Focus Group Statement
Focus Group Application (Example)
Download Focus Group Application For Your Profession (Microsoft Word document)
FOCUS GROUP STATEMENT
Date Completed: December 2003
Focus Group Ad Hoc Committee:
Samuel R. Atcherson, M.Ed. (Committee Co-Chair)
Danielle N. Rastetter, D.V.M. (Committee Co-Chair)
Candice Corriher Barrere, D.V.M.
PURPOSE
The purpose of this ad hoc committee was to establish guidelines for the disciplines the Association of Medical Professionals with Hearing Losses (AMPHL) will serve and represent, and the ultimate goal was to protect the AMPHL’s original and intended goals. These guidelines needed to be constructed in order to clarify the classification of a medical professional, who will be a representative of the AMPHL. A representative of the AMPHL will fall into at least one of two categories: 1) an officer or board director and/ or 2) a subscriber1 with benefits.
CONSIDERATIONS
There were several questions to consider and these are not listed in any particular order of importance:
1. What is a medical professional with a hearing loss?
A medical professional with hearing loss (MPHL) is an individual with residual activity limitations and participation restrictions2 who works in the healthcare arena. It is expected that all MPHL will have some degree of hearing-related or communicative difficulty in their work settings.
2. Why and for whom was AMPHL created?
Professionals and students with hearing loss in traditional medicine (i.e., medical doctors and veterinarians) primarily founded the AMPHL, and it was designed primarily for the working clinician. In its conception, the AMPHL was intended to assist people working in and interested in professions focused on human and animal health. These professions were expected to have direct hands-on interactions with their human or animal patients. The AMPHL’s goals focus on improving accessibility to professions and within professions for MPHL. It is conceivable that certain MPHL will have greater needs than others and whose needs cannot be met by other existing advocacy organizations (e.g., SHHH, AGBell, and NAD). The AMPHL wishes to serve only those whose needs cannot be met elsewhere, thereby curbing redundancy of services.
3. Who serves on the AMPHL executive board?
According to the bylaws, director and officer positions are held primarily by MPHL, with the exception of three director positions reserved for Resource Staff3. Resource staff directors are individuals who serve special functions that make significant contributions to the initiative of the AMPHL.
4. Does the AMPHL have a membership structure?
There is no formal membership structure at this time; however, a subscribership structure has been developed.
CONCERNS
There were several concerns posed by former and current officers and directors and these are also not in any particular order of importance:
1. Over-diversification
Over-diversifying the subscribership and the executive board may cause the AMPHL to lose sight of its original and intended goals. If the AMPHL adopts a policy of inclusion, the AMPHL executive board may be forced to represent those who are not “working clinicians”. Since the AMPHL was created for the “working clinician” who has direct “hands-on” interaction with the human or animal patient, should the AMPHL also represent those who do not fit these criteria?
2. Under-diversification
Under-diversifying the subscribership and the executive board may cause the AMPHL to become relegated to a resource or website without the need for an active subscribership or executive decision-making board. The implications for adopting a policy of exclusion are such that in 5 to 10 years, many of the obstacles faced by the narrow range of represented individuals will become fewer, or for the most part, resolved. Advancing technology, public education, improvements in accessibility, and progressive acceptance (becoming more the norm) for individuals with hearing loss in health care fields may play a role in this relegation. A final implication of under-diversifying concerns conference participation. The issues that the typical MPHL face involve a lot more than just stethoscopes, school-acceptance barriers, employment barriers, and technological modifications. Other issues include: developments in clinical communication strategies (effective communication), developments in clinical compensatory strategies (how one goes about ensuring effective communication), education about (re)habilitative devices (i.e., interfacing clinical tools with hearing aids and cochlear implants), education about disability with respect to MPHLs, and much more. The AMPHL has the potential to serve many needs across a wide range of healthcare disciplines.
3. Should MPHL in “alternative medicine” be served?
Though we have never had such inquiry or request, it is conceivable that an individual may inquire.
4. How do we regulate the designation of officers and board positions open to MPHL other than physicians and veterinarians and resource staff?
The difficulty here lies in classifying the medical professional and whether certain individuals are appropriate for certain positions (e.g., a clinical researcher in a board position reserved for medical professionals who are not physicians or veterinarians).
5. The AMPHL directors and officers already have significant responsibilities within the organization. How do we meet an inquiring4 profession’s needs while not already overloading the responsibilities of existing officers and directors, especially if existing officers and directors are not intimately familiar with the details of inquiring profession?
If a profession is considered and accepted as a profession in need of the AMPHL’s assistance, the person who made the initial application for consideration will be responsible for being the inquiring profession’s representative. This responsibility includes writing a section of the AMPHL’s website explaining the profession, specific difficulties an MPHL with hearing loss may encounter, and proposed solutions. They may also be contacted to help arrange speakers or displays pertaining to their profession for conferences held by the AMPHL. If the contact person is not performing these responsibilities adequately or has not transitioned them to another representative of the profession who is performing adequately, the acceptance of their profession as one of focus by the AMPHL may be revoked with a majority vote of the executive board.
CLASSIFICATION OF A MEDICAL PROFESSIONAL
The classification of a medical professional is one that will be elusive because there are a number of different terms that have been loosely used and exchanged to describe an individual who works in clinics and conducts clinical work. It was impossible to develop a concrete definition for all of the professionals that will conceivably be represented by the AMPHL. The terms that must be clarified include: clinic, clinical, clinician, healthcare, medical, specialist, technician, and therapist. Below are the basic definitions:
Clinic (Origin: Greek; bed) – 1) an institution, building, or part of a building where ambulatory patients are cared for, 2) a medical establishment run by several specialists working in cooperation and sharing the same facilities, 3) a group session offering counsel or instruction in a particular field or activity, and 4) a seminar or meeting of physicians and medical students in which medical instruction is conducted in the presence of the patient, as at the bedside. A place where such instruction occurs. A class or lecture of medical instruction conducted in this manner.
Clinical – 1) of, relating to, or connected with a clinic, or to the study of disease in the living subject, 2) involving, pertaining to, or founded on actual observation and treatment of patients; “clinical observation”; “clinical case study”, and 3) distinguished from theoretical or basic sciences.
Clinician – 1) a health professional, such as a physician, psychiatrist, psychologist, or nurse, involved in clinical practice and engaged in the care of patients, and 2) distinguished from one specializing in research or working in other areas.
Healthcare - services provided to individuals or communities by agents of the health services or professions for the purpose of promoting, maintaining, monitoring, or restoring health.
Medical - pertaining to medicine or to the treatment of diseases, pertaining to medicine as opposed to surgery.
Specialist – 1) one who devotes himself to some specialty; as, a medical specialist, and 2) one who devotes himself to diseases of particular parts of the body, as the eye, the ear, the nerves, etc.
Technician - one with the knowledge and skill to carry out a specific technical procedure.
Therapist - one professionally trained and/or skilled in the practice of a particular type of therapy.
The AMPHL shall not define the “working clinician”. Rather it shall use a working definition for the term medical professional. With this working definition, consideration of representation of professionals and disciplines in question can be determined.
“Medical professionals are health care clinicians with broad or specialized expertise who are: 1) clinicians involved in direct care, diagnosis, treatment, remediation, consultation, and prevention of human or animal patient diseases and disorders, 2) clinicians involved in supervised care, diagnosis, treatment, remediation, consultation, and prevention of human or animal patient diseases and disorders (e.g., assistants), or 3) health care technicians whose work is an integral part of the well-being of a human or animal patient. A clinician or technician who conducts research, in addition to performing clinical or technical responsibilities, shall continue to be recognized as a clinician or technician.”
There are many disciplines under which a medical professional will fall; however, the AMPHL chooses to focus specifically on disciplines whose hearing-related accessibility issues and specific hearing-related needs that cannot be met by existing advocacy organizations. Accessibility issues include individuals with hearing loss engaged in clinical environments and training institutions, and individuals with hearing losses using tools and equipment that may hinder, prevent, or impede one from conducting their responsibilities optimally and accurately. Some specific areas of interest include: amplified, electronic, and visual stethoscopes; see-through surgical masks; and various methods for obtaining and assimilating the tremendous amount of information required of medical professionals (e.g., CART reporting, sign language interpreters, assistive listening devices, etc.). Therefore, in addition to classification as a medical professional, an individual or discipline shall have needs that cannot be met by existing organizations.
The AMPHL does not represent individuals whose only primary area of specialty is research (applied or basic). Though a researcher may conduct medical or health research, work in a clinic, and/ or work with a medical team, they do not fit the immediate criteria of a medical professional defined in this document. In this case, there is another organization that meets the needs of researchers with hearing loss: http://www.deafacademics.org.
It will be an impossible and daunting task to compile a list of medical professionals the AMPHL will represent. Therefore, subscribership and executive board positions shall be selectively open until there is question regarding a specific profession and/ or question regarding a request not previously investigated by the AMPHL. The individual or discipline in question shall write a letter or e-mail to a member of the AMPHL executive board for consideration of representation by the AMPHL. In this letter or e-mail, the individual or discipline shall delineate and illustrate how their need(s) are not being met elsewhere, and what the AMPHL can do to meet their request(s). A form is provided below for such request. When the professional or academic need(s) of an individual or discipline can be met by existing organizations, the AMPHL shall refer them to the appropriate organization in a follow-up letter.
The AMPHL shall document all disciplines in two categories: 1) disciplines it represents and 2) disciplines it does not represent. These decisions shall not be permanent, however. It shall be anticipated that a discipline may experience changes in their scope of practice that eventually warrant the assistance of the AMPHL. These disciplines shall be re-considered.
With the exception of the resource staff, only individuals who are medical professionals (as classified by this document) with hearing loss shall serve officer and director positions. There is no obvious contest as to the role of physicians and veterinarians and the executive board positions that they are permitted to serve. Resource staff director positions are somewhat more flexible. Directors who serve in these positions do not have to have a hearing loss and they do not need to be clinicians. Resource staff directors are expected to make significant contributions to the AMPHL according to their specific skills. For example, an audiologist is a hearing specialist who may provide consultation on hearing technology and technological modifications. A disability specialist may provide consultation on hearing disability issues. A lawyer may provide consultation on disability law within the scope of hearing loss and healthcare. Finally, there may be individuals who have specific and unique experiences such as fund-raising, administration, etc. Individuals who are not medical professionals (as classified by this document) and who can make significant contributions to the AMPHL are encouraged to apply for a resource staff director position.
CONCLUSIONS
This document represents the results of the ad hoc committee, which provides some guidelines for the AMPHL representation of subscribers and executive board members. It is not our intent to take an exclusionary position. The primary goal was to protect the AMPHL’s original and intended goals, and subsequently preserve the function and benefits of the AMPHL for the subscribers whom it will serve.
1. The terms “subscriber” and “subscribership” have been adopted to replace the terms “member” and “membership”. The 2001 AMPHL Board elected not to have a formal membership structure at the time of the annual board meeting due to the small infrastructure of the organization.
2. World Health Organization (WHO; 2001) terms “activity limitations” and “participation restriction” were developed to replace “disability” and “handicap”.
3. The label “Resource Staff” was developed to replace the label “Medical Support Staff”.
4. An “inquiring” profession is one whose needs are not currently being served by the AMPHL.
FOCUS GROUP APPLICATION (EXAMPLE)
Request Form for Profession Representation by the AMPHL
We welcome your interest in the AMPHL! You should have already reviewed the above position statement, which provides guidelines for profession representation by the AMPHL. If you have read the statement and believe that your healthcare profession meets the AMPHL’s criteria, we invite you complete the form below for consideration. Your response will be distributed to all officers and directors, and you may expect to receive a response within two to three months. To assist you, we have also included a completed form for audiologists.
a. Does your profession classify itself as “clinicians”? If not, tell us how AMPHL currently does and does not serve your needs.
b. Does your profession have “direct hands-on” interaction with human or animal patients and to what extent.
c. What are the profession’s potential working conditions?
d. What are the potential difficulties (situational and environmental) imposed by hearing loss within your profession?
e. What potential instruments are used in your profession, particularly those which might require the ability to hear?
f. What services can AMPHL provide for this profession that cannot already be provided by other organization such as the Self Help for Hard of Hearing (SHHH), Alexander Graham Bell Association (AGBell), the National Association of the Deaf (NAD), or other similar organizations?
Please also remember that, if your profession is deemed one that meets AMPHL’s criteria, you will be instituted as the contact person for your profession. If you cannot be the contact person, you will need to recommend another representative of your profession. You or the recommended representative will be expected to write a section of the AMPHL’s website explaining your profession, specific difficulties an MPHL with hearing loss may encounter, and proposed solutions. You may also be contacted to help arrange speakers or displays pertaining to your profession for AMPHL conferences. If these responsibilities are not taken and implemented in an adequate and timely manner, the acceptance of your profession for representation by the AMPHL may be revoked with a majority vote of the executive board.
EXAMPLE
Audiology (Audiologists)
a. Does your profession classify itself as “clinicians”? If not, tell us how AMPHL currently does and does not serve your needs.
The field of audiology classifies itself as clinicians. Most refer to themselves as hearing healthcare professionals, but some will refer to themselves as medical professionals (those in medical audiology).
b. Does your profession have “direct hands-on” interaction with human or animal patients and to what extent.
Audiologists are independent practitioners who have their own clients or patients. Audiologists are hearing healthcare specialists who remediate hearing and communication disorders that have no contraindications or waivers from medical doctors. Audiologists see and follow clients or patients throughout the (re)habilitative process.
c. What are the profession’s potential working conditions?
Audiologists work in a number of different settings: schools, hospital clinics, balance clinics, ENT offices, ORs, independent practices, industrial settings, corporate franchise chains, and university clinics. The working conditions may vary from setting to setting and clinic to clinic. With the exception of taking noise measurements in industrial audiology or assessing balance functions, audiologists conduct hearing and electrophysiological tests in quiet environments. Testing requires quiet settings due to measurement of auditory thresholds and word recognition abilities. Audiologists work with a number of instruments, some of which require the ability to hear and some of which do not. In all cases, the ability to hear is necessary for standard audiologic testing. One must be able to make sure their audiometers and earphones work, they must be able to accurately measure verbal responses for speech testing, and they to some extent need to be able to check hearing aids. Some audiologists determine cochlear implant candidacy, which requires careful testing and clinical competency, and they must be able to interact with the cochlear implant patient during programming and rehab sessions. Audiologists will have to know how to operate a computer.
d. What are the potential difficulties (situational and environmental) imposed by hearing loss within your profession?
Because audiology for the most part requires the ability to hear, it is obvious that audiologists with hearing loss may face greater difficulty in training and during their career. There are several issues to consider: 1) potential difficulty with speech testing, 2) if hearing is significant, it may affect their ability to produce speech test materials for client repetition, 3) checking hearing aids, 4) taking phone calls from clients, 5) administering a central auditory processing test battery, and 6) conducting electronystagmography testing when some subtests require the lights off.
e. What potential instruments are used in your profession, particularly those which might require the ability to hear?
Hearing aid test boxes, hearing aid stethosets, hearing aids, calibration equipment, audiometers, immittance bridges, and electrophysiologic equipment. Though many of these do not actually require the audiologist to “hear”, if troubleshooting of instruments is required, the audiologist must be able to perform system checks, which do require them to hear. Periodically, an earphone may be jammed with earwax, a set of earphones unplugged, or even bridges on the audiometers, which provide feedback to the audiologist.
f. What services can AMPHL provide for this profession that cannot already be provided by other organization such as the Self Help for Hard of Hearing (SHHH), Alexander Graham Bell Association (AGBell), the National Association of the Deaf (NAD), or other similar organizations?
Other organizations have solved the problems that plague audiologists with hearing loss, primarily because the instruments that audiologists use are not accessible to these organizations. Therefore, the AMPHL becomes a viable alternative, which is expected to have other audiologists affiliated with AMPHL.
The AMPHL has not received a lot of inquiries from audiologists, primarily because there are so few audiologists with hearing loss severe enough to pose problems. However, because of advancing technology and improvements in (re)habilitation, audiology is now more accessible to potential students with hearing loss. The AMPHL provides social support and encouragement for those who doubt their abilities. The AMPHL hooks inquiring students or audiologists to others audiologists affiliated with AMPHL (myself). The AMPHL may help to answer questions about using hearing aids and adapters with clinical equipment. The AMPHL allows audiologists who are officers, directors, or sponsors to educate others about hearing loss and related topics. The AMPHL currently does not have resources on clinical compensatory strategies. The AMPHL could have a part in developing specialized assistive technology for audiologists with hearing loss that would allow them interface with audiometric equipment. They could partake a grant that would develop audiology training methods for students with hearing loss. The AMPHL could assist in making audiology more accessibly by challenging the professional licensure board to consider waving the speech therapy requirement (requiring audiology students to do a minimum number of hours of speech therapy).
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