Amanda Mooneyham, a medical student in the US, is using live captioning* so she is able to take an active part in the learning situation in theatre, on an equal footing with her hearing colleagues.

See this short video.  (If like me you can’t hear it very well, click the CC button for subtitles. Or try the “interactive transcript” button below the screen. I haven’t seen interactive subtitles before. Neat.)

The operating theatre has a live internet link to a speech-to-text reporter (also known as a palantypist) who transcribes everything word for word in the same way a court reporter does. The text is displayed on a tablet computer. Amanda can read what someone in theatre says almost immediately it is spoken.

Amanda says, “the main thing that I use it for is when they are quizzing us in the middle of the procedure, especially questions about anatomy. …. At other points there will be commands like ‘hold this retractor’ or ‘cut this suture.’”

She also uses hearing aids and picks up clues from body language. As she says, “I use visual cues. A lot of times there are posture changes, their hands change or there’s a pause … It’s really a visual game …. Deaf people are visual learners by nature so it’s nice to be able to take part in something that kind of uses our strengths.”

Her tutors want to make sure that all their students have a similar experience, whatever interests, background or disability they may have. “Who knows, Amanda may decide she wants to be a surgeon.” “If she has the motivation, we have to bring in the means.”

What about in the UK? Well, I don’t yet know of someone using speech-to-text in the operating theatre in the UK but some people are using it for some of their training or in conferences. If we don’t ask, we won’t get. So consider asking whether you can have speech to text reporting (STTR) for certain parts of your work and training.

Most commonly, the palantypist joins you wherever you are. Some can also offer remote STTR over an internet connection, as Amanda has in theatre.

Please do get in touch if you have experience to pass on of using STTR. Thanks.

Link to CCAC website

This video was distributed by CCAC, an international group of volunteers advocating better access to captioning and CART (realtime captioning/live speech to text reporting.) They welcome new members and opportunities to collaborate with other organisations and individuals .

*It’s usually called (realtime) captioning in the US and (live) speech to text reporting in the UK.

(Back to article)

• See “stethoscope ear tips and hearing aids,”
• “BTEs with stethoscopes,”
• “stethoscopes with headphones”
• and “stethoscopes with hearing aids.“

In brief, options include:

• removing your hearing aids and using a stethoscope with normal earpieces
• adapted ear pieces or ear moulds
• headphones are often, but not always, possible
• Certain electronic stethoscopes can also be connected using your T switch or direct audio input (DAI) cables. However it is better to use stethoscope earpieces, adapted ear pieces or ear moulds or headphones if possible. These usually bypass hearing aid speakers, which do not have good low frequency response.

See also stethoscopes with hearing aids.

In brief, options include:

• removing your hearing aids and using a stethoscope with normal earpieces.
• adapted ear pieces or ear moulds
• headphones.

Adapted ear pieces and ear moulds can be uncomfortable over ITE aids. They can also give problems with feedback, as can headphones.

If your hearing aids do not have vents, the preferred option is to remove them for auscultation. Otherwise the sounds are being transmitted by your hearing aids. The speakers do not usually have a good low frequency response.

• Certain electronic stethoscopes can also be connected using your T switch. Again, this is not ideal due to the lack of low frequency response.

See also stethoscopes with hearing aids.

In brief, options include:

• removing your hearing aids and using a stethoscope with normal earpieces.
• adapted ear pieces or ear moulds
• headphones are a very convenient and comfortable option.

If your hearing aids do not have vents, the preferred option is to remove them for auscultation. Otherwise the sounds are being transmitted by your hearing aids. The speakers do not usually have a good low frequency response.

• Certain electronic stethoscopes can also be connected using your T switch. Again, this is not ideal due to the lack of low frequency response.

See also stethoscopes with hearing aids.

• If you have open fitting hearing aids, you may not need to do anything: you may be comfortable using normal ear pieces over the domes. Of course check you can hear through the stethoscope and the domes aren’t occluding the stethoscope ear tips. And check the domes and fine tubing aren’t being damaged.

• Special ear tips such as Steth-O-Mates can be used with CIC and sometimes ITE aids. It is sometimes difficult keeping them in the correct position and people occasionally find them uncomfortable. I think people with ITEs tend to have more trouble getting them to stay in place without buckling or feedback. But they don’t cost much and are convenient to use so worth a try. The smaller size fit over CICs and larger over ITE. Specify your make of stethoscope to get the right screw fitting.

• Ear moulds can be used with stethoscopes in different ways. See examples on the Westone website.
  

  Westone style 28B

  • You can have purpose-built ear moulds for your hearing aids, that will accept a stethoscope tip. This may be as simple as carving out a hollow over the vent on your moulds. See here for detailed information about doing this for BTEs.
  • Moulds can also be made that are attached permanently to your stethoscope and worn over CIC and possibly ITE hearing aids. Some people find the pressure on the hearing aids uncomfortable. Similar ear moulds have also been made for BTE users but these seem more likely to suffer from feedback.

Do not use normal headphones with your stethoscope. Heart and lung sounds are at lower frequencies than speech and music. Most headphones do not have a good enough low-frequency response. If you are buying your own headphones, you will need to check the specifications carefully comparing them to headphones provided by stethoscope manufacturers. Sorry, but I don’t know the technical information: of course you need to check which frequencies are amplified but I guess there will also be something about how much those frequencies are amplified. Safer is to buy headphones sold to use with stethoscopes.

I’m only aware of one amplified stethoscope with headphones available in the UK at present, the Cardionics E-scope. A lot of people are using this very successfully. It can be supplied with different models of headphones suitable for different hearing aids and instruments. PMS Instruments has a clear guide about which to choose. If you will be using it in very noisy conditions such as at the roadside, it can be supplied with aviation-style headphones.

The Cardionics E-scope can also be used with the T-switch on your hearing instruments or direct audio input which is a cable that plugs into adaptors on your hearing instruments. You can have the full set for your trial period and return the accessories you don’t want to buy.

The UK supplier I am aware of is PMS Instruments and we have found them very helpful in providing one-month trial period. Cardionics are also very helpful and will advise and answer technical questions. You can also buy the stethoscope direct from Cardionics in the US.

Before you buy: you can probably get substantial (or even 100%) funding through Access to Work or the Disabled Students Allowance. You must have your assessment before you buy as they will not fund in retrospect.