To recognize this significant year, 1946, in the history of audiology, we are featuring an interview with Anna McCraney, AuD, ABAC, with Certification #1946.
What is your background in audiology?
I attended the University of Wyoming (UW) with the intention, not of becoming an audiologist, but of becoming a veterinarian. I remember sitting in a class that was so boring I couldn’t even say now what it was beyond simply a science class, and there was a deaf student in my class. I was fascinated with the graceful and efficient signs of American Sign Language (ASL).
My only previous exposure to ASL was as a 10-year-old girl scout where we learned to sign the alphabet. As the semester wore on, I managed to pick up a little sign-language. The next semester, I enrolled in an ASL class to satisfy the university’s language requirement. I ended up taking all the ASL classes UW offered. Somewhere along the way, I switched my major to Speech and Hearing Science and graduated with honors from the University of Wyoming in 1994.
When I sought graduate school guidance from my academic advisor, himself an audiologist with a master’s degree, he discouraged me from pursuing an AuD, he said it would never catch on. In the early 90s, the AuD movement was only beginning to gain traction. Like many of his colleagues, I believe he saw the AuD movement as a threat. It was unclear at the time what the implications would be for practicing master’s level audiologists if a doctorate became the entry-level degree.
At the time, Baylor College of Medicine (BCM) in Houston offered the only AuD program, and it was under the direction of Dr. James Jerger. Only a handful of students would be offered a spot each year. Learning under Dr. Jerger was everything one would expect it to be: challenging and rewarding. He implored us to think critically. Rather than teaching us only how to test, he taught us to ask what a particular test might teach us about a patient’s auditory system. He didn’t want our reason for doing a test simply to be because that’s what we were taught to do. He wanted us to know why we were doing a test.
After graduating from BCM in 1999, I worked at Texas Children’s Hospital for several years. Then in 2008, I joined Ototronix, home of the MAXUM Middle Ear Implant System, where I work as the director of audiology. In my role, I’ve been a clinical trainer during audiologist and surgeon trainings, co-authored papers, presented research and worked with patients on three continents. I even got to collaborate with the late Dr. Michael Glasscock, one of the world’s foremost neurotologists, on the opening of the Glasscock Hearing Center where I provided all the audiology services for patients in this MAXUM clinic.
What was your motivation for becoming ABA Certified?
It is required by law that a practicing audiologist maintain state licensure in my state. When licensure is granted, it means that the audiologist has met designated educational and experiential requirements set forth by the licensing body.
By contrast, board certification is voluntary with more stringent continuing education requirements for recertification. My intent in seeking board certification was to demonstrate publicly my willingness to do more than is required to ensure that I am following our current understanding of best practices.
If you could give a piece of advice to your younger self, audiology-wise, what would it be?
When I was a student at BCM we staffed cases together weekly, and I remember one of us asking Dr. Jerger why we ran patients through so much more testing than other clinics did. He said, “If you don’t ask the questions, you won’t get the answers.” It was because we did tests no one else did that we found information no one else found.
From this, my best advice to any audiologist, regardless of experience level, is to commit to regular and intellectually honest self-appraisals of one’s practice of audiology. It’s so easy to slip into complacency in the name of efficiency. To keep up with clinic demands, we tend to settle into a routine of doing the same tests in the same order following the same procedures someone once taught us with little time to think about whether they’re the bests tests or if we’re asking the right questions.
I’ve been guilty of this myself. For example, I used to test unaided word recognition at most comfortable level (MCL). My goal was to approximate PB max, or a patient’s best possible word recognition score, in one list. I reasoned that speech would likely be clearest where it is most comfortable. In graduate school, we did full performance-intensity functions, but somewhere along my career path, I learned to abbreviate the protocol. I didn’t test at SRT+40 like so many because I didn’t see any value in routinely testing SRT, and because the SRT+40 method is often too loud for severe losses and too soft for sloping losses. It wasn’t until I took the time to reacquaint myself with the research that I switched to testing using the UCL-5 approach.
I think perhaps the most prevalent example of audiologists not taking the time to critically evaluate their practices is the fact that it’s commonplace for us to use monitored live voice in lieu of recorded materials despite that fact that research has shown that doing so renders the word recognition score uninterpretable due to excessive variability. The question we’re not asking in this case is why are we testing word recognition? It doesn’t seem to be to understand the impact of a patient’s hearing loss on his speech understanding.
What is your favorite thing to do?
I’d have to say my favorite thing to do in my role as an audiologist is to help patients understand the nature of their hearing loss and why it affects them in the ways that it does. It’s not unusual for patients to leave my office saying they finally feel like they understand their loss. That’s when I know I’ve done my job. I feel like the best patients are the best-informed patients. I find that they’re most compliant with my treatment recommendations when they understand why I’ve advised them to do (or not do) certain things.
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