Innovative Approach to Pediatric Rehabilitation Education Equips Brazil’s Hearing Professionals for Far-Reaching Change

What good are newborn screening tests if there is no one to rehabilitate the children? That’s the question that prompted Ida Advisory Board Member Deborah Viviane Ferrari to join fellow professionals in creating an innovative online course in auditory rehabilitation to train clinicians throughout Brazil.

Despite a 2010 law requiring hearing screenings for all newborns through Brazil’s socialized healthcare system, many audiologists were not prepared to take on the increased numbers of pediatric patients. To answer that need, Deborah and colleagues Professor Orozimbo Alves Costa and Maria Cecilia Bevilacqua (in memoriam) of the Speech Language and Audiology Department, School of Dentistry of Bauru at the University of Sao Paulo developed, in partnership with the Hospital Samaritano - São Paulo, “Auditory Rehabilitation in Hearing Impaired Children: Emphasis from Birth to 3 Years Old.” 

With financial support from the PROADI-SUS of the Ministry of Health, the online course debuted in August 2013 to an initial study body of 105 students, made up of audiologists and ENT physicians.

The course runs 18 months to meet the 400 hours of training required for a specialization course. This allows students, many of whom work full time, to complete the course in a more relaxed timeframe. The online access also makes it possible for students in remote locations to participate and enjoy the same quality education as their peers who are more centrally located. Approximately 70% of the students were from the north and northeast of Brazil, regions with fewer educational institutions.

Students work in small groups and are assigned mentors who check who is online, for how long, which activities they choose and any postings they make. There are also professors in charge of content and assistants that help with student interactions and problems with content.  “Any student who hasn’t logged into the system, which is based on the Moodle platform, in six days is contacted,” explains Deborah. “We ask what’s going on, what’s happening, what can we do to help?”

The positive point is the freedom to do the activities at any time, including at night and on weekends. There were difficult weeks because of business trips or periods of greater workload. But despite the stress of meeting course deadlines, I could balance work and stu — Sandro Coelho, ENT and course participant

The comprehensive course covers topics in diagnosis, family-centered care, hearing aid fittings, cochlear implants, FM system fitting and techniques for auditory rehabilitation.  An advantage of the online platform is the opportunity to include a variety of materials from PDFs to video.  

Ida ethnographic videos are used to generate discussion and reinforce course content. Although the course focuses on children from birth to three years, students who see older children have explored the use of the My World tool.

Students are not required to watch the video classes that they do not find useful, but an average of 700 accesses a day suggests that they are watching. There is also a library area where students can access articles and other materials uploaded for them, as well as share materials they find interesting.

The coursework also includes strategies presented in the Change Guide to teach students how to create change in their services, and how to feel empowered to make those changes.

I tried to implement the techniques for assessing hearing in children – for instance: visual reinforcement audiometry – in the routine of my hearing healthcare service. I have changed some of my attitudes, especially in relation to sheltering families of hearing impaired children during the diagnostic process. — Cibele Vieira de Lima Candia, audiologist and course participant