratively, both contributing positively to the hearing health care of patients. In order to receive appropriate hearing care for their individual needs the public should understand the significant differences between the two professions when seeking hearing health-care services.
Speech-Language and Audiology Canada. SAC Position Paper: Differences Between Audiologists and Hearing Instrument Practitioners in Hearing Health Care, May, 2013, pp. 2-4.