Certificate Program for Otolaryngology Personnel (CPOP): a good solution for many practice challenges.

Otolaryngologists face many challenges while trying to fulfill our mission of providing outstanding healthcare. For example, there are not enough audiologists in the workforce to provide for all the auditory testing and rehabilitation needs of otolaryngology patients, let alone for the patients of pediatricians, internists, neurologists, and others involved in the assessment of hearing and balance. Even if there were an unlimited number of audiologists, economic pressures have forced physicians to consider the cost-effectiveness of each allied health professional whom we employ. Similar concerns exist for evaluation of patients with balance disorders, voice disorders, and other maladies.

To address these problems, during the past several years the American Academy of Otolaryngology Head and Neck Surgery has developed its Certificate Program for Otolaryngology Personnel (CPOP). The program was launched approximately 2 years ago, but many otolaryngologists remain unaware of its existence and its potential.

The only portion of the CPOP program available currently is the OTO Tech program. Its curriculum evolved from the audiometric technician program developed approximately a decade ago by the American Neurotologic Society (AN S). The three-part CPOP courses are given several times annually and have already proven highly successful. Students are all sponsored by otolaryngologists and have included nurses, physician assistants, medical assistants, secretaries, and even a few physicians.

The first part of the program involves self-study. Students are provided with educational materials, including a book, and they must pass an examination in order to proceed to the next level. Part 2 is a 21/2-day, hands-on training workshop with lectures provided by otolaryngologists and audiologists. Students learn to perform otoscopic examinations, tuning fork tests, pure tone and speech audiometry with and without masking, and tympanometry. They are also given basic informational lectures on more advanced audiologic testing, hearing aids, balance problems, and other relevant subjects. Scope-of-practice training is stressed.

The third part of the program is a supervisory period of approximately 6 months, during which specific numbers of procedures must be performed and reviewed for accuracy. At the conclusion of the 6-month period, logbooks are submitted to the AAOHNS, and a certificate is awarded for satisfactory completion of the program.

Information about the OTO Tech program can be obtained through the Academy at www.entnet.org/education/CPOP.cfm.

OTO technicians are not audiologists and are not intended to replace audiologists. Rather, they are designed to fill an important role in collaboration with otolaryngologists and audiologists, helping to provide excellent, cost-effective hearing healthcare and improve patients' access to expert hearing evaluation.

Prior to the development of the OTO Tech program and its antecedent audiometric technician program under the auspices of the ANS, there were few options for training staff to perform audiometry. Either people committed 6 years to a master's degree in audiology and licensure, or they performed testing with no formal training or certificate. Audiometry is often performed in the offices of family practitioners and pediatricians by office personnel who have received no training at all beyond reading the audiometer manual (and sometimes not even that); and the practice in the offices of some otolaryngologists without audiologists has not always been much better. Now that there is a reasonable training alternative that does not require an excessive time commitment, such informal and inconsistent training has become obsolete for nonaudiologist personnel who are called upon to test hearing.

The OTO Tech program is only the first of planned, psychometrically sound, meticulously designed training programs for otolaryngology personnel. The Academy should be commended on the success of its initial effort and encouraged to proceed with plans to launch certificate program training for front-office personnel, balance technicians, and voice technicians, and to fill other needed roles. Private and academic otolaryngologists would do well to consider incorporating CPOP personnel into their practices as adjuncts to certified audiologists, speech-language pathologists, and other traditional allied health personnel.

Initial experience with OTO technicians suggests that office personnel trained through CPOP programs can become even more valuable and dedicated assets to the physician's office than they were before training. Not only does the practice benefit, but the technicians also benefit from their increased knowledge and their ability to recognize clinical situations that exceed the limits of their expertise and scope of practice, and require referral to an audiologist.

It is reasonable to anticipate that this experience will be duplicated in areas other than hearing assessment. As we strive to provide superior patient care, optimize the time and use of our certified audiologists and speech-language pathologists, and remain economically viable, expanded use of trained technicians may prove to be a very effective strategy for otolaryngologic practice in the 21st century.

ROBERT THAYER SATALOFF, MD, DMA 

Editor-in-Chief

EAR, NOSE & THROAT JOURNAL