David Downs

Infusing an inter‐professional and inter‐university perspective into healthcare education

A national (USA) student‐led, case‐based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition focuses students in medical and related healthcare programs on the provision of healthcare that is safe, timely, equitable, patient‐centred, effective and efficient. Students work in four‐person, inter‐professional teams to research and analyse a designated case. They then present their findings and recommendations to a panel of independent judges. Students, with support from their faculty advisors, approach the case as they see fit. Following initial participation in this CLARION competition, an inter‐professional team of students from two universities and their advisory faculty developed a two‐semester, pre‐competition course as a model to facilitate transformation in healthcare education. The course is theoretical, empirical and practical. It has multiple levels of learning and is designed to mentor students, develop faculty, measure learning outcomes and stimulate administrators in higher education to think creatively about curriculum development across disciplines. This integrated and inter‐professional approach is pivotal in healthcare education to ensure students learn safe and evidence‐based clinical practice that meets the highest standards for quality care.

Visual and Cognitive Predictors of Visual Enhancement in Noisy Listening Conditions

Researchers have demonstrated that visual and auditory cues interact, improving speech intelligibility under noisy listening conditions. For instance, recent findings demonstrated that simulated cataracts hinder the ability of listeners to utilize visual cues to understand (i.e., speechread) televised speech sentences. The purpose of this study was to determine which measures of visual, auditory, and cognitive performance predicted participants’ ability to speechread televised spoken messages in the presence of background babble. Specifically, 30 young adults with normal visual acuity and hearing sensitivity completed a battery of visual, auditory, and cognitive assessments. Speech intelligibility was tested under two conditions: auditory-only with no visual input and auditory-visual with normal viewing. Speech intelligibility scores were used to calculate average visual enhancement, or the average benefit participants gained from viewing visual information in addition to auditory information. Regression analyses demonstrated that the best predictors of visual enhancement were measures of contrast sensitivity and executive functioning, including the Digit Symbol Substitution Test and Trail Making Test, part B. These results suggest that audiovisual speech integration is dependent on both low-level sensory information and high-level cognitive processes, particularly those associated with executive functioning.

Prevalence of Communication Disorders in HIV-Infected Adults

Few adult patients with HIV/AIDS are evaluated for communication disorders. A broad inventory of the communication disorders was obtained in a convenience sample of 82 adult HIV/AIDS patients who presented for medical appointments. Each participant underwent a head and neck exam and a communications skills evaluation. Speech, language, and cognition were assessed using a 10-item test battery. A 14-item hearing test battery was conducted in a separate session. The primary outcomes were the presence and degree of communication disorders. Head and neck exams revealed 40% with ear-related issues. Only 2 participants showed normal findings on all 24 communication skills assessments. Four demonstrated normal findings on all speech-language-cognitive assessments, whereas 8 had normal findings on the complete hearing test battery. A relatively high prevalence of cognitive and language deficits and central auditory disturbances were found. Clinicians must recognize the potential for communication deficits even in a relatively healthy patient with HIV.