In pursuit of increasing the application of tele-audiology in South Africa: COVID-19 puts on the alert for patient site facilitator training

Abstract

Background: The coronavirus disease 2019 (COVID-19) presented and highlighted new and unanticipated challenges to the provision of clinical services, raising an urgency for the application of different models of service delivery, including tele-audiology. In many tele-audiology encounters, a site facilitator is needed at the patient site to help with the hands-on aspects of procedures, and the implications of this requirement are significant for the resource-constrained African context.Objectives: The aim of this scoping review was to investigate published evidence on training provided to patient site facilitators (PSFs) for tele-audiology application to guide the South African audiology community in tele-audiology application initiatives.Method: Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE and ProQuest were searched to identify peer-reviewed publications, published in English, between 2017 and 2021 related to training of PSFs. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were followed during the screening process as well as for illustrating the process.Results: Findings are discussed under four key themes: (1) type of tele-audiology and the implications thereof, (2) length of training and its implications, (3) diversity in the range of PSFs used and its implications for the training, and (4) heterogeneity in the training.Conclusion: The findings highlight important considerations for tele-audiology application within the African context, specifically decision-making around who can serve in the role of PSFs, as well as content and nature of training required, with implications for policy and regulations as well as human resource strategy. These findings are important for the COVID-19 pandemic era and beyond.

The impact of COVID-19 on speech–language and hearing professions in low- and middle-income countries: Challenges and opportunities explored

“…Thus, telepractice became placed at the forefront of these models – therefore requiring knowledge and skills in this model. Khoza-Shangase ( 2022b ) reported on the lack of sufficient knowledge and skills in telepractice by audiologists, while Madahana et al (2022b) highlighted the lack of utilisation of AI for clinical application. This knowledge and application gap is a missed opportunity for clinical care in these fields during and beyond COVID-19.…”

“…Challenges to practice created by COVID-19 were worsened by access and infrastructure challenges, as well as the related high infrastructural costs. Over and above infrastructure and system challenges directly related to curbing the spread of COVID-19 in the form of personal protective equipment (PPE) and infection prevention and control (IPC) measures (Achmat & Gerber, 2022 ), noteworthy other infrastructure and cost- related challenges were experienced by both professionals and patients (Khoza-Shangase, 2022b ; McAllister et al, 2022 ; Tar-Mahomed & Kater, 2022 ). Access to the technology and its infrastructural support for innovative clinical service provision was raised as a serious barrier.…”

“…This included (1) access to technological devices (e.g. computers, laptops, tablets and smartphones), with a lack of resources reported by Coutts et al ( 2022 ); (2) connectivity in the form of access to Internet with good bandwidth; (3) stable power supply; and (4) technology-associated costs, including data costs (Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022a , 2022b ; McAllister et al, 2022 ; Tar-Mahomed & Kater, 2022 ). In South Africa, a major challenge was maintaining a stable power supply with load-shedding, which is scheduled national electricity supply interruption.…”

“…In South Africa, a major challenge was maintaining a stable power supply with load-shedding, which is scheduled national electricity supply interruption. Khatib and Hlayisi ( 2022 ) raised limitations regarding available technologies such as technological compatibility of older hearing aids, while Khoza-Shangase ( 2022b ) reported on challenges around technological abilities of patients, clinicians as well as patient-site facilitators (PSFs). Khatib and Hlayisi ( 2022 ) reported that patients were not ready for this model of service delivery, thus requiring deliberations around reliability of some online assessments.…”

“…of key solutions for practice challenges for both patients and service providers Khoza-Shangase (2022b). added to these factors the crucial potential role of PSFs during telepractice within the South African context.…”