Boston University doctor of science degree program: Clinical doctorate in audiology

Boston University doctor of science degree program: Clinical doctorate in audiology

Kidd, Gerald D Jr

This article describes the development of the Boston University Clinical Doctoral Program in Audiology dating from its inception in 1985 to the present. The issues surrounding the establishment of the clinical doctorate, entering the program, and the curriculum are discussed. The unique features of this program and associated resources available within the clinical and scientific community of the greater Boston area are highlighted.

Key Words: clinical doctorate, Doctor of Science, AuD

In 1985, Boston University opened what was, to our knowledge, the first clinical doctoral program in audiology in the United States (see also Bankson, 1993; Cox, Bankson, Kidd, & Burkard, 1992a, 1992b). In 1994, it also was the first doctoral-only program to be granted accreditation by the American Speech-Language-Hearing Association Council on Academic Accreditation. The factors motivating the development of this program were not so different from those that are now often advanced in support of the AuD degree. In particular, it was felt that the requisite knowledge base underlying the practice of the profession of audiology had expanded significantly and that mastery of that body of knowledge exceeded what could reasonably be expected during a 1- or 2-year master’s degree program. Not only had the breadth of the profession grown, but so too had the depth and complexity of the understanding of the sense of hearing and the sophistication of the tools used to examine it. In response to this perceived need for advanced education in audiology, a new doctoral program was developed that allowed students to choose between a traditional, research-oriented track and a clinically oriented track.

Part of the reason for offering two tracks was to accommodate the needs of students who wished to obtain knowledge and experience beyond that provided in a master’s degree program but who intended to pursue careers in clinical audiology. In the absence of a professional doctoral program, many such students only had the option of a traditional, research-oriented PhD degree, which often proved an uncomfortable and unsatisfactory match for both the students-who in reality wanted advanced clinical training-and the PhD programs, which by definition evaluated students on the basis of the research competence they demonstrated. The outcome, in our view, was often a compromise in which the research product (the dissertation) was sometimes scientifically less rigorous than desired and the student, albeit gaining a professional credential, may have left with knowledge that did not really further his or her career objectives. When we first opened the clinical doctorate program, we explicitly sought to provide a remedy for this situation by providing the clinical-track students with different experiences than their research-track counterparts and by holding them to a different set of standards of performance. In particular, progress through the clinical track involved demonstrating a series of clinical competencies with specific performance objectives that were formally measured and documented before advancement to the next level was allowed (for a complete description of the evaluation of clinical competencies, see Cox et al., 1992a, 1992b). Correspondingly, in the research track, demonstration of the ability to conduct research was required through the presentation to the faculty of a research project that had to be completed and approved before preliminary examinations could be taken and before a dissertation could be begun.

In 1985 there was no doctoral degree tag other than the PhD (or in the case of Boston University and a few others, the Doctor of Science or ScD) for audiology programs. An early decision was whether the clinical-track students would receive a degree with a different tag than the research-track students. Although we pursued the possibility of a different degree tag with the Boston University administration, ultimately we decided against it for two reasons. First, and most important, we were concerned that a new, separately tagged degree would not be recognized outside-or even inside-of the field, which could have adversely affected the ability of our graduates to find jobs (the former remains a concern with the AuD tag). Second, the prevailing attitude at the time for the majority of the field was that the PhD degree tag was sufficiently robust to encompass a clinical doctoral program.

The principles guiding the development of the new program were based on the premise that contemporary audiologists are not technicians learning only how to implement procedures or observe patient responses. Instead, it was our belief that gaining competence to assess the hearing of an individual, and the physical status of the ear and auditory pathways of the nervous system, required an understanding much deeper than simply learning how to implement techniques. We felt that the study of audiology means, literally, understanding the science of hearing (indeed, the word itself is a combination of the Latin word audire, to hear, and the Greek logia, meaning in this context the science, doctrine, or theory of; Webster’s Unabridged Dictionary, 1977). Clinical audiology involves studying hearing as part of the communication system of an individual, whereas psychoacoustics and auditory physiology involve studying the sense of hearing as a general process with the intent of learning about the underlying mechanisms involved.

In designing our curriculum, we took the position that substantial coursework in hearing science was as essential a component in the education of audiologists as was coursework in diagnosis and rehabilitation. Further, the intent was that the clinical doctoral degree should be the equal of a more traditional research-oriented doctoral degree, but should have a different emphasis. Thus, much of the coursework was the same for the two tracks. However, research-track students emphasize laboratory-based activities that would lead to a dissertation intended to make a significant original contribution to the research literature. Clinical-track students emphasize advanced clinical activities intended to prepare them to become master clinicians, and they engage in applied research experiences intended to provide them with a clinical area of specialization. However, all students, regardless of which track, were expected to be informed and active consumers of both the research and clinical literature, and journal review seminars were mandatory. Most recently, these seminars were held in conjunction with the lecture series sponsored by the Boston University Hearing Research Center (HRC; more information about the HRC and a list of speakers may be found at www.bu.edu/hrc). The HRC is a wonderful resource for our program, as it is a multidisciplinary group of researchers including both faculty and postdoctoral, graduate, and undergraduate students involved in nearly every aspect of the exploration of the auditory system and process of hearing.

In addition to the exposure to scientific research in the various laboratories of the HRC and the seminar series, audiology students benefit from interactions with students in disciplines such as biomedical engineering and cognitive and neural systems who share their interest in the auditory system. It is an excellent model for collaborative interactions and brings together many subspecialties in the fields of acoustics, psychology, medicine, psychology, and engineering.

Educational Opportunities and Unique Features of Boston University

The Boston area is well known for its extensive medical facilities and health care research. Though student training is improved with access to excellent hospitals and related medical professionals, an atmosphere of innovation and education is also an important asset of this region. Here, the audiology profession can derive significant benefits from partnering with those engaged in technological development through the encouragement of joint entrepreneurial business practices and by taking advantage of an excellent public health infrastructure.

A recent report issued by the Association of Independent Colleges and the University of Massachusetts (2003) described the economic impact of the research universities on the Boston area. The report noted that the Boston area “has long been recognized as a leader in the fields of education, innovation and knowledge” (p. 2). The specific universities cited include Boston College, Boston University, Brandeis University, Harvard University, Massachusetts Institute of Technology, Northeastern University, Tufts University, and the University of Massachusetts. These schools carried out approximately $1.5 billion of funded research in the year 2000, constantly exploring and developing the latest knowledge and technologies. The audiology program at Boston University has ties with many of these institutions, which create many educational opportunities for our students. These connections include involvement of faculty members from other schools to be on our students’ research committees, access to specialized coursework through consortium agreements, participation in local area seminars and workshops, and ongoing collaboration on faculty research projects.

Within Boston University there are opportunities for students wishing to specialize in various aspects of audiological practice. Students benefit by interactions with students and faculty in a variety of disciplines and have the opportunity to take coursework in biomedical engineering, public health, biostatistics, cognitive and neural systems, neuropsychology and imaging, or health care management. As noted above, the HRC is a unique resource for the audiology program and greatly facilitates these interdisciplinary activities. Sargent College of Health and Rehabilitation Sciences, which houses the audiology program, is an acknowledged international leader in the area of evidence-based practice, and multidisciplinary opportunities within the college are strongly encouraged. The College has an Institute for the Evaluation of Rehabilitation Effectiveness and offers frequent workshops on procedures for measuring and documenting outcomes assessment.

In addition to the research environment and location, the resources available for practicum placement and course instructors are extensive. As noted previously, the greater Boston area is known for the number of highly regarded medical facilities. The Boston University program benefits from the opportunity for clinical placement with virtually every medical institution in the area (i.e., Children’s Hospital, Massachusetts Eye and Ear Infirmary, New England Medical Center, Brigham & Women’s Hospital, and Boston University Medical Center, among many others). Our students have the opportunity to be exposed to all aspects of modern audiology and medicine. In addition to the large medical institutions, we have numerous practicum sites at specialty hospitals, individual clinics, and private practice groups. Our program has been very fortunate in the support and commitment that the audiology community in the Boston area has shown over the years by accepting our students for practicum and by contributing to the teaching of courses at Boston University. In large part because of their efforts, we are able to offer a broad exposure to all aspects of auditory and vestibular diseases, function, and assessment.

Admission Requirements

In order to be admitted into the clinical track, the applicant must have accomplished the following:

1. Acquired a bachelor’s or master’s degree from an accredited college or university.

2. Demonstrated evidence of high academic aptitude in the form of previous academic records, scores on the GRE, and letters of recommendation. In addition, the applicant must show promise of being an outstanding clinician who can function independently with a wide breadth of clients and be capable of excellent communication with other professionals.

3. Completed prerequisite courses in college level math, statistics, biology, and physics. If not completed by the time of entrance, they can be completed early in the program.

4. Been given a personal interview by the Boston University faculty.

Degree Requirements

The requirements for the clinical track of the ScD in audiology include the following:

1. Completion of a minimum of 110 graduate credits for a post-bachelor’s degree and 78 graduate credits for a post-master’s degree student (based on 4-credit courses). Ninety-two of these credits must be completed at Boston University (60 for post-master’s degree students) with a 3.0 or better grade point average.

2. Successful completion of written and oral qualifying examinations following completion of at least 64 credit hours for those entering at the post-master’s degree level, or 96 credit hours when entering the post-bachelor’s degree level.

3. Completion of 2 years or four semesters of full-time residency.

4. Completion of an Advanced Clinical Practicum.

5. Completion of a supervised research project. This project may address clinical research topics (e.g., the refinement of a clinical technique, the standardization of a clinical tool, or an increase in the knowledge about a specific clinical population) but must result in a manuscript that is suitable for publication in a refereed journal. It is expected that the scope of the project typically will be less than that of a dissertation and that more faculty supervision may occur than is usual for a dissertation, although ultimately it is the student’s responsibility to satisfy the requirements of the advisory committee. Before the project can be initiated, the student must meet the clinical practica performance requirement. This means the student must be performing at the intern level in all areas.

Curriculum1

Students who do not hold a bachelor’s degree in speech and hearing are required to take the following courses or their equivalents as prerequisites for the doctoral curriculum: Introduction to Speech and Language Disorders (CD 531); Introduction to Audiology (CD 541); Phonetics (CD 521); Anatomy and Physiology of the Speech Mechanism (CD 522); Language Theories, Acquisition and Analysis (CD 708); and Introduction to the Clinical Process (CD 547). The courses listed in Table 1 are minimum requirements for a clinical doctorate in audiology for a post-master’s student. For a post-bachelor’s candidate, it is expected that an additional 32 hours of course work would be completed. See the Appendix for the program of a recent graduate.

1We currently are engaged in a formal review and revision of the curriculum for the clinical track of the doctoral program and have suspended admissions until the process is completed. We continue to admit students into the research track of the program. The discussion of the requirements and curriculum contained in this document apply to the program from 1985 to the present. Prospective applicants should consult our Web site (www.bu.edu/sargent) for current information regarding our program offerings.

References

Association of Independent Colleges and Universities of Massachusetts. (2003). Engines of economic growth: The impact of Boston’s eight research universities on the metropolitan Boston area. Retrieved March 2003 from http:// www.masscolleges.org/economic

Bankson, N. W. ( 1993) The Boston University professional doctorate in audiology. Paper presented at the Council of Graduate Programs in Communication Sciences & Disorders, Charleston, SC, April 1993.

Cox, L. C., Bankson, N. W., Kidd, G. D., & Burkard, R. F. (1992a). The clinical doctoral program at Boston University part one: Program overview. Audiology Today, 4(3), 23-25.

Cox, L. C., Bankson, N. W., Kidd, G. D. & Burkard, R. F. (1992b). The professional doctoral program at Boston University part two: Experience and commentary on the AuD. Audiology Today, 4(6), 17-19.

Webster’s unabridged dictionary (2nd ed.). (1977). New York: Collins-World.

Received March 31, 2003

Accepted May 27, 2003

DOI: 10.1044/1059-0889(2003/002)

Gerald D. Kidd Jr. L. Clarke Cox Melanie L. Matthies Boston University

Contact author: Clarke Cox, PhD, 720 Harrison Avenue, Suite 601, Boston, MA 02118. E-mail: clarke.cox@bmc.org

Copyright American Speech-Language-Hearing Association Jun 2003

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