A Student’s Perspective on Vestibular Practice in Audiology
Striking the Right Balance
Michael Vekasi, AuD, R.Aud, Aud(C), FAAA and Erica Zaia are coordinating the “Striking the Right Balance,” column which will cover the latest information on “all things vestibular.”
The profession of audiology is changing. Vestibular practices are growing and expanding and students are now applying to audiology in the hopes of specializing in vestibular testing.
In this edition of “Striking the Right Balance,” Curt Wetmore, a third-year audiology student from Dalhousie University, will speak about his decision to become an audiologist, his interest in vestibular testing, and his volunteer experience with the CAA Vestibular Special Interest Group. He is part of the growing number of students who see the great potential in having a rewarding career helping patients with vestibular problems. With more students interested in this specialty, audiologists and clinical coordinators will need to do their part by providing extensive hands-on supervision opportunities to enhance student training.
If you would like to be more involved in all things vestibular, please sign up for the Vestibular Special Interest Group. Joining will give you access to our Facebook page, access to a master contact list of other vestibular specialists across the country, and to a Drop Box of shared vestibular educational resources. Sign up by simply emailing maxine.armstrong@uhn.ca or janine.verge@cdha.nshealth.ca to let us know you want to be a part.
Hi. I’m Curt. I’m a third-year audiology student at Dalhousie University. I have a particular interest in balance disorders and I think you should too.
I graduated in 2010 from St. Francis Xavier University with a Bachelor of Science in human kinetics. My interests during my undergrad spanned from medicine, to gender in sport, to physiotherapy. After I graduated, I started working as a kinesiologist at a private physiotherapy clinic. During my year of work there, I discovered a branch of physiotherapy called vestibular rehabilitation. Though this type of rehabilitation sparked my interest, my curiosity quickly shifted to the testing and diagnostic end of these vestibular injuries. As fate would have it, at this same time in my life, friends of mine took ownership of Ritcey Hearing, a private practice in my hometown of Woodstock New Brunswick. This gave me more insight into the field of audiology and also gave me an opportunity to observe diagnostic techniques, hearing aid fitting, and the business aspects of a private practice. All signs seemed to be pointing towards audiology so I decided to go for it. I began studying at Dalhousie University in 2012 and I have now just entered my third and final year.
This past summer I completed my first twelve week internship at the Nova Scotia Hearing and Speech Centers at the Dickson Building site in Halifax, Nova Scotia. I was under the shared supervision of Duncan Floyd and Janine Verge. My placement was split between regular diagnostic audiology and vestibular audiology where my clinical responsibilities included audiological assessments, ABR, rotary chair, posturography, cervical and ocular VEMPs, and ENG/VNG. Throughout the course of the summer, I became comfortable with obtaining case histories, counseling, analyzing test data, and making appropriate recommendations and referrals based on the results. I also quickly learned that the vestibular population that I was working with was very different from the other patients I was seeing. The case histories were very complex and the vestibular testing took much longer than a hearing assessment. There were times when I spent 3–5 hours with one patient. This allowed for a stronger rapport to be built and more intensive counseling which I found to be an extremely rewarding experience.
Vestibular audiology is an incredibly interesting field with so much possibility for students and new graduates. It is a branch of audiology that is rapidly expanding. VEDA (www.vestibular.org) reports that 80% of people aged 65 years and older have experienced dizziness, and BPPV, the most common vestibular disorder, is the cause of approximately 50% of dizziness in older people. With the population of seniors expected to grow over the next 30 years, audiologists who specialize in vestibular testing will be in great demand. According to the Canadian Academy of Audiology, assessment and treatment of balance disorders is an important aspect in the scope of practice of audiologists. Yet, I don’t feel as though vestibular audiology gets the attention it deserves (and needs). Since the type of vestibular tests and the rehabilitation practices have increased in recent years, audiology programs across Canada should consider expanding their curriculums by adding full classes (yes, plural) on vestibular anatomy, vestibular testing, and vestibular rehabilitation. In my program I was lucky to get some hands on experience performing vestibular testing but not all programs offer this experience to their students. It is within our scope of practice to see this patient population but how can we be expected to if students are not given the appropriate level of education and experience. What does this mean for vestibular patients if we do not enhance our training?
I am currently the CAA representative for Dalhousie University and a volunteer for the CAA National Vestibular Special Interest Group. The goals of the special interest group are to support audiologists and supportive personnel who specialize in vestibular testing and rehabilitation, to enhance communication between members, and to advocate on behalf of members to special interest groups. The group has a Facebook page that has recently been created (https://www.facebook.com/pages/CAA-National-Vestibular-Special-Interest-Group/786957408022254) and I am helping to create a shared information bank for all members using Drop Box. Hopefully this will spark a national interest and lead to a greater understanding of the importance of vestibular testing. The group is also trying to create a national contact list of members detailing the vestibular tests and equipment they have. I think this is important because it will allow students like me who are interested in a vestibular placement the ability to better scope out externship possibilities across Canada. For more information on the National Vestibular Interest Group or to join the movement, email Janine Verge at vergej@cdha.nshealth.ca.
To my fellow students: consider getting more involved with vestibular audiology – it is part of our scope of practice, after all, and the field needs you! Not only is it an interesting and rewarding path, but by joining the national special interest group you will have the opportunity to have a say in the future of audiology in Canada. Additionally, get involved with organizations like the Canadian Academy of Audiology. This will be a great opportunity to get your name out there, further your learning, and build up your CV. Seize the opportunity to make connections, get your foot in the door, network, and build relationships with your colleagues and future employers. You are your greatest investment, so make it a worthwhile one!
If you have any questions about my interest in vestibular audiology – or yours for that matter – please don’t hesitate to contact me at fwcurt@gmail.com. I love what I do, I love talking about what I do, and I apologize in advance if I chat your ear off. Pun intended.