Smartphone hearing screening with integrated quality control and data management.

OBJECTIVE: To determine if a smartphone application could be used as a calibrated screening audiometer with real-time noise monitoring for school screening using automated test sequences. DESIGN: The investigation comprised three studies. Study 1 evaluated calibration accuracy across four Samsung S5301 smartphones (Android v4.0.4) using commercial Sennheiser HD202 headphones. Study 2 involved referencing smartphone microphone sensitivity to narrowband noise intensity as measured in octave bands by a sound-level meter between 30 and 75 dB SPL (5 dB increments). Study 3 compared screening outcomes of smartphone based and conventional hearing screening. STUDY SAMPLE: Study 2: 15 normal-hearing subjects (age range, 18-22 years; all female). Study 3: 162 children (324 ears) aged 5 to 7 years. RESULTS: Smartphone calibration at 20, 30, and 40 dB was within 1 dB of recommended reference equivalent thresholds levels. Microphone calibration for noise monitoring had maximum variability across phones of 0.9, 0.6, and 2.9 dB at 1, 2, and 4 kHz, respectively, from reference intensities (30 to 75 dB SPL). Screening outcomes demonstrated no significant difference between smartphone and conventional audiometry with an overall referral rate of 4.3% and 3.7%, respectively. CONCLUSIONS: The newly developed smartphone application can be accurately calibrated for audiometry with valid real-time noise monitoring, and clinical results are comparable to conventional screening.

Through the eyes of another: improving the skills of forensic providers using a consumer-informed role-play procedure.

OBJECTIVE: We describe an intervention aimed at improving the quality of care delivered by forensic clinicians and at exposing them to the principles of client-centered care. METHOD: Thirty-five forensic clinicians belonging to various professional disciplines participated in a day-long, multi-modal training developed with the help of former residents of a maximum-security forensic hospital. The main components of the training included a 1.5-hour simulation during which participants role-played being hospital residents, a video on discrimination, and a panel discussion with several of the former hospital residents. RESULTS: Participants rated the training as very relevant to their work, very worthy of being recommended to their peers, and as a profoundly positive and enriching experience. The benefits derived from the training included greater connectedness among the staff and better understanding of the patients' experiences. CONCLUSION: Factors that appear to have contributed to the success of the training sessions include administrative support, use of a multi-modal approach, and use of small groups.