Episode Transcript
Rebecca: Hello and welcome to the Future is Sound. A partnership in hearing podcast brought to you by Oticon Canada. I'm your host, Becca Angel. Thanks for joining me on my first podcast journey where we will chat broadly about all things hearing. We will launch fun new episodes every month and if you have any suggestions or comments, be sure to get in touch. Okay, let’s get started.
Hi everyone and welcome to the podcast. Our guest today is Dave Gordey, a familiar name probably to lots of you. He has been a pediatric audiologist for 27 years. I'm dating you Dave.
Dave: Yes you are.
Rebecca: He has previously worked in a pediatric clinic and hospital in Victoria and North Vancouver in British Columbia. Dave is also the director of pediatric audiology and research for Oticon and Copenhagen, Denmark, and is also the past president of the Canadian academy of audiology. Dave has also taught at York University and the University of British Columbia, and Dave’s current research projects include pediatric hearing aids, bone conduction devices, and children unilateral hearing loss, dissocial and emotional development of children with hearing loss, and knowledge translation and implementation science in pediatric audiology. A big warm welcome to you Dave, thanks so much for being here and being a guest on the new podcast.
Dave: Thank you Becca and my pleasure to be here.
Rebecca: That was a lot to unpack. You have many years of experience in this industry and I feel like you continue to add more accolades to your name.
Dave: I'm surprised I'm still in the field to be honest. I think as a new grad, I thought, I'll probably be an audiologist for five years before doing something different and I don’t know where the time goes but I think it’s still a really great and interesting profession to be a part of.
Rebecca: It’s great. I was wondering, I know that when I started with Oticon almost four and a half years ago now, you were maybe just jumping into your PhD or it might have been a couple of years ago. Can you tell us a little bit more about your PhD research and what that was all about?
Dave: Yeah. When I was working as a clinical audiologist, I used to be troubled by some of the kids that I saw that wore hearing aids, children that were deaf or hard of hearing. I was always very puzzled by why some of the kids had this really great social lives and groups of friends and others seem to be struggling on that front and both were wearing Well-Fit hearing technology and many of my colleagues when I would raise this, I would say, do you think it might be related to their personality?
For me, I never quite bought that. It seems like something was happening with these kids as they were growing that they were being coached or equipped in some way, to be better prepared at developing relationships and friendships. After working at Oticon for a while, I had a discussion by chance with Dr. Sheila Moodie from Western University. We were both attending a conference and she was asking me some questions about clinical work and I brought this up to her and she said, that sounds like a really great topic for a research study and that’s something you could build a PhD on.
That’s when I decided to go back to school as a spry 40-year-old and with my research question looking at the relationships of children who are deaf and hard of hearing and what are the facilitators to those kids having the ability to really develop them well. It’s a really interesting study where we looked at, specifically classroom relationships and engaged stakeholders like parents, teachers, and students themselves to ask them, what it is that you think are the key elements for children who are deaf or hard of hearing to be able to feel included and have these relationships.
Rebecca: Do you find that the things you discovered in that study are sort of fueling more of your studies today?
Dave: Yeah. I think one of the things that I've noticed is that today, a really hot topic is inclusion and engagement of children who are deaf and hard of hearing and I think the reason for that is that, most kids today who are wearing hearing technology are attending their neighborhood classroom, their neighborhood schools. They're being educated alongside their peers that have typical or normal hearing. Because of that, there is this interest of, what is it that is needed for children to feel that they are engaged in their classrooms?
Are there barriers to communication access? What is it that they need to have to feel included? I would say, having that foundation of understanding the key elements required to build relationships in the classroom and identifying other things needed for engagement in the classroom has really, just set up a number of different projects that are available to look at.
Rebecca: Yeah. Where can we find most of these studies?
Dave: My PhD work is actually available through York University. The full 144 pages is available there for light reading with your glass of wine or beer on Friday night.
Rebecca: Maybe multiple Friday nights.
Dave: Yes, and I'm in the process right now of splitting it up into a couple of smaller publications and that’s taking me a little bit longer than I had hoped, but I'm in the home stretch there, both about 80% written and they're going to make their way into some peer review [inaudible 00:06:41] hopefully in the spring.
Rebecca: Nice. I'm sure we’re all going to look forward to that. You’ll have to let me know when that’s available to pass on.
Dave: Definitely.
Rebecca: One thing that I think is interesting. I mean I did a thesis at UBC and there's so much preparation and work as you know that goes into some of these studies. But, for people that aren’t as familiar with that process, can you run us through briefly like a start to finish on a peer reviewed paper, some of the steps maybe that a lot of people wouldn’t be aware of?
Dave: Yeah. I think there's two different components. There's the research study itself and then there's the publication. I would say one of the biggest challenges with the research study is really the recruitment of your participants. If you think I'm one person and there are probably thousands of other researchers out there who are also looking for participants not even just in audiology but other disciplines that include children, many of these institutions where we might find participants like schools for example, are being bombarded with requests for research participants.
With that being said, the interest by many institutions to help out is somewhat restricted because they have their own jobs to do in terms of teaching students for example in the schools. Recruitment is definitely a big problem. I guess it depends on the type of research question and how interesting it is to those that are working in the field because I know when I was doing my PhD research, there was a lot of interest. A lot of my colleagues who are working in the schools said, I will do what I need to do to help you get those participants because we really need to know more about this. In terms of the development of a research study, there's first the research proposal where you're reviewing the current literature.
What has been covered previously in this general area and then where does your study fit in. Creating that proposal is very key and then it’s also very important when it is reviewed by the ethics committee, to say that, yes, you may proceed. Your study is not going to pose any harm to your participants. You may go ahead and engage them and do your study. Once you have all of this data gathered and you're writing up your study for a publication, it’s really then making a couple of key decisions. One is where do you want this information to be accessible.
I typically ask myself, who is the audience that I feel might most be interested or benefit from the study, and then what journal does that typically speak to or those group of professionals. For example, the study that I just described for my PhD about classroom relationships, it’s probably not so well suited to ear and hearing for example, but for maybe hearing speech in the ASEAN journal, because you're going to get a lot of professionals who are working in the schools. I think finding the journal that is a really nice fit for your publication is something that you do.
The other thing to consider is what is called the impact factor of the journal. That impact factor of that journal is really going to give you a good idea of how rigorous their research process is in terms of reviewing articles and the quality of the work and so forth. There actually is a place where you can type in the impact factor of audiology journals if you just actually use Google, and it will give you a ranking of…
Rebecca: I didn’t know that.
Dave: …yeah, of the top audiology journals. That being said, you may not for example, ear and hearing is always close to the top, if not always at the top. That means getting an accepted publication in that journal is probably very competitive versus let’s say the journal of American Academy of Audiology let’s say it ranks number eight. That means that that competitiveness is still there, but there may be that opportunity to submit something there. I would say first and foremost, the most important thing is finding a place for your journal to be published where it’s going to reach the intended audience.
The impact factor is kind of slightly important but not so much. There are just many, many journals that you’ve never heard of before, like the international journal of otolaryngology, rhinology, and audiology which is published in a very small office in New York City and they are reaching a different type of audience, probably more international. It’s less important, but there are options to choose from.
Rebecca: Obviously, finishing something that you’ve done all this preparation for and all this recruitment for, and then writing it, and then having it published in a journal, that finale is obviously very rewarding. I was just wondering if there's another part of the process that you really enjoy about being a researcher?
Dave: I think the data collection part for me is always the most fun because you're directly observing in many cases the responses to these tests that you have setup and you're getting first hand to start to see the data come together and I guess the things that’s most rewarding for me is I'm always surprised when things come up that I had never even thought of. That's always really interesting because when you set out to do a study, there are elements that are somewhat predictable and that you're thinking, well these are results that I expect to see, but I think the beauty is to see those unexpected pieces.
I think the rest of the research process I would say more of the challenging part is when you submit things for peer review, it means that your peers are going to critique your work and even the most seasoned researchers get their manuscript back with pages and pages of comments where people are posing questions to you. Why didn’t you do this? Have you ever thought about doing this? Your methodology here may be flawed, did you ever consider this? You really are like, my baby, how dare you talk about my baby that way. You come to learn very quickly that this is about, this peer reviewed committee wanting to elevate your work and your writing to the next level. I would say that I was prepared for that. I had a colleague in Edmundston who said to me, just be prepared.
Your very first manuscript you submit, get a box of Kleenex handy, a stiff drink, because you're not going to like what they’ll say. But just realize, it’s for the growth potential for your article. I see that now when I look at finished products of where the manuscript was that I submitted and then after peer review, and questions, and suggestions, it’s just so much more polished. It’s still that back and forth as you negotiate your final article.
Rebecca: It’s a necessary evil. I was going to say when you talked about recruitment when I was deciding whether to do a thesis or write the exam at UBC and when I was given a couple of options for ideas in the brain lab there, I always wanted to do something with kids, but the recruitment process for children is so much harder and time consuming. The ethics for that is so different to collecting adult data. Then there's an option of doing normative data versus abnormal data and again, collecting normative data is a lot easier to get. I sort of copped out on the easy route for that one and ended on adult norms.
Even getting participants for that was challenging. I may have had 50 but then there were 20 [inaudible 00:15:58] recordings that we just had to throw out. Even if you get a lot of participants, some of that data, you don’t even get to keep because it didn’t work or whatever. In terms of your work with Oticon Research and Pediatrics, can you talk a little bit about the challenges there with getting children participants for some of these studies that we like to do at Oticon?
Dave: Pediatric research is the main focus of my work. It is challenging when we think about kids and I know frequently, I am asked questions when we release studies, why don’t we see more research with babies or preschool aged kids? I’d really like to see that. My answer to that is, so would I. Can you go ahead and create some outcome measures that might allow us to gather performance data on these little ones.
Sorry, I'm being a little silly, but that’s the main limitation. We use school aged kids because we have these tests that allow us to measure performance with our hearing aids or our collaborators, allow them to measure performance and with babies, we are really limited on tools such as parent observation. When we start using observational tools, then we’re getting into a realm of subjective perceptions and that again challenges the integrity of the research study.
Typically, our pathway with research with kids has been, let’s use school aged kids who can perform a wide variety of test measures that are really solid and give us a lot of different perspectives on the functioning of our hearing aids. That will allow us to translate or postulate how this might apply to babies.
Rebecca: Right. It’s something that hopefully we’ll eventually be able to get a little bit easier in the future.
Dave: I think there are tools being developed right now where we see speech AVR where they're using this—Kristin Uhler from Colorado is doing these measures where she’s looking at objective ways to predict speech recognition scores in children who are deaf or hard of hearing. When those tools are perfected, that really would change the types of populations we could work with and then as you mentioned, ethics review boards do get a little nervous when we start talking about developing brains, developing speech and language systems, everything that preschool aged kids are. Whether or not that changes or not, I'm not too sure.
Rebecca: Just on another topic, I was wondering, in your opinion, we don’t really get to see that many side by side hearing aid manufacturer comparisons. Can you say anything on that topic?
Dave: In my opinion, it’s always tricky. I would always want to think about a fair comparison. With staggered product launches from manufacturers, if I say the Oticon Opn Play is our current hearing aid that we just released. Why don’t we go ahead and compare it to the other manufacturer, but wait, their hearing aid is now six months old, but they have a new one coming out in three months. It’s about balancing those release times.
When is it fair to actually do those comparisons? I think the other thing that’s really challenging is which features are you wanting to compare. Probably the easiest thing to compare is simply performance data through questionnaires. If you were to have kids comment on individual opinions of which technology they prefer in different types of environments. That could probably be a fair comparison. But again, we know that the individual experiences of kids who are deaf or hard hearing is quite variable.
For us to group together a bunch of kids and try and control for that variability, it’s really challenging. It doesn’t mean that we can't do it or that we won’t do it, it just means that we have to interpret the data very carefully. We know that there will be people looking at that data that will say, hey, wait a minute, and they're going to start acknowledging all the limitations that we will know exists going in. You're talking about an effort to develop a research study knowing there's a pile of limitations.
Rebecca: Yeah, and acclimatization too. Anyone that’s been wearing Opn Play already for a year and then is going to try something else, there's just so many variables there.
Dave: Yeah, acclimatization is an interesting one because there isn't really any research that talks about how much time does it take for a child to adapt to a different hearing aid signal processing strategy. There are some that would say, they don’t need time, and there's others that say, but I noticed that the kids, when I change them over and I fit them, those that are working clinically they say, but I do notice it takes them a while to adjust.
That’s another gray area as you just highlighted. Acclimatization is a factor that should be considered and there isn't anything to reflect on other than some studies where some researchers have said, we just fit them, and then we do the measures, and acclimatization doesn’t seem to be an issue. It’s a balance and I guess it depends really what the focus of the research is and the role of acclimatization.
Rebecca: Just to conclude our quick session, I was wondering if you could perhaps give our listeners a little sneak peek on some research coming for Oticon? Of course without giving too much away.
Dave: One of the things that I love about Oticon is that we are so focused on the lives of children and adults that have hearing differences, hearing loss, and we’re always looking at conceptual studies with our features, but then we’re also looking at more holistically or the impact functionally of how our hearing technology really helps children and adults. With that being said, I can tell you I'm really interested in further evaluating the impact of hearing loss on children in their daily lives. What does it mean for kids to go to a birthday party?
What does it mean for children to go to the movie theater? How important is it for kids to hear a whisper? Can they hear a whisper? These are without giving too much away, studies are in development and we’ll launch this spring that are further evaluating the experiences of children who are deaf and hard of hearing in their day-to-day listening environments and what do we need to do or how does our hearing technology support their engagement, their participation, and their inclusion. I think that’s a really needed pathway research wise, and I'm excited to follow that.
Rebecca: Cool. I look forward to it. I'm sure everyone is looking forward to it. Thank you again for being here. If we have any links or research papers, we can paste them below and people can check them out. Just shoot me in the email with anything you’d like us to include.
Dave: Thank you Becca.
Rebecca: You're welcome. Hopefully we’ll see you soon.
Dave: Bye.
Rebecca: Bye.
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