research
I Can Hear and See You When You Wear a Surgical Mask! The surgical face mask is commonly worn in hospitals and other healthcare settings. Its purpose is to provide a protective barrier between the healthcare worker and the patient against airborne liquid droplets during talking, coughing, or sneezing, as well as offering some protection against bodily fluid splashes. While these surgical masks appear to be just paper, they are made with fabric that is breathable and blocks small particles often invisible to the naked eye. But what happens when the patient has a hearing loss in the healthcare setting? Or, what if it’s the other way around and the patient has to wear a mask, while the healthcare worker has a hearing loss? In these situations, the surgical mask now imposes a visual barrier to speechreading (lipreading). It blocks access to the lips, mouth, and teeth. It is this communication issue that has motivated the Association of Medical Professionals With Hearing Losses (AMPHL) to solicit solutions. My involvement in this issue began when I first joined the AMPHL oard of in 2001 and I learned a great deal from the early groundwork of Stacy Cordwell Carroll, RN, Ph.D., a nurse practitioner with a hearing loss. She had written about being able to speechread the words of a patient who could not use her voice to . Around this time, I came across an old clipping from a June 1938 Modern Mechanix magazine featuring a nurse wearing a clear mask alongside the headline, “Surgical Mask Made From Transparent Material.” You might think that after all this time, a transparent mask would be commonplace, but that’s not the case. I began my first research study in the mid-2000s with my colleagues Lisa Lucks Mendel, Ph.D., and Julia Gardino, Au.D. In that study, we explored whether the conventional paper mask distorted the sounds of speech and how well listeners with and without typical hearing could understand recorded sentences against a background of recorded dental office noise. This paper was published in 2008 in the Journal of the American Academy of Audiology.
Visual Cues The 2011 AMPHL conference in Portland, Oregon, was when I first met Jeanne Hahne, RN, MSN, who presented 24
hearing health
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on her vision and invention of a transparent mask. Jeanne wanted to make the healthcare environment friendlier for children who would be able to see the smiles of those wearing the mask. She also realized that such a mask would remove communication barriers for individuals with hearing loss and for individuals who work in noisy settings. Years later, I asked Jeanne if I could study the acoustics and speech understanding of her invention, and that resulted in another publication with Lucks Mende and some audiology students and research associates. In that study, we added a third group of listeners who had severe-to-profound hearing loss, and because of the transparent mask, we were able to compare the groups with no mask, with a conventional mask, and with a transparent mask in both audio-only and audio-visual conditions. This paper was published in 2017, also in the Journal of the American Academy of Audiology. In 2017, Jeanne and I received a technology grant from the National Institutes of Health. We proposed that there was a need to improve communication, minimize communication-related medical errors, and increase patient satisfaction, and that this could be done through the use of a transparent surgical mask. Jeanne worked with a manufacturer to further refine the invention, now called FaceView Mask. I have since completed two additional research studies. The first study was to repeat the 2017 study, but with the FaceView Mask specifically, and the second study was to give some health professionals and student trainees the opportunity to provide their feedback while using the FaceView Mask in real world or simulated clinical settings. Results are underway and will hopefully be published in the near future. (FaceView is the mask that we used in our research, but it is not the only transparent mask available.)
Studying the Effects Combined, our studies have revealed a number of interesting findings. First, the conventional paper and transparent masks do affect the sound quality slightly, but not enough to affect speech understanding. Typical hearing listeners generally performed quite well whether there was no mask, the conventional mask, or the transparent mask even when noise was also present.
photo credit: ben krain, university of arkansas little rock communications
By Samuel R. Atcherson, Ph.D.
