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  1. Dzulkarnain AAA, Rahmat S, Ismail AW, Musa R, Badzis M, Tengku Zam Zam TZH
    Med J Malaysia, 2019 04;74(2):168-173.
    PMID: 31079129
    INTRODUCTION: This paper describes the development and the evaluation of a new Two-dimensional (2D) computer-based (CB) Simulated Learning Environment (SLE) software for routine audiology tests that comes with learning assistance for audiology students. The aim of the study was to serve as preliminary evaluation on the effectiveness of the new 2D CB SLE audiology software among audiology students.

    MATERIALS AND METHODS: The development process of the new 2D CB SLE includes, (i) the identification of common errors made by students in the audiology clinic, (ii) the development of five case simulations that include four routine audiology tests incorporating learning assistance derived from the errors commonly made by audiology students and, (iii) the development of 2D CB SLE from a technical perspective. A preliminary evaluation of the use of the 2D CB SLE software was conducted among twenty-six second-year undergraduate audiology students.

    RESULTS: The pre-analysis evaluation of the new 2D CB SLE showed that the majority of the students perceived the new 2D CB SLE software as realistic and helpful for them in achieving the course learning outcomes and in improving their clinical skills. The mean overall scores among the twenty-six students using the self-reported questionnaire were significantly higher when using the 2D CB SLE software than with the existing software typically used in their SLE training.

    CONCLUSIONS: This new 2D CB SLE software has the potential for use by audiology students for enhancing their learning.

    Matched MeSH terms: Audiology/education*
  2. Quar TK, Rashid MFN, Rosdi MYM, Ishak WS, Chong FY
    Am J Audiol, 2023 Mar;32(1):59-69.
    PMID: 36446036 DOI: 10.1044/2022_AJA-22-00033
    OBJECTIVE: This study aimed to determine the challenges faced by individuals with hearing loss at a time when many nations were attempting to move from the COVID-19 pandemic to endemic.

    DESIGN: A cross-sectional survey was conducted on Malaysian adults with hearing loss to determine the impact of the COVID-19 crisis on hearing aid management, communication difficulties, psychosocial challenges, and access to audiological services.

    STUDY SAMPLE: One hundred forty-six individuals aged 18 years old and above with hearing loss were recruited from hearing health care centers to participate in the survey.

    RESULTS: Many of the participants (54.2%) reported significant difficulties communicating with people wearing face masks. For hearing aid management, repairing (36.3%) and fine-tuning devices (30.2%) were considered more challenging than obtaining a battery (21.3%). The COVID-19 pandemic had a serious psychosocial impact on a small portion of the individuals surveyed. Remote services were rarely offered by the audiologists, and most participants preferred in-person treatment. However, the majority perceived that creating awareness and training on telehealth was important.

    CONCLUSIONS: Effective management for people with hearing loss needs to consider the challenges faced by them, as the world prepares to live with the coronavirus. Clinical protocols should consider providing a service that is helpful for the clients as well as safe and sustainable in future pandemics.

    Matched MeSH terms: Audiology*
  3. Dzulkarnain AA, Rahmat S, Mohd Puzi NA, Badzis M
    Med J Malaysia, 2017 02;72(1):37-45.
    PMID: 28255138 MyJurnal
    INTRODUCTION: This discussion paper reviews and synthesises the literature on simulated learning environment (SLE) from allied health sciences, medical and nursing in general and audiology specifically. The focus of the paper is on discussing the use of high-fidelity (HF) SLE and describing the challenges for developing a HF SLE for clinical audiology training.

    METHODS: Through the review of the literature, this paper discusses seven questions, (i) What is SLE? (ii) What are the types of SLEs? (iii) How is SLE classified? (iv) What is HF SLE? (v) What types of SLEs are available in audiology and their level of fidelity? (vi) What are the components needed for developing HF SLE? (vii) What are the possible types of HF SLEs that are suitable for audiology training? Publications were identified by structured searches from three major databases PubMed, Web of Knowledge and PsychInfo and from the reference lists of relevant articles. The authors discussed and mapped the levels of fidelity of SLE audiology training modules from the literature and the learning domains involved in the clinical audiology courses.

    RESULTS: The discussion paper has highlighted that most of the existing SLE audiology training modules consist of either low- or medium-fidelity types of simulators. Those components needed to achieve a HF SLE for audiology training are also highlighted.

    CONCLUSION: Overall, this review recommends that the combined approach of different levels and types of SLE could be used to obtain a HF SLE training module in audiology training.

    Matched MeSH terms: Audiology
  4. Dzulkarnain AA, Wan Mhd Pandi WM, Wilson WJ, Bradley AP, Sapian F
    Int J Audiol, 2014 Aug;53(8):514-21.
    PMID: 24702636 DOI: 10.3109/14992027.2014.897763
    To determine if a computer simulation can be used to improve the ability of audiology students to analyse ABR waveforms.
    Matched MeSH terms: Audiology/education*
  5. Amri NA, Quar TK, Chong FY
    Am J Audiol, 2019 Dec 16;28(4):877-894.
    PMID: 31600460 DOI: 10.1044/2019_AJA-18-0156
    Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight (N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23-48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.
    Matched MeSH terms: Audiology/methods; Audiology/standards
  6. Noraidah Ismail, Sarah Rahmat
    MyJurnal
    This paper aims to synthesize available literature on occupational noise in Malaysia and to relate this to the current noise management practices and control. The review focuses on several main
    scopes; i) history of occupational noise management in Malaysia; ii) legislative developments and legal precedents of occupational noise in Malaysia ; and iii) the hearing conservation programs (HCP) and hearing loss prevention programs (HLPP). Narrative review and synthesis. Related publications and references were identified through several ways: i) by structured searches in PubMed, Google scholar, Web of Knowledge and Science Direct using the combinations of ‘occupational noise’, ‘noise induced hearing loss; ‘hearing’, ‘knowledge’, awareness’, ‘hearing conservation program’, ‘hearing protection devices’ as key words ii) by inspecting the reference lists of relevant articles. The number of publications within the audiology which address this topic, is rather limited. All the above mentioned scopes were discussed and synthesis of literature from other related fields such as medical, health and occupational safety and health were also referred to facilitate the discussion. This paper concludes that there are an emerging trend for the studies of occupational noise Malaysia in the literature. However, the effectiveness of HCP in Malaysia, and to what extent it is accepted and being implemented is yet to be investigated.
    Matched MeSH terms: Audiology
  7. Dzulkarnain AAA, Sani MKA, Rahmat S, Jusoh M
    J Audiol Otol, 2019 Jul;23(3):121-128.
    PMID: 30857383 DOI: 10.7874/jao.2018.00381
    BACKGROUND AND OBJECTIVES: There is a scant evidence on the use of simulations in audiology (especially in Malaysia) for case-history taking, although this technique is widely used for training medical and nursing students. Feedback is one of the important components in simulations training; however, it is unknown if feedback by instructors could influence the simulated patient (SP) training outcome for case-history taking among audiology students. Aim of the present study is to determine whether the SP training with feedback in addition to the standard role-play and seminar training is an effective learning tool for audiology case-history taking.

    SUBJECTS AND METHODS: Twenty-six second-year undergraduate audiology students participated. A cross-over study design was used. All students initially attended two hours of seminar and role-play sessions. They were then divided into three types of training, 1) SP training (Group A), 2) SP with feedback (Group B), and 3) a non-additional training group (Group C). After two training sessions, the students changed their types of training to, 1) Group A and C: SP training with feedback, and 2) Group B: non-additional training. All the groups were assessed at three points: 1) pre-test, 2) intermediate, and 3) post-test. The normalized median score differences between and within the respective groups were analysed using non-parametric tests at 95% confidence intervals.

    RESULTS: Groups with additional SP trainings (with and without feedback) showed a significantly higher normalized gain score than no training group (p<0.05).

    CONCLUSIONS: The SP training (with/ without feedback) is a beneficial learning tool for history taking to students in audiology major.

    Matched MeSH terms: Audiology
  8. Dzulkarnain AA, Che Azid N
    Med J Malaysia, 2014 Aug;69(4):156-61.
    PMID: 25500842 MyJurnal
    AIM OF STUDY: This study investigated the consistency in Auditory Brainstem Response (ABR) waveform evaluations between two audiologists (inter-audiologist agreement) and within each of the audiologist (intra-audiologist agreement).
    METHODS: Two audiologists from one of the audiology clinics in Kuantan, Pahang, Malaysia were involved in this study. Both audiologists were required to identify and mark the presence of Waves I, III and V in 66 ABR waveforms. Over a one-month interval, each audiologist was required to carry out the same procedure on the same ABR waveforms. This process was continued until we had three separate reviews from each audiologist.
    RESULTS: There was a high inter-audiologist ABR waveform identification agreement (over the range 81.71-89.77%), but a lower intra-audiologist ABR waveform identification agreement (over the range 50%-78%) for both audiologists. Our results also showed a high intra-audiologist ABR latency agreement within 0.2 ms (>90%), but a slightly lower inter-audiologist latency agreement (75-84%) within 0.2 ms.
    CONCLUSION: Our results support the need for the clinic to implement further strategies for improving the respective lower agreements and consistencies. These include conducting a continuous education program and using an objective algorithm to support their interpretations.

    Study site:; International Islamic University, Malaysia (IIUM) Hearing
    and Speech Clinic
    Matched MeSH terms: Audiology
  9. Mohd Ibrahim H, Mohamed Yusoff FH, Ahmad K, Van Dort S
    Med J Malaysia, 2015 Dec;70(6):321-5.
    PMID: 26988203 MyJurnal
    INTRODUCTION: Little is known about the treatment outcomes of children with cleft lip and/or palate (CLP) receiving surgical care for primary lip and palate closure in Malaysia.

    OBJECTIVES: This study examined the speech and hearing status of Malay-speaking children with CLP residing in Kuala Lumpur.

    METHODS: Parents whose children were between the age of 5 and 7 years were recruited via the Cleft Lip and Palate Association of Malaysia (CLAPAM) registry. Parents completed a survey and the children completed a speech and hearing assessment at the Audiology and Speech Sciences Clinic, Universiti Kebangsaan Malaysia.

    OUTCOMES: Speech measures include nasality rating, nasalance scores, articulation errors and speech intelligibility rating, while hearing measures include hearing thresholds and tympanometry results for each child.

    RESULTS: Out of 118 registered members who fulfilled the inclusion criteria, 21 agreed to participate in the study. The overall speech and hearing status of children in this sample were poor. Only four (19%) participants had normal speech intelligibility rating and normal hearing bilaterally. In terms of overall cleft management, only four (19%) participants were seen by a cleft team while seven (33%) had never had their hearing tested prior to this study.

    CONCLUSION: Participants in this sample had poor outcomes in speech and hearing and received uncoordinated and fragmented cleft care. This finding calls for further large scale research and collaborative efforts into improving and providing centralised, multidisciplinary care for children born with CLP.

    Matched MeSH terms: Audiology
  10. Jalaei B, Zakaria MN, Sidek D
    Iran J Otorhinolaryngol, 2017 Jan;29(90):53-57.
    PMID: 28229064
    INTRODUCTION: Noonan syndrome (NS) is a heterogeneous genetic disease that affects many parts of the body. It was named after Dr. Jacqueline Anne Noonan, a paediatric cardiologist.

    CASE REPORT: We report audiological tests and auditory brainstem response (ABR) findings in a 5-year old Malay boy with NS. Despite showing the marked signs of NS, the child could only produce a few meaningful words. Audiological tests found him to have bilateral mild conductive hearing loss at low frequencies. In ABR testing, despite having good waveform morphology, the results were atypical. Absolute latency of wave V was normal but interpeak latencies of wave's I-V, I-II, II-III were prolonged. Interestingly, interpeak latency of waves III-V was abnormally shorter.

    CONCLUSION: Abnormal ABR results are possibly due to abnormal anatomical condition of brainstem and might contribute to speech delay.

    Matched MeSH terms: Audiology
  11. Sofia Jaffer, Mohd Shakil Razi
    MyJurnal
    This retrospective study was conducted at the audiology clinic of UKM in the year 2000. It was intended to detect the effect of walkman on the hearing system of its users and to investigate whether distortion product otoacoustic emission test can provide an early and reliable sign of cochlear damage or not. Distortion product otoacoustic emission test helps to determine the function of outer hair cell. Outer hair cells get damaged with exposure to loud sound, drugs and aging. Thirty subjects (20 in the study group and 10 in the control group), between the ages of 19-25 years, who fulfilled all the criteria of selection, were investigated. There were two sets of criteria (general and specific). Anyone, in the control or study group, failing in any of these criteria was excluded from the study. According to the general criteria, it was essential for all the subjects to have clean ear canals, normal hearing at all the frequencies (250Hz- 8000Hz), normal middle ear function (Type A tympanogram), no middle ear problem, not used/using any ototoxic medicine, no family history of hearing loss, no history of ear surgery, not exposed to any form of loud noise like disco, concert, F1 racing or gun shooting. According to the special criteria it was essential for the subjects in the control group to have never used a walkman and those in the study group must have been using a walkman for at least 6 months. Comparison of distortion product emission levels between control and study groups revealed that emissions were significantly lower in the study group, across all the frequencies, suggesting outer hair cell damage in the walkman users. These differences reached level of statistical significance (p<0.05) at 2, 4, 6 and 8kHz. Using walkman at an intensity unsafe for hearing and a duration longer than recommended is suspected for the outer hair cell damage in our study group. Those using walkman for longer duration and higher intensity manifested much lower emission levels. Our study supports the literature that distortion product emission test is a much sensitive test than pure-tone audiometry, as it can detect cochlear damage long before it appears in an audiogram. It is recommended that people who are exposed to loud noise regularly should be monitored with distortion product emission test. It is suggested that the use of walkman.
    Study site: Audiology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Audiology
  12. Daud MK, Noh NF, Sidek DS, Abd Rahman N, Abd Rani N, Zakaria MN
    B-ENT, 2011;7(4):245-9.
    PMID: 22338236
    The effect of noise on employees of dental clinics is debatable. The purposes of this study were to determine the intensity and frequency components of dental instruments used by dental staff nurses and the prevalence of noise induced hearing loss.
    Matched MeSH terms: Audiology
  13. Ali A, Hickson L, Meyer C
    Int J Audiol, 2017 Jun;56(6):408-416.
    PMID: 28388865 DOI: 10.1080/14992027.2017.1305515
    OBJECTIVE: This study explored the nature of audiological services for adults with hearing impairment in Malaysia, with an emphasis on whether current services address clients' overall functioning as described by the World Health Organisation's International Classification of Functioning, Disability, and Health (ICF) framework.

    DESIGN: An online survey exploring current practice, skills and confidence of audiologists, and the infrastructure and facilities available in their workplaces, was distributed to audiologists in Malaysia via professional associations and social media.

    STUDY SAMPLE: A total of 111 audiologists, 84.7% female and 15.3% male (range = 23-44 years), participated in the study.

    RESULTS: Although audiologists in Malaysia reported addressing all of the ICF domains, less than 26% of them assessed the patients' speech perception, carried out real-ear measurements, or used outcome measures routinely. The majority of the audiologists reported feeling confident in managing adult patients. However, 83% of the audiologists indicated they wanted to improve their skills related to management of adult patients, particularly in the areas of counselling and auditory training.

    CONCLUSIONS: Inadequate infrastructure, resources and facilities in the workplace may have contributed to the gaps in service provision and influenced the current practice of audiological management for adult patients in Malaysia.

    Matched MeSH terms: Audiology/trends*
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