Competency Performance Checklist

Assessing Ears

Student: Date:___________________

Skill Competency
Demonstrated
Yes No
Preparation
1. Introduce self and verify client’s identity.
2. Explain the procedure to the client.
3. Gather the appropriate equipment (gloves, tuning fork, and otoscope).
4. Perform hand hygiene and observe other appropriate infection
prevention procedures.
5. Provide for client’s privacy.
6. Position the client appropriately.
External Ear Structures
1. Inspect the auricle, tragus, and lobule for size and shape, position,
lesions/discoloration, and discharge.
2. Palpate the auricle and mastoid process for tenderness.
Otoscopic Examination
1. Inspect the external auditory canal with the otoscope for discharge,
color and consistency of cerumen, color and consistency of canal walls,
and nodules.
2. Inspect the tympanic membrane, using the otoscope, for color and
shape, consistency, and landmarks.
3. Have the client perform the Valsalva maneuver, and observe the center
of the tympanic membrane for a flutter. (Do not do this procedure on
an older client, as it may interfere with equilibrium and cause
dizziness.)
Hearing and Equilibrium Tests
1. Perform the whisper test by having the client place a finger on the
tragus of one ear. Whisper a two-syllable word 30.4–60.9 cm (1–2 ft)
behind the client. Repeat on the other ear.
2. Perform the Weber test by using a tuning fork placed on the center of
the head or forehead and asking whether the client hears the sound
better in one ear or the same in both ears.
3. Perform the Rinne test by using a tuning fork and placing the base on
the client’s mastoid process. When the client no longer hears the
sound, note the time interval, and move it in front of the external ear.
When the client no longer hears a sound, note the time interval.
4. Perform the Romberg test to evaluate equilibrium. With feet together
and arms at the side, close eyes for 20 seconds. Observe for swaying.
Completing the examination
1. Tells the patient the results of the examination and asks if there are
any questions.
2. Washes hands (alcohol or soap).
3. Document findings.
Final Score /18
Comments:

Overall Performance: Satisfactory Unsatisfactory

Instructor:__________________________________