ABSTRACT
Introduction: People with cystic fibrosis (PwCF) regularly receive antibiotics for treatment of lung infections, which can include intravenous aminoglycosides (IVAG) resulting in potential ototoxicity. Sound booth audiometry is costly, time-consuming, and requires further outpatient visits and audiologists. A quality improvement project delivered by specialist pharmacists to implement a tablet audiometry ototoxicity monitoring programme was launched in PwCF receiving IVAG therapy. Objectives: To implement a tablet ototoxicity screening programme in adults with CF. Methods: PwCF receiving IVAG completed tablet-based audiometry (0.25– 16 kHz) (Shoebox MD) alongside validated ototoxicity questionnaires at the beginning and end of treatment. Following a clinical pathway, clinicians undertook shared decision-making processes regarding continuation of AG if abnormality was detected, alongside referral for sound-booth audiometry. Results: Data were collected from April–Dec 2021. Thirty-eight patients (median [IQR] age 28.5 ([15.5] years;mean [SD] ppFEV1 62.3 [26.5]) were screenedwhowere on IVAG. Fifteen patients (39%)were referred for formal audiometry due to abnormal baseline results, of which 5 had symptoms of hearing loss identified through questionnaires. 3% (1/38) stopped AG therapy due to identified potential ototoxic risk. Twenty-two patients received screening at beginning and end of IVAG therapy: significant ototoxic effects were seen in 2 of these patients (9%);20 patients (91%) had no significant change from baseline audiometry. Conclusions: We present pilot results to show feasibility of tablet-based ototoxicity screening. More IV courses were completed at home than anticipated (due to Covid19) limiting end of IV testing. Further 3-month testing is planned to detect potential delayed ototoxic change. Nevertheless, our results show tablet audiometry to be an effective and practical screening tool used by non-audiologists for accurate, early identification of hearing loss and ototoxicity.
ABSTRACT
This spring, students across the globe transitioned from in-person classes to remote learning as a result of the COVID-19 pandemic. This unprecedented change to undergraduate education saw institutions adopting multiple online teaching modalities and instructional platforms. We sought to understand students’ experiences with and perspectives on those methods of remote instruction in order to inform pedagogical decisions during the current pandemic and in future development of online courses and virtual learning experiences. Our survey gathered quantitative and qualitative data regarding students’ experiences with synchronous and asynchronous methods of remote learning and specific pedagogical techniques associated with each. A total of 4,789 undergraduate participants representing institutions across 95 countries were recruited via Instagram. We find that most students prefer synchronous online classes, and students whose primary mode of remote instruction has been synchronous report being more engaged and motivated. Our qualitative data show that students miss the social aspects of learning on campus, and it is possible that synchronous learning helps to mitigate some feelings of isolation. Students whose synchronous classes include active-learning techniques (which are inherently more social) report significantly higher levels of engagement, motivation, enjoyment, and satisfaction with instruction. Respondents’ recommendations for changes emphasize increased engagement, interaction, and student participation. We conclude that active-learning methods, which are known to increase motivation, engagement, and learning in traditional classrooms, also have a positive impact in the remote-learning environment. Integrating these elements into online courses will improve the student experience. © Copyright © 2021 Nguyen, Netto, Wilkins, Bröker, Vargas, Sealfon, Puthipiroj, Li, Bowler, Hinson, Pujar and Stein.