Goal-setting in audiology: where practice aligns with, or falls short of, best practice.

OBJECTIVE: To examine how clinical goal-setting is used in routine audiological practice and the extent to which practice aligns with evidence-informed elements of person-centred goal-setting. DESIGN: Multi-method exploratory study comprising semi-structured interviews, in-clinic observations, and an international online survey. STUDY SAMPLE: Survey responses from 97 hearing health professionals from 16 countries; interview transcripts from eight audiologists; observations from 12 adult hearing assessment appointments conducted by four audiologists. RESULTS: Goal-setting was widely endorsed as best practice in audiological rehabilitation, with the Client Oriented Scale of Improvement commonly used to structure discussions. However, findings identified several convergent barriers to effective goal-setting: clients were not consistently active partners and were often unaware of formal goals; clinicians reported difficulty eliciting specific, personally meaningful goals, particularly with communication or cognitive barriers; time pressure constrained goal discussions; structured tools to support goal elicitation and client access to goals were limited; goals were frequently documented but not used as an ongoing rehabilitation focus. CONCLUSIONS: Goal-setting in audiology is practised frequently but appears to be enacted inconsistently as an iterative rehabilitation process. Strengthening client ownership, goal specificity, strategy planning, and structured review would likely improve its clinical utility.