Hello, everyone, and welcome. Thank you for joining us today, and thank you to Sierra and IHS for having me and putting together this webinar series that I hope will benefit a lot of people out there who are currently training or interested in doing training in the future. Before we get to the content, I have a little bit of housekeeping. CE credit for this webinar is available on the IHS website. These slides and additional resources can be found on the webinar page. Our agenda for this webinar is to discuss requirements for trainers, provide an overview of adult learning theory, cover components of a training plan, and discuss tools and strategies for the training experience. Kind of an overview of a lot of things related to training. As you're watching or listening to this webinar, think about the experiences you've had during your training. Maybe even back to your days spent in primary school. Consider some of the qualities that you liked about your trainers or your teachers. Throughout the presentation, reflect on whether those qualities align with the qualities we discuss. Then I'd challenge you to consider what qualities you want to embody as a trainer. You know, what do you want your trainees to, you know, remember about you and your approach to training? In regards to training, some things I commonly see within our profession are that trainers receive little to no instruction on how to train. They may not have had the option of whether they wanted to be a trainer or not. A lot of people are just told, hey, you're going to be training this person. Trainers sometimes have very few tools to support the learning process in the clinical environment. And many times they're still held to the same performance standards as their colleagues who aren't supervising trainees. And as a note, I'll be using the term requirements in a broad sense. We will be showing information from various jurisdictions and reviewing the requirements for every state is beyond the scope of this presentation. There's just no way we can get to every state, every province. That's a lot. Each state is different. So if you have specific questions about your jurisdictional laws regarding training and supervision, I encourage you to contact your governing agency and or an attorney. The information provided in this webinar is not meant to be legal advice. Many of us know that every jurisdiction has different requirements for training and supervision. If you've been licensed in other states, if you've moved, if you're dual licensed and move, you know, between different clinic locations. It is the responsibility of the trainer to understand and to follow those requirements. This includes understanding requirements for the trainee. So not only knowing what's expected of you as a professional in the field, but also knowing what's required of you as a trainer and what's required of trainees that will potentially be under your supervision. Along the slides for this presentation, we'll be including a generic checklist for trainers to use as they're going through this training process, setting up a training plan, looking at jurisdictional requirements, all of those things. As I said previously, identifying the requirements for each state or jurisdiction is really beyond the scope of this webinar. So while doing your research into the requirements for training or supervision, there are some key terms to look for. While every state or jurisdiction has different requirements, there are a few questions that we can all ask ourselves. For instance, what terminology does the state or jurisdiction use for trainers? Is the title sponsor, preceptor, supervisor, etc.? Is there a minimum number of years that someone needs to practice before they qualify to be a supervisor or a sponsor or a trainee? And are there additional training requirements for supervisors or sponsors? For example, some governing bodies require that the licensed professional is also board certified by the National Board for Certification in Hearing Instrument Sciences to sponsor and train a trainee. Another thing to consider is if there's a limit to the number of trainees each trainer can supervise at one time, some states it's one, some states it's three. Again, another, you know, facet to each state that changes depending on where you live. And then what documentation is required from the trainer and from the trainee for the governing body, the licensing board? What do you need to submit on behalf of yourself, on behalf of the trainee? Do you need to submit forms together? Those are all important questions to ask yourself and things to look for when you're doing research into the requirements to meet state and jurisdictional law. So here's some more keywords to look for. Specifically, it's important to know what type of supervision is required during the training process. Direct supervision is common for new trainees. And direct supervision requires that trainees have immediate access to their sponsor or trainer. They have to be in the building available to the trainee. Indirect supervision usually starts after the trainee has met a certain level of clinical ability or a specific number of clinical hours. And indirect supervision allows that trainee the ability to practice in a different location than their trainer or sponsor. They don't have to be physically in the same building at all points in time. It's important that we specifically call out the responsibility of the trainer to review all documentation, chart notes submitted by the trainee at all stages of the training process. Whether it's direct, indirect. The requirement to review all documentation and chart notes, paperwork submitted by the trainee or entered by the trainee. It's a responsibility of the trainer to review all of those and sign all of those as well. Once the trainee has met state or jurisdictional requirements for licensure and has been issued their own license or registration, the trainer should be, in most cases, released from any previous responsibility for the trainee's actions. Until that point, the trainer should be taking time at the end of each day or after each appointment to review and sign all documentation. As a trainer or a sponsor, any trainee you take on is usually, according to jurisdictional law, tied to your license. And you're ultimately responsible for the actions of the trainee. You want to be making sure that things are entered correctly and giving the trainee feedback on things that maybe aren't correct or need some tweaking. Some additional considerations when you're looking at jurisdictional law is proper title usage. It varies by state, so if the trainee has to be called a trainee or maybe they're called a student. In Missouri, for example, the specific title for a trainee is a hearing instrument specialist in training. They can't abbreviate that to trainee or hearing aid tech. They must use that specific title in any marketing or name tags, anything where they're displaying their professional credentials. They have to use that specific wording. Look at the rules for displaying your license. Many states have rules about requirements to display your license in a place where the patient can see it in the office. This applies mostly most of the time to trainees as well. So that's something to look for when you're going through and doing research. Another thing to look for is the scope of practice for the trainee. Trainers should be very familiar with their own scope of practice. And the scope of practice, if it's different for the trainee. Scope of practice is dictated by each jurisdiction. And sometimes it might be different for a trainee based on the state or jurisdictional training guidelines. So that scope might be impacted by the training plan or phases of the training plan, depending on the jurisdiction. Another thing to consider is what happens if the trainee seeks employment elsewhere? And it's important to think about, like, what other ethical considerations are there for supervision that might not be addressed by the jurisdictional law? Another thing to consider is what happens if the trainee seeks employment elsewhere? Is there documentation that needs to be submitted to the state? Does the trainee have to submit that? Does it have to come from the sponsor or the supervisor? These are all, you know, something that you would want to have conversation about with your trainee early on. And also, what ethical considerations are there for supervision that might not be addressed by the jurisdiction? For example, the law might dictate a full scope of practice that includes everything on day one of training. But ethically, we know it's not a good idea to give a trainee a full patient schedule to handle on their own day one of their training experience. You may find that there are things you want to implement in your training plan that go beyond the jurisdictional requirements. So how many of you have heard the phrase, do as I say, not as I do? Probably everyone. Early in my training, I briefly had a mentor that would always say that before doing something that was counter to best practice or downright unsafe. And, of course, it always made me so uncomfortable and was very confusing to see and hear. And when training adults, this way of thinking is highly problematic. Not only is it counter to best practices, but it implies that when the trainee is that what the trainee is learning is not applicable to the real world. You're basically telling them what they're learning in their studies and in best practices guidelines is, you know, irrelevant. And this is what you're actually going to do. Anytime you see someone doing something and you're learning from them, it's much more likely that you're going to pick up on those habits than trying to do something counter to what you're seeing frequently. Teaching and demonstrating clinical best practices prepares the trainee for their future as a provider, and it prepares the trainee to take their licensing exams. When they learn best practices for providing hearing health care services from day one of their training, they won't have to go back and relearn concepts just to pass their exams. In those stressful situations, more often than not, they're going to fall back on what they're used to, what they're comfortable with. So starting with best practices from day one is, you know, the best way to ensure they're ready for those exams. And on the opposite end of the spectrum, one of my favorite phrases in relation to teaching is perfect practice makes perfect. It's what I tell trainees when they start complaining about having to demonstrate a skill they feel they've mastered or, you know, they're working through activities or assignments that they've done previously. And I remind them perfect practice makes perfect. I want to see them perform this skill, demonstrate this ability over and over again perfectly before I'm comfortable with them going to take their exams, handling their own patient schedule. You know, really just letting go of the reins for the training program. It also applies to how trainers approach their day-to-day practice, whether working with a trainee or not. Just like it's difficult for a trainee to relearn a concept, it's difficult to model best practices if we aren't doing them routinely ourselves. So even as a trainer, perfect practice makes perfect. If we want to be demonstrating best practices, it's best to be doing best practices all the time. Then we don't have to worry about, oh, actually, I need to do this method this way, because that's how the trainee is learning it and, you know, trying to adjust your normal to teach. Again, in stressful, busy situations, it's more likely that we're going to fall back on the routine things that are comfortable and well-known. As part of this series, we'll take a closer look at some of the topics that trainers struggle to teach, for example, masking, using the sprint chart and methods of validation and verification. Many of the topics include concepts that have been deemed best practice since most of us went through our licensing exams. Some of the concepts are difficult to learn when you don't have access to the tools in your clinic. Some of them take time to learn and implement, which can slow down appointments and a busy schedule. We understand the struggles, but best practices change for good reason and not without justification. It is the trainer's ethical and, depending on the applicable rules and regulations, legal responsibility to follow and teach best practices. This is a small look at IHS's current best practice guidelines. You can find the full document and most current version on the IHS website by scanning the QR code provided. Now, let's take a look at adult learning theory. Teaching adults varies greatly from teaching K-12 age children. As we look at this topic, reflect on your most recent training experiences or maybe the last time you learned a new skill for your job or otherwise. You know, the last time a new product launched and you had to learn, you know, a whole new software for that product, something like that. And see if you identify any similarities between your recent experiences and the concepts we discuss. So who are we training? We took a look at data from trainees enrolled in the IHS distance learning course in preparation for this webinar. I'm sure most of this won't come as a surprise if you've ever supervised a trainee. We are in fact training adults. The median age for trainees enrolled in the distance learning course in 2022 was 35. The youngest was 18 and the oldest was 67. 18 to 67 is a huge range, but that median age of 35 I feel like is something that we've all seen or anyone who's done training in the past has seen. Most of our, you know, the people coming into the field are not straight out of high school, although there are exceptions. We know that many trainees come into the profession as a second career. They may have families and they may have people depending on them outside of work. When training adults, it's imperative to understand that their life experiences fundamentally change their approach to learning. We cannot teach trainees the way we were taught in grade school. If we as humans are a culmination of all of our life experiences, we should approach the training process with understanding that we will be working with complex and dynamic human beings. Getting to know your trainee is critical to connecting with them, cultivating trust and understanding their strengths. So what's the difference between teaching children and adults? Well, adults, as those complex and dynamic human beings, have a different relationship with knowledge. In our childhood, we're mostly extrinsically motivated, meaning we learn new concepts to win a prize, make our parents happy, or to avoid the negative consequences of failing a class or being held back a grade. As we age and develop a sense of autonomy, we become more intrinsically motivated. We learn new concepts or skills because we want to. And there's a sense of ownership in the learning process that is not present at younger ages. So how do we approach the learning process for adults? A couple of the phrases I heard the most while in college were sage on the stage and guide on the side. I studied specifically, you know, education for my bachelor's, I had an emphasis in online teaching and learning. And for my master's, it was an emphasis in adult education, and online teaching and learning. So I heard these quite frequently, sage on the stage, or guide on the side. And a sage on the stage, that's a phrase describing a more traditional approach to teaching. It puts the instructor or teacher in the role of sage, someone who is very knowledgeable and who students will learn from. When we think about children's learning theory, this approach makes sense because most children don't have a large knowledge base, nor do they have the skills to find the information effectively on their own. So you have your sage on the stage as your instructor up in front of the class, disseminating all of the knowledge that the learners need. On the opposite end of the spectrum, we have the guide on the side. The guide on the side is an instructor, trainer, sponsor, fill in the term, who can provide instruction, lead a learning activity, etc. and can also allow space for the student to uncover new information throughout the learning process. In this regard, the learning process is a partnership. The guide is available to help provide direction and learning materials, but they travel alongside the student. When concepts get complicated, or a trainee is having a difficult time engaging with a specific topic, it's important to remember that adults don't usually learn new things just because they can. Especially if it's a topic that isn't fun to learn. I'd wager that you don't spend your evenings reading through the manuals for your appliances. I know I tend to get the thing plugged in, then start fiddling with it until it works correctly, or I get so frustrated I have to dig the manual out of the trash. Intrinsic motivation makes a huge difference in our approach to learning. For difficult concepts, having the trainee explain why they're struggling with the concept can provide clarity for how to help them move forward. So if you're working with a trainee on, you know, a specific skill, maybe it's learning how to brace, and the trainee is getting frustrated, it's important to guide on the side, come alongside them, and ask them questions to clarify or get to the root of what they're struggling with. Do they need more hands on practice? Do they need to hear a concept explained in a different way? Or do they maybe need to understand why they have to learn this? It could be that they just have a mental block because the topic that you're currently working with them on isn't connected to anything else that seems relevant. And speaking of connecting ideas or concepts, adults learn by connecting new information to current information or previous knowledge. They want to learn skills that are applicable to their career or their life. So trainees will learn what they need to learn if they understand they need the knowledge for their career. If they perceive that something is unimportant, they will be much less motivated to learn it. Trainer and employer buy-in to the training plan and learning materials significantly impacts the trainee's rate of retention. So as a trainer, it's very important to maintain a positive attitude toward the training plan, the training materials, and following best practices. New concepts need to be introduced in a methodical way. Once you've helped the trainee make a connection to the topic, start with the most basic version. For instance, you wouldn't expect a trainee to make changes to compression ratios the first time they sit down to learn the fitting software. It would be much more effective to discuss how what they've learned about hearing assessments, lifestyle and communication needs, and hearing aid styles will now be pulled together in one place, the fitting software. Trainees could then connect the hearing aids and verify all of the information in the chart matches what they're seeing in the software. Giving them time to find commonly used settings is a great way to get them used to navigating the software. When they're able to handle basic navigation and adjustments, it would be appropriate to move on to traditionally complicated features like compression. An effective way to introduce concepts methodically is by providing more support as the trainee is learning a new concept. Then when they become more confident and skilled, the trainer can gradually provide less and less support. This is known as scaffolding, and I think a lot of times this happens naturally as we're training people in the clinic. Many times there's a period of having the trainee observe, and then there's working with them into handling, you know, performing otoscopy, or doing air conduction testing, and then kind of the trainer and the trainee working as a partner to move through the appointment together, and as the trainee builds confidence and they become more efficient with the tasks, the trainer usually hands off more and more and more of the appointment. This process of starting with a lot of support and then gradually lowering the amount of support you provide is known as scaffolding. Many trainees will hit topics that are initially abstract or difficult for them to understand. It's usually one of the first things they learn, and learning all the skills needed to start work in a new profession is going to be daunting, but don't skip topics just because the trainee is struggling with them. Remind the trainee that not every concept is easy to learn. Some topics will take more effort, both mentally and emotionally. They might get tired of, you know, repositioning an O2 block over and over again, but they have to keep working at it in order to build those skills because they're going to need them. There's a balance, and as trainers, we have to find it in every learning experience. Many people tell me that their training consisted of being thrown to the wolves or thrown into the deep end without a life vest, and for me, as someone who's passionate about training and learning, it makes me sad to hear that, and when a trainee is thrown into the deep end, they don't have the support they need, and it results in them experiencing high levels of stress. This is counterproductive to the learning process, and hopefully, we can learn new training skills together and avoid that approach in the future. New concepts, procedures, skills should be relevant and should be introduced at an appropriate time. Relevant, meaning the trainee is able to connect the new concepts to prior knowledge, or they're able to acknowledge that they have to learn the theory as a foundation for future concepts. Appropriate time, meaning the trainee demonstrates a deep understanding of previous concepts, so before you move on to something new, as a trainer, you have to think about if this is a relevant time to introduce a new topic. If we're talking about hearing assessments and performing air conduction testing, is that the right time to start talking about speaker strengths? Probably not, so it's good to keep learning relevant to what you're currently looking at and adding new concepts at the appropriate time, so when the trainee has a really, really solid understanding of how to perform air conduction and bone conduction, their bracketing is smooth, they don't have hiccups, they have few to no questions about the process, and they can go through it on their own, then that would be an acceptable or appropriate time to add, you know, SRT or other speech tests, or to introduce the topic of masking, so it's really important to keep those two things in mind, is this relevant to what we're currently talking about, and is this the appropriate time? Memory is not infinite. The trainee will enter each learning activity, you know, come into the office each day with a pre-existing mental load, and it's important to build skills for managing the mental load. The mental load consists of anything or everything that is distracting or taxing the brain. For example, on any given day, the trainee might be thinking, did I remember to pay the utility bill? What will I feed my family for dinner? Do I know the programming software for the fitting appointment later today? Did I remember to introduce myself to the patient? And they might be asking themselves all these questions or thinking about these things as they're sitting down to do intake with their patient. You know, kind of reflects that, you know, saying about being kind because you never know what someone's going through. Along those lines, this kind of being aware of the mental load and how to manage that mental load is really important to successful training experiences. So if your trainee's eyes look really distant or they're making, you know, what you call silly mistakes, their mental load is probably too high. Making silly mistakes happens when we are overwhelmed and the memory portion of our brain shuts down. This makes it difficult to remember how to do something, even if you've done it well many times before, or to store new knowledge in long-term memory. So if the mental load is too high, your stress levels are too high, the memory portion of your brain is not working as well as it needs to be for effective learning and demonstrating skills. From the training perspective as a trainer, whenever the brain isn't working to store new information, that training time is really being wasted. The trainee is not benefiting from that time spent together. So if you've blocked time to work one-on-one and maybe the trainee is making, you know, mistakes that they haven't made in a while, it's important to, you know, connect with them and figure out what's going on. And if you're working with them on something and coaching them and you feel like a broken record after explaining the concept a few times, reflect on the scenario or that day's schedules, your interactions with that trainee. Are there distractors in the environment right now? You know, are there patients waiting in the hall who are talking loudly? Are there, is the front office assistant listening to music or, you know, talking on the phone loudly? Is the concept you're trying to teach multifaceted? Should it be broken down into smaller parts or simplified for better understanding? Sometimes concepts, you know, the big picture can be really overwhelming and have a lot of different moving parts that initially are difficult to comprehend. So breaking that down into, you know, bite-sized chunks can help with retention and deeper learning, moving those concepts into long-term memory. And if any of this is happening, communicating with the trainee is very important to finding the root of the problem and fighting a way to get back on track so you're not wasting, you know, that precious time that you have together and you can have those open lines of communication and build trust and be able to say, okay, you know, it seems like something's going on, you know, fill me in, what's going on? What can I help with? How can I support you? So after working with the trainee to help them build connections between prior knowledge and new knowledge or new content, scaffolding your clinical activities, your work that you're doing together by giving them a lot of support in the beginning and then gradually providing less and less support, and managing the mental load, all of those learning concepts help build confidence and a deep understanding of new concepts, and they help the trainee to reach the stage of automation. And what do I mean by automation? As we learn new concepts, if we learn them at a deep level, and they're transferred to long-term memory, we no longer have to juggle so many things in our head at one time. Learning a new skill starts with having to look up the information needed, observing demonstrations or listening to a lecture. If that information that we're looking up, we've observed by watching YouTube videos, or we've learned in a lecture is retained, it moves to working memory and short-term memory. So now we don't have to go to Google and search and look up this information. We don't have to re-watch this YouTube video for the 50th time. We don't have to go back and replay this lecture. We are able to store all of that in our brains, in your working memory or your short-term memory. In this stage, the information is available in the brain via recall. So you're able to think about something, recall that information. It takes a little bit of effort. Recall is way faster than having to look up the information in a book or pull up the YouTube video, but there's still a significant amount of working memory required. If you're using recall, you're using a good amount of your working memory or you're adding to the mental load to pull that up out of your memory and connect it to what you're doing in the moment. When information that you're learning is understood and retained at a deep level, you've practiced this thing, you've watched the videos over and over again, and you've finally learned how to do it. You've done it multiple times. At that deep level, it becomes automated. This means that the brain no longer has to use large amounts of working memory for recall. You're not having to go through your memory and pull up this information, which recall again is much faster than having to go and look something up on Google or YouTube. But it still requires mental effort. When you reach that deep level of learning, that level of automation, the brain simply knows what to do. For example, when a trainee first learns to perform otoscopy, they have to think about infection prevention protocols. Did I wipe this down? Did I throw that away? They have to think about how they're bracing, how they're manipulating the ear, how they're maneuvering the otoscope in the ear, and they have to analyze what they're seeing. All of these things are going through their head constantly every time they perform otoscopy. So usually the process takes them a little bit longer. It's more stressful. And as experienced providers, we simply analyze what we see. We don't have to think about bracing. We don't have to think about manipulating the ear. It just is a natural process for us now. Our brains automatically know what to do. The other steps that trainees have to worry about become automatic to us, and they don't take up so much working memory or require such a high mental load. Learning to ride a bike is another great example of automation in action. It can be something that's very complicated to learn, resulting in cuts and bruises. But once you know how to ride a bike, it's very automatic getting back on one, even if it's been a long time since you learned or since the last time you were on a bike. This is kind of where we can come back to the idea of perfect practice makes perfect. Not only does automation help with the length of time a new skill takes in the clinic, as we said, when you're learning to do otoscopy, thinking about all those things, it takes a lot longer than once it's an automated skill. So it helps with the length of time new skills take in the clinic, but it also helps in the training goes to take their licensing exams. If they have a deep level of understanding or their brain has kind of automated some of these skills or information, then they'll have fewer concepts that they have to juggle in their head while taking an exam. And if they don't have all these things juggling in their head, it gives them more space for understanding and analyzing the question or task in front of them. We all know taking tests is a stressful process, which we know stress adds to the mental load. It decreases working memory. And so the more the trainee can perform perfect practice and move these new skills to a place of deep learning and automation, the easier it's going to be when they go to take their exams, whether it's a written exam or a practical exam. Both take a lot of mental effort due to the stress and then trying to figure out what's being asked in the question or by the proctor. And every trainee will connect with content in different ways. Everyone has a preference on things that they like to study and things that they don't like to study. And your training methods, what works for one may not work for another. Part of the training process is learning more about your trainee, which requires communication. And communication is everything. My suggestion is to start the training process with an open conversation about career goals, realistic expectations, strengths and weaknesses, and preferred communication styles. You know, you want to know if the trainee is looking for a fast track training and learning option. Do they want a lifelong mentor? You want to know what previous experience they have in the hearing health care field, if any. These types of questions help the trainee, the trainer, understand the trainee's approach to this learning process. So if someone's wanting fast track training, that might impact, you know, your timeline, your goals, that kind of thing. And if a fast track learning option isn't an option in your jurisdiction because of the laws, that's something you can just tell them upfront. Well, you know, our state or province requires this length of training no matter what. So you can kind of set expectations and understand where the trainee is coming from and what their expectations are. You want to, with the trainee, discuss and explain the legal and ethical responsibilities of trainers. So for yourself, it's important for trainees to know that. It will help them understand your approach to the training process and, you know, maybe even give them a broader look at things in the sense that they will now know that there are things you're required to track or prepare for, et cetera, as the trainer that they don't have to do. And you should also discuss and explain the legal and ethical responsibilities of the trainee. So, you know, we talked about going through, making sure that you understand the trainee's scope of practice, all of that research that you did prior to and, you know, starting a training program or a training process. You want to come back to that information and make sure that the trainee understands all of those responsibilities that they now have. And it's important they know what they do in the clinic and beyond can impact your license as the trainer. So having really clear, upfront conversations about these things helps everyone kind of get a point of reference and also to understand how their actions impact the others. If, you know, looking back at communication, thinking about communication in the training process, if you're in a busy clinic and you don't have time to answer questions during an appointment, communicate that. Let the trainee know before you, they step into the first appointment, that you'd like them to write down their questions so you can talk about them after the appointment or at the end of the day. So they're not interrupting you, you know, during the testing process or while you're trying to counsel the patient or do intake, any of those types of things. So set those communication expectations even for your appointments. If the trainee asks you a question about something and you don't know the answer, be honest. Tell them, well, I'm not, you know, I don't really know. I'm not sure, but I can look it up and get back to you. Take the time to look up the answer. Or if you can't find the answer, you've got a support team through IHS and if they can't help point you to find, you know, a way to find that answer, they can help you connect with people, other people who do training or someone that can help you with that information. Now let's discuss the steps for creating a training plan. To create a training plan, you should, as the trainer, have an understanding of the job, the profession. You should set goals. Goals are usually more broad in scope. You should identify clinical activities. Those are specific activities that determine how the trainee will meet the more broad goals that you set previously. And they get, you know, identifying clinical activities. The clinical activities can be as detailed as you want to be. You'll want to implement phases or a timeline. And you'll want to evaluate the performance for your, of your trainee and yourself. And you'll also, you know, at, could be at any point in the training process, but, you know, definitely at the end, you'll want to evaluate how that training process was overall. The first step in building a training plan is to understand the job. This includes identifying best practices and the scope of practice. The scope of practice is usually outlined by each jurisdiction. You'll have a list within your laws, and you could pull that information so that you have it as you're creating this training plan. It's good to probably have that scope of practice around during the training process anyway as a reference. Best practices guidelines can be found through professional organizations like IHS. Earlier in the presentation, I showed a clip of the most current best practices recommendation document from IHS. If you didn't grab a picture or a scan of that QR code, you can flip back, scan it, or you can pull up the slides on the webpage with this webinar and scan it. Your, you know, state societies or state chapters may have best practices recommendations. Other organizations do. IHS's is pretty straightforward, and I think a good place to start. Once the trainer and trainee have a firm understanding of best practices and the scope of practice, they can look at the individual duties more closely. This can be done independently between the two of you in partnership with your company Are there company, you know, procedures or, you know, rules in place for training or by using the competency model created by IHS? The competency model from IHS is a breakdown of clinical tasks by percentage based on the results of their job task analysis survey. And this survey is sent to all licensed or registered hearing aid specialists, whether they're members or non-members. And the results provide a real-world look at day-to-day clinical activities as reported by licensed or registered hearing aid specialists. IHS uses that competency model to develop the international licensing exam questions and to map the questions to those specific domains and to develop and map the skills assessed on the IHS practical exam, which is another reason you might consider using that to when you're creating your training plan and getting an understanding of the job. There are a lot of different things you can pull from. And, you know, the more resources you have, the better off you'll be to really making sure that you have covered all of your basis. So here you can see a just little clip of the IHS competency model. You can find the whole document by scanning the QR code on the slide. They've got, you know, descriptions of each section and kind of a percentage breakdown of what licensed or registered hearing aid specialist said in those surveys, the amount of time they spend, percentage of time they spend in their clinical practice doing these different tasks. Next, the trainer and trainee should work together to set broad goals. Using the trainer manual makes this process a lot easier, but if you aren't using the trainer manual or the distance learning course, you can use the IHS best practices document as a starting point. This document, this is the document we reviewed earlier in the presentation when we discussed best practices. And goals should be broad and also actionable, meaning the trainee reaches the goal by demonstrating specific skills. The trainer manual makes setting these goals easy. They have learning objectives which easily translate into goals in both the trainee workbook and the trainer manual at the beginning of each unit. These make excellent goals, they're very specific, and they correspond to suggested clinical activities that are listed in the trainer manual. So that kind of leads you into the next step. And another method of setting goals is by looking at jurisdictional licensing exam requirements. It's a way of starting with the end. And starting with the end guarantees that the trainees, the trainee will cover the knowledge required for their exams. If you know what is required on their exams, you'll know exactly what needs to be covered in their training plan. Here I've got a clip from the Arizona practical exam study guide, and it's very detailed in describing what the trainee will be required to demonstrate on the practical exam. So looking at this, you'd have to tweak the wording a little bit. It's not just a copy and paste, but it gives some good, you know, reference and a place to start. So moving from broad goals, we go then into identifying clinical activities. And the clinical activities are the more specific tasks or things that trainees will do to meet those more broad goals. Some jurisdictions will have a training plan outlined. Many do not. Even if the state has specific activities outlined for the trainee, it's still beneficial to review and expand areas that might be lacking. The trainer manual and the student workbook have extensive suggestions for clinical activities. The trainer manual has very specific things that the trainee the trainee individually or the trainee and the trainer can be doing in clinic to meet those goals or meet those objectives. And this is where trainers would use the scaffolding approach, where they are going to provide a lot of support for new skills at the beginning and then gradually provide less and less support as the trainee demonstrates a deep level of understanding. Here's an example from the state of Maine, and they've outlined specific clinical activities that trainees must complete during their training program. This could serve as a foundation for a more detailed list of clinical activities that culminate in their ability to perform these listed activities. We know that, you know, this is a pretty broad look at what should be done during training. But, you know, it lays the foundation and then you can further break that down into specific specific clinical activities that will help support their accomplishing those bigger tasks. So, here we have on the left recommended clinical activities from the trainer manual from IHS that the trainee can perform to meet those previously defined goals or objectives. And on the right are examples of exercises that are in the trainee's workbook that help them build clinical skills outside of the clinical environment. These are things that they can work on at home that will help prepare them for performing those clinical activities and just kind of bring their independent learning and clinical application together. With the goals and the clinical activities identified, they can then be grouped into phases. And the phases of training include independent learning, observation, direct supervision, indirect supervision, and independent practice. Phases can also be outlined by with a timeline. It doesn't necessarily have to be these specific phases. It could be a certain amount of time that you're spending on each, you know, set of skills. It could be a certain amount of time that you're spending on each, you know, set of skills. But I've found that structuring it by phases is just a little bit more organized and creates more realistic expectations for the trainee and the trainer. And let's talk about what all of these different phases are. So independent learning is time spent outside of observation or interactions with patients and clients. It's mostly time spent reading, completing online learning activities, completing one-on-one practice with the trainer, etc. Direct supervision, as discussed, is any interaction the trainee has with the patient client with the trainer actively observing or readily available on premises. Indirect supervision allows for the trainee to provide services without the trainer or sponsor, supervisor, what have you, present or available on premises. So it could be that the trainee in the indirect supervision phase is seeing patients at a different clinic from their trainer clinic from their trainer or their sponsor. Both direct and indirect supervision still require the trainer to review and sign all documentation and paperwork completed by the training. Still have to go through and read all of that, sign it yourself, and it's an excellent time, again, to reinforce documentation that looks good to help provide some support for documentation that's maybe a little lacking or if something's incorrect to course correct the trainee there. Independent practice comes after the trainee obtains their own license or registration and the trainer is no longer required to sign off on their documentation and paperwork. So we go from book learning, you know, independent learning time to observation where the trainee is in the clinic but not directly interacting with the patients or clients they're watching the trainer go through their daily processes, tasks, could also be time that they're observing other staff in the clinic but there's no hands-on work with patients or clients. And then we go to direct supervision, indirect supervision, and independent practice. There may be times when the trainee is in multiple phases based on the job tasks. For example, a trainee may be able to clean and troubleshoot hearing aids under indirect supervision while still in the observation phase for real ear measurements. Again, it's important to introduce concepts at the right time and when the trainee is ready. Training does not end with the license or registration. When you reach that stage where they're in the phase of independent practice, it's important that that trainee still has support because trainees don't go from minimally qualified to highly qualified overnight. You know, there's a day between them taking their exam and passing their exam. So there's still support that the trainee needs. So it's important to include that independent practice that the training needs. So it's important to include that independent practice phase in the training plan so that the newly licensed trainee maintains a good support system. This might look like having a meeting every other week or once a month to review patient files. It might be spending a week in the same clinic once a month for the next six months, or it might be scheduling a time to video chat at the start and end of each week. It's really up to the trainee and trainer to decide what will work best for their training plan. So here I've pulled Florida's laws for training to show an example of implementing phases. Trainers in Florida already have the training phases outlined for them. You can see stages one through four and their corresponding timeline in months. This is a very structured approach. Not all states have this kind of structure to their training requirements, but be sure to review your jurisdictional requirements for to find out what the specific requirements are. And each training plan must be evaluated for effectiveness. Changes to the plan can be made at any time to add clarity or provide additional time for comprehension. Each trainer should evaluate their own training abilities using, you know, this phase. It's important to build in ways that you're going to be evaluating yourself. You know, this should, any kind of evaluation, especially for the trainer and the trainee should be done in real time and after the training is complete. So looking at it, you know, day to day and looking at it holistically. Self-evaluations might look like getting feedback from trainees, might be getting feedback from other providers or staff in the clinic or present during clinical activities. It might be reviewing recordings of learning activities completed without patients present. You know, maybe you just record one of your training activities and watch that on your own to see if the way you're explaining things is clear, just kind of to get a view of what your trainee is experiencing. Sometimes we say things and they really make sense to us. And then if we hear them back ourselves, we might realize that something sounds a little bit wonky. In another way of, you know, evaluating yourself is also by looking at the trainee's ability to pass their licensing exams. It's a pretty, you know, big thing and, you know, everybody wants their trainee to pass their exams. So that's a pretty easy way to evaluate your training abilities. And trainers must be able to evaluate trainees in real time and at regular intervals. Evaluations for trainees by trainers should be happening frequently so that trainees are getting structured feedback and frequently enough that they can solve, you know, maybe bad habits that they're forming or things like that. Evaluating the trainee can be both formal and informal. A formal evaluation might be utilizing rubrics to critically analyze clinical skills. Informal feedback might include providing insights from observing a hearing assessment performed by the trainee. So, you know, hey, I sat in on your test with Mr. So-and-so. You know, here are some things that I saw during the appointment that worked well. Here is something I'm a little concerned on. And then, you know, a way of making that process less stressful or painful is what I call the sandwich method of providing feedback. When you have to give critical feedback, you can preface it and follow it up with some positive things so that the trainee is getting positive reinforcement for the things that they've done well. Sometimes this method of feedback can make the critical feedback seem less important. So, it's important to know when certain feedback is, you know, needs to be handled differently. But for day-to-day things and small, you know, missteps, this can be a good way to help build trust between the trainee and the trainer early on in the training process and also build the trainee's confidence in their own abilities. If we're only giving them critical feedback, they're going to have a very critical view of themselves and their clinical abilities. So, it's important that whether you're using that sandwich method or not that you're giving them plenty of positive feedback and positive reinforcement for the things that they're doing well. Now, we're going to look at a few tools available to trainers through IHS and also give a couple of recommendations just from me. And we'll be providing topic-specific tools and resources in subsequent webinars in this series. So, not going to go into a lot of detail for tools, but we're going to do a little bit of an overview and some quick tips just to get you started. So, tools available from IHS include the trainer manual, which we've looked at in a few different perspectives. The trainer manual has all of those objectives listed out that you can use for goals. There's clinical activities, like recommended activities or skills that you can be working on with the trainee that line up with implementing clinical activities to support goals. It's just, it's a very well laid out manual and very, very detailed. Lines up exactly with the distance learning course workbook and textbook. So you don't have to worry about trying to align things with what your trainee is looking at. Also, IHS has available a resource called ILE Test Prep. It's a website with practice tests using questions previously used on the ILE. It's an excellent tool for building test taking skills. Obviously, trainees are not going to see the same questions on the ILE Test Prep website that they'll see on the ILE, but it can give them a really good look at the way the questions are structured. And it will give them a little bit of insight on what domains or sections they might need to do some additional studying in. And just a little bit of information about the ILE Test Prep. In the last three years, about half of all ILE test takers have also used the ILE Test Prep service. So about 50% of all of the ILE test takers have used the ILE Test Prep. And for those of you who have used ILE Test Prep in the past, the ILE Test Prep website is moving to the new learning management system. And that should result in making it easier for you to assign practice tests and the ability to look at the trainees' results from their practice tests and, you know, more specifics about each practice test. So that's exciting. This is more of an update than a tool or a resource, but IHS has launched a new version of the practical exam. That new version includes relay measurement, hearing aid troubleshooting, and masking. So if your jurisdiction is one that uses the IHS practical exam, you might just check the IHS website and learn a little bit about, you know, what's changed and what the trainee will be assessed on during that exam. Another, you know, more of an update, but the distance learning course will be moving to the new learning management system around May 1st, 2024. And the new learning management system will make it easier for trainers using the trainer manual to view the trainee's progress through the distance learning course. So exciting tools there. And starting January 1st of 2024, the ILE is now mapped to the new competency model. That job task analysis survey we talked about earlier in the competency model that it's built on, the ILE is now mapped completely to the new competency model. And also starting January 1st, 2024, all ILE questions are now referenced to the distance learning textbook and workbook. This means that everything covered on the ILE can be found somewhere in the distance learning course materials. So here's a look at the trainer manual and additional resources available to trainers in the learning management system. Some of those resources include recommended clinical activities, training resources, answer keys, et cetera. Access to this site comes with your purchase of the trainer manual. One additional tool or really a strategy that I would like to share with you that you could implement tomorrow with your trainee is to schedule time for communication. Probably, you know, might be tired of hearing me say that, but communication is so, so important. And when there isn't a time scheduled to review files, sign paperwork, and answer trainee questions, those things can start falling through the cracks. We all know how busy a schedule can get. And if there isn't a set time for communication, it's bound to fall by the wayside. By starting the day with a huddle to review the schedule, identify responsibilities, and assign tasks, the trainer can set clear expectations. If there are any other employees in the clinical environment, it can be helpful to include them as well. Blocking time after each appointment or at the end of the day leaves time for the trainer to review and sign all documentation and paperwork. Whether the jurisdictional rules require this or not, it is best practice to do so. This is also the perfect time to provide feedback, positive or critical. Without the pressure of being in front of patients or clients, the trainee can focus on hearing that feedback provided to them. This is another example of managing that mental load. Communicating early on in the training process about what's acceptable and unacceptable in the presence of patients or clients or workplace colleagues is very important with regard to feedback specifically. So when you're having those initial conversations about preferred communication styles, things like that, it's important to talk to them about if they prefer to be corrected, you know, or provided feedback straight away or if they would prefer to receive feedback one-on-one without other people around. Not that you can always, you know, communicate all those, you know, requests or preferences, but it does kind of help, again, build that trust and rapport with your trainee. So really, really good strategy for building strong communication and also clarity, making sure that all of these requirements are met as far as documentation is to build time into the schedule for communication. And I'd also like to share some, again, things that you can do, you know, implement tomorrow with your trainee and ideas for how to make the training process work for you. And a lot of practices already, you know, do this, but in the early stages of the training process, train trainees on workflow, just clinic general workflow. Think about what the trainee can do to help speed up clinical activities, things like cleaning after an appointment and then preparing a room for the next appointment, getting hearing aids, you know, charged, laid out, making sure that things are cleaned and disinfected properly, stuff like that. Cross-train the trainee with front office staff. This not only gives the trainee insight to that front office position, it also gives a support system for the clinic holistically if someone is out of the office. Teach the trainee how to provide technical support. So are there things the trainee can do to help the clinic run more smoothly? Maybe ensuring equipment is in working order, updating software, assisting patients with cell phone connectivity and other assistive devices, or performing listening checks and cleaning hearing aids. These are all fairly simple tasks that can quickly eat up valuable clinical time. And think about patient counseling. Are there parts of patient counseling that you could have the trainee handle? Could they instruct patients on cleaning and caring for the devices? Can they help with discussing communication strategies or maybe providing additional resources to the patients? By training the trainees on these tasks that they can do independently early on in the training plan, you increase clinical efficiency and give the trainee a sense of ownership or buy-in to the clinic as a whole. And it gives you more time to focus on seeing patients and then also hopefully providing one-on-one training and support for that trainee. So just some ideas to consider, especially when you're in a clinic that is very busy and you find that you don't have a ton of extra time to spend with the trainee. And, you know, let's be real. We all know how busy the clinical environment can be. We also know we want to provide an excellent training experience, but sometimes there can be bumps in the road. Busy schedules result in not having enough time to spend with the trainee. When you add your sales goals, KPIs, and meeting employer expectations, training can easily take a backseat. You can combat this by being transparent about the factors impacting your available time with the trainee. Sharing, you know, those stressors or just, you know, additional facets of your position as the trainer and as a hearing health care provider can help build trust between the trainer and the trainee. And it gives the trainees a real-world look at the requirements of the job, you know, beyond just their training and learning all of this new content and these new skills. It can be hard to get trainees excited about certain topics. We talked about that a little bit. And it can be tough training on topics you're not excited about. Not every trainer likes, you know, training on every topic. So give yourself grace if something doesn't go as well as you'd imagined it. If you, you know, start into a topic and realize that how you're explaining it is, you know, complicated and not really helping, just take a break from it and come back to it the next day or at a later time and tell the trainee, you know, I think that might have been a little confusing. Let's re-approach this topic and see if we can, you know, learn this in an easier-to-understand way. Things like that, just being, you know, very clear and open when things don't go exactly as you had planned them. If something like that does happen, where a trainee is struggling to get interested or excited about a topic, you can help the trainee connect the new topic to a previous topic to support the learning process. So if they're really struggling, take a step back and think what other parts of this training plan or of this, you know, position does this specific topic that is being, that's, you know, maybe boring or hard for the trainee to understand, what else is that connected to, that I can help the trainee build those connections so that it's easier for them to learn and commit that information to their long-term memory. It's also important to be an advocate for yourself and your trainee. If your role as a trainer is not clearly defined with your employer, start that conversation. Training is critical to growing a business and should be done with intention. You know, having those expectations about the additional time it takes to train someone, the additional requirements, if there are additional requirements for your jurisdiction, all of those things, you know, play into that discussion with the employer. Indeed.com reported in 2017 that most, that the cost of onboarding and training someone is on average equal to a third of their yearly salary. So we know turnover is expensive. It can be frustrating for everyone, for the employer, for the trainer who's invested time, you know, everyone involved. If there are things that you need as a trainer, like learning materials, equipment, or just time in the schedule for hands-on activities, talk with your employer about it. They might not know that you need those things. Again, open communication is, you know, key. And if there are topics you're not familiar with or comfortable with, ask for more training. Ask your employer or, you know, as part of this series, we're going to be going into some common what to do when you don't know what to do scenarios. And you can also request training from manufacturers, sales reps. You can check the IHS website for other webinars on a variety of topics. Or search online. There's bound to be information out there that can help build your confidence or help get you familiar with topics in the training plan that maybe you don't feel very confident or comfortable with. I know IHS is happy to help connect you with people to get your questions answered. And I'm always happy to answer questions and connect you to resources as well. And finally, at some point in the training process or at many points, there will be communication challenges that just happens when you have two or more people communicating with each other. Remember that we are only human. And if communication challenges are happening frequently, consider scheduling a time to meet with a trainee to discuss strategies for better communication. This is, again, where that morning huddle and end-of-day debrief might come into play. Might be a good tool to use to help facilitate that communication. And here is my contact information if you have any questions or just want to connect on LinkedIn. Thank you so much for joining us for this webinar and for helping to train future professionals in our profession. IHS contact information is also listed if you have questions, comments, or suggestions. Thank you again, and happy training.

webinar

trainer requirements

adult learning theory

training plan components

tools and strategies

communication

expectations and goals

feedback

IHS resources

cross-training

realistic expectations

advocacy

evaluation