Assistive Technology Transfer Update

Abstract

The Rehabilitation Engineering Research Center on Technology Transfer (T²RERC) seeks to develop best practices in Technology Transfer. The "Stakeholder's Forum" is a critical step in the Demand Pull Project. To improve the effectiveness of Forum protocols, surveys are taken before, during and after each discussion group and following the conclusion of the overall forum. This information is used to improve protocols used in subsequent forums. Lessons learned from the Stakeholder's Forum on Hearing Enhancement were used to improve the Stakeholder's Forum on Communication Enhancement.

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Full Text

The Stakeholders Forum on Hearing Enhancement and Assistive Listening systems is the second in a series of professional forums sponsored by the Rehabilitation Engineering Research Center on Technology Transfer [T²RERC] to support our Demand-Pull project. This year's Forum was another success, an experience gratifying to participants and hosts alike. It was designed in the basic mold of last year's Stakeholders Forum on Wheeled Mobility, with refinements from evaluations of that event.

The Forum, held this past June at the Crowne Plaza La Guardia Hotel in New York City, brought together 62 participants –each one expert in an aspect unique to Hearing Assistive Technology. They represented product customers - end-users with disabilities, clinicians and caregivers; manufacturers (product producers); researchers (advanced technology producers); and funding agencies (resource providers). The Forum's purpose? To bring the stakeholders' multiple perspectives into effective interaction, enabling them to systematically discuss issues surrounding current hearing technologies, and to identify valid technology needs expected to advance the state of the practice in hearing enhancement products.

Before the Forum:
Quality assurance is vital for ongoing refinement and consolidation of best practices in any project. In the broader context, the Stakeholder Forum processes represent our current understanding of best practices for the Demand-Pull model of technology transfer, tested in actual use. Assuring the quality of the Forum process and outcomes, and observing these best practices in action, are integral parts of our project activity.

To achieve the targeted outcomes at the desired quality level, we must ensure the quality of the inputs that produce them. We began our systematic approach far in advance of the Forum itself. During the months prior to the Forum, manufacturing, research, clinical and consumer experts on hearing enhancement provided input through interview sessions conducted by the T²RERC. These sessions explored the current status of product features and functions, and focused on the capabilities of their underlying technologies. Analysis of this information, along with a literature review, allowed us to identify about twelve potential topics in need of further exploration. Then, working with our partner, RERC on Hearing Enhancement (Hearing-RERC) at the Lexington Center for the Deaf in New York City, we selected the four Technology Areas deemed most important for making significant advancements in the state of the technology underlying hearing enhancement devices. The Hearing-RERC then helped us develop the "white-papers" for each Technology Area. These white papers present the current state of knowledge and practice for each of the four selected Technology Areas. All Forum participants received the white papers in advance so they arrived with the same current knowledge about each Technology Area. Trained moderators from the T²RERC led the discussions at the Forum by the larger and more diverse group of stakeholders. Their varied perspectives generated the consensus statements needed to create Problem Statements, the intended outcomes of the Forum.

At the Forum:
Participation in the Forum was strictly by invitation. Our sixty-two invitees included: advanced technology developers, consumers, nationally and internationally known researchers, hearing enhancement product manufacturers, clinical and technical experts, and experts in third-party reimbursement. Participants brought specific knowledge about hearing aid technology and assistive listening systems, their underlying technologies, or their application and use.

The discussions concentrated on the four Technology Areas:

1. Earmolds,
2. Infrared and Inductive Loop Systems,
3. FM and Related Technology,
4. Microphone Technology.

Structured after last year's Forum, we conducted four sessions simultaneously each day, corresponding to the four Technology Areas. Thus there were two sessions for each Area, one on each day. Participants took part in two different sessions, one on each day, depending on their expertise and interest. The interactions were highly structured, with moderators using pre-prepared scripts to guide the discussions. One scribe recorded notes on a personal computer for reference and display, another recorded points on a flip chart, and a technical consultant aided the moderator. To ensure that our participants with hearing-impairments could fully engage in the discussions, each room had a CART system for real-time captioning, and an assistive listening system with microphones near all the participants and receivers for each hard-of-hearing individual. The room layouts ensured that there were no visual barriers between speakers for ease of lip-reading. For each Technology Area, the consensus that emerged from the discussions of the two sessions were systematically merged, summarized and reported at a general session at the end of the Forum.

Our "on-site" evaluation is an important part of the Forum. A team of two evaluators made direct observation of the interactions at every session, circulating from room to room, and recording the unique features of each session. We used a formal checklist to observe what styles the moderators used, the way they employed the audio-visual aids, and how effectively their team coordinated its roles to monitor discussions, clarify technical content and summarize key points. We carried observations back and forth between live sessions, reinforcing their strengths and correcting process errors.

Participant stakeholders evaluated the quality of each individual session against their own expectations, using a survey form. We analyzed their responses and comments at the end of the day and fed them back to the moderating teams immediately, enabling them to modify their second-day sessions in accordance with the needs perceived on the first day. The participants' insights into our strengths and weaknesses during the Forum enabled us to monitor the processes, improve them while they were still being conducted, and keep them appropriately focused and directed. Stakeholders also made final evaluations of the Forum using a separate survey at the conclusion.

Best practices in focus: what was different this year?
We acknowledged the success of our Wheeled Mobility Forum last year, but we also pledged to further improve our process and outcomes. We incorporated valuable suggestions to improve this year's Forum in five ways:

1. We maintained and strengthened our structured format for the sessions. In particular, we refined the scripts and trained the moderators in their use. Bringing scripts to a more standardized form helped our two new moderators – one a stronger subject matter expert and the other a more experienced facilitator – to be on track at various points.

2. In the interest of drawing their best contributions, we included a pre-training session for our consumer participants using a format that simulated the sessions.

3. We expanded our consumer recruitment efforts to include participants who were not only "information-rich" (expert) consumers, but also articulate contributors.

4. We strove for better technical/laymen communication, both by training our moderators and by appropriate room layout at the sessions.

5. We selected a better venue for this year's Forum. Having all meeting rooms on a single floor made a big difference in accessibility also for our own project staffers who had functional limitations.

Stakeholders Evaluate the Forum:
In all, 52 to 57 participants consistently filled out the evaluation forms expressing their satisfaction levels about the session they attended and making additional comments. They evaluated them for: content (topics relevant? discussions deep enough?); purpose (achieved?); and personal satisfaction (felt comfortable? able to contribute?). Overall perceptions were very positive about all sessions. Evaluations varied due to participant mix and differences in moderator styles. They ranged from reasonably satisfactory (3.4 points on a 5 point scale) to highly satisfactory (4.9 points). Two moderators scored higher ratings the second day, and the other two scored higher on the first day. On the whole, moderators got higher average ratings than last year – ranging from 4.1 to 4.5, [compared to 3.8 to 4.2 from last year].

Besides enriching its outcomes, we expected that the participant stakeholders would also benefit from the Forum through: exposure to the state-of-the-art technology; networking opportunities – in particular business partnerships and collaborations; untapped business opportunities; and shaping the future of the hearing aid and assistive listening industries. The perceptions of the stakeholder groups this year were not much different from those of last year's in this regard. Different stakeholder groups valued different aspects of the Forum as its strength, but the opportunity to network with, and learn about, the ideas of other stakeholder groups was upheld as the Forum's strength by all groups. Thirty-nine (39) out of the 45 survey responses (about 87%) indicated this as a benefit from the Forum. Networking and quality of the interactions also made a repeated appearance in the open-ended comments participants made pointing to forum strengths.

Next in order to networking was "exposure to new or innovative technology" acknowledged as a benefit by thirty (or two-thirds) participants. In terms of proportions, this included most (10 out of 12) technology producers, over half (12 out of 19) of customers, so also (6 out of 11) of manufacturers and 2 out of the 3 attending resource providers. "Being able to identify direction for new product development" (58%), "being able to identify need for new technology" (50%) and "being able to identify new business opportunities" (one-third) were next, in that order.

Participant evaluations of the organization of the Forum were higher than last year. Rating averages were 4.7 points (vs. 4.1 last year) for adequacy of the facilities; 4.8 points (vs. 4.0 last year) for accessibility of the facilities; and 4.6 points (vs. 4.2 last year) for background information provided by the white papers. It is worth noting that the need to emphasize accessibility arrangements was one of the suggestions from our last year's feedback.

In-house Input and Informal Observations:
In addition to the formal observation by the evaluation team, there were also informal observations reported by the organizers. The spontaneous comments they captured from the stakeholders outside the sessions corroborate the above results. These comments described the various activities of the Forum with remarks such as: "the most focused meeting, with the clearest objectives"; "the most constructive group meeting [he] had ever participated in"; "the mix of stakeholders provided a level of insight not previously encountered"; and "the sessions were illuminating". The perception on the whole was that the entire program was well run and conducted in a professional manner. Most of the specific comments mentioned as "strengths" of the Forum reflected our best practices, improved from last year, reinforcing our decision to incorporate them. On the other hand, we derived "lessons" from this year's experience in the constructive suggestions some participants made about our practices.

Self-evaluative feedback from project staff, including the moderators, scribes, evaluators and on-site technical team, also pointed to a high level of satisfaction on everyone's part. It reinforced both features that we maintained and those we improved from last year. At the same time, we acknowledge and appreciate several constructive comments related to improving the process further. The comments related to: recruiting consumers earlier; making white papers available earlier to participants; better attendance keeping; optimal room and group size; improved survey administration; effective flip-chart work; eliciting better input from the partner RERC; making more time available for discussions as well as for report preparation; and participant cost-reimbursement policies.

Epilogue
As the old adage goes, "The proof of the pudding is in the eating." Back at the T²RERC, Problem Statements are now in development, using the rich material generated at the Forum. We are grateful to: our project sponsor, the National Institute on Disability and Rehabilitation Research (NIDRR): our partner RERC on Hearing Enhancement at the Lexington Center for the Deaf/School for the Deaf in Queens, New York; our co-sponsor, the Northeast Region of the Federal Laboratory Consortium; the Research Triangle Institute (RTI) that provided us expertise on technology transfer from the federal labs; and, in a very special way, all of the stakeholders who participated in the Forum

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