Clinical Vestibular Competency Course
The Johns Hopkins University Clinical Vestibular Competency Course is designed for rehabilitation specialists (physical and occupational therapists) and clinicians who have a strong interest in vestibular pathology and rehabilitation. This intensive course includes a robust online curriculum with an option to attend additional three-day in-person training that offers an opportunity to practice your skills and get certified.
On this page:
Course Overview | Faculty | Core Curriculum | Elective Curriculum | In-person Curriculum | FAQs
Course Options
Hybrid Course – Online Core, Elective and In-person Curriculum
Virtual content: available until November 30, 2024
In-person event dates: September 13 – 15, 2024
Cost: $2,800
Participants get access to our core and elective virtual lectures as well as a three-day in-person event that includes an option to earn a certificate of competency through knowledge and skill examination.
Virtual Course - Online Core and Elective Curriculum
Virtual content: available until November 30, 2024
Cost: $2,500
Participants get access to our core and elective virtual lectures with no in-person attendance and no testing or certification. Participants receive a certificate of attendance.
Course Overview
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This course is designed for rehabilitation specialists (physical and occupational therapists). We welcome other clinicians who are interested in vestibular medicine and rehabilitation, including nurse practitioners, physician assistants, audiologists and physicians.
We recommend that participants have at least two years of experience managing patients with vestibular dysfunction and have previously studied the anatomy, physiology and pathophysiology of the vestibular system.
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Upon completion of this course, participants will be expected to:
- Understand and explain anatomy and physiology of the vestibular system.
- Explain and interpret the clinical significance of diagnostic studies, lab data, physical assessments and interview data obtained from medical records.
- Explain and identify signs and symptoms of vestibular dysfunction and be able to appropriately refer to a different provider when necessary.
- Identify therapeutic management for vestibular dysfunction including medications and diet and surgical procedures.
- Identify red flags related to central dysfunction and understand how to address them.
- Formulate care plans for people with vestibular dysfunction based on medical records, vestibular testing and physical evaluation.
- Demonstrate appropriate interdisciplinary care communication and collaboration.
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Participants are expected to improve their abilities in the following:
- Skillful performance of oculomotor examination
- Identification of central and peripheral causes for nystagmus
- Interpretation of nystagmus patterns suggestive of pathology
- Differentiation of BPPV type with the appropriate treatment considering:
- Canalithiasis vs. cupulolithiasis
- Anterior, posterior and horizontal canal
- Rehabilitative management for unilateral and bilateral vestibular dysfunction
- Understand the neuro-otologic approach for surgical management of various vestibular disorders (i.e., Meniere’s Disease, superior semicircular canal dehiscence)
- Understand the rehabilitative and medical management for central vestibular disorders (i.e. traumatic brain injury, migraine).
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This course offers three types of content, online core, online elective and in-person curriculum. The Maryland State Physical Therapy Board has approved the hybrid course option (online and in-person) for up to 4.63 CEUs. The CEUs for each of these curriculums are:
- Online content: 2.88 CEUs
- Core: 1.81 CEUs
- Elective: 1.07 CEUS
- In-person content: 1.75 CEUs
- Lecture and lab: 1.1 CEUs
- Testing: 0.65 CEUs
- Online content: 2.88 CEUs
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The competency certification test is a knowledge-based written examination, which includes case presentations, a visual examination of oculomotor videos and a practical/skills examination. These examinations will be based on the online core and in-person content.
Participants will be provided with a certificate of competency if they attend and complete the online and in-person courses, including the examinations. A certification of attendance will be provided for the virtual-only course option or for those who do not successfully pass the examinations.
The competency certification indicates a successful didactic and psychomotor demonstration of clinical assessment and treatment skills for common vestibular disorders. The competency certification does not certify that the participant retains those skills and knowledge or applies them appropriately in the future.
Course Faculty
- Michael Schubert, P.T., Ph.D., F.A.P.T.A. | Course Director
- Daniel Ludwig, P.T., D.P.T., N.C.S. | Assistant Course Director
- Allison Nogi, P.T., D.P.T., N.C.S. | Founding Course Director
- Yuri Agrawal, M.D. M.P.H.
- Kathleen Bechtold, Ph.D.
- John Carey, M.D.
- Brittaney Colebank M.O.T., O.T.R./L., B.C.P.R., C.B.I.S.T.
- Hayley Cook, P.T., D.P.T., N.C.S.
- Allison Dale, P.T.
- Monique DeLuca, P.T., D.P.T., O.C.S.
- Megan Drews, P.T., D.P.T., P.C.S.
- Elizabeth Fracica, M.D., M.P.H.
- Daniel Gold, D.O.
- Colin Grove, P.T., Ph.D.
- Carolyn Jenks, M.D.
- Amir Kheradmand, M.D.
- Gina Kim, M.O.T., O.T.R./L., C.B.I.S., C.S.R.S.
- Andrea Lasner, P.T., D.P.T.
- Jennifer Millar, P.T., M.S.
- David Mueller, P.T., D.P.T., O.C.S.
- Aleesha Shaik, M.D., M.P.H.
- Mark Shelhamer, Sc.D.
- Anne Spar, P.T., N.C.S.
- Nana Tevzadze, M.D., Ph.D.
- David Zee, M.D.
Frequently Asked Questions
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Courses are available through November 30, 2024. We recommend completing the online content before attending the in-person portion of the course in September.
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Registration for the hybrid course option ends on July 31, 2024.
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The course is held at The Johns Hopkins Hospital at 1800 Orleans Street, Baltimore, Maryland 21287 in the Chevy Chase Auditorium/Arcade.
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Parking is available at the Orleans Street Garage (1795 Orleans Street, Baltimore, Maryland 21287). The cost of parking will not be reimbursed, please reference the parking garage rates to estimate your expense.
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There is a Residence Inn Baltimore by Marriott located near the hospital with a room block available at a discounted rate for the first 30 guests: Residence Inn Baltimore by Marriott. There are also several hotels available in the Inner Harbor, Fells Point and Harbor East areas.
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To receive a competency certificate, you must pass a written exam, video exam and a practical exam on September 15.
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You need to register for the course with your respective state board of physical therapy or occupational therapy to claim CEUs. A course syllabus will be provided online to assist with obtaining CEUs. Maryland State Physical Therapy Board has approved the hybrid course option (online and in-person) for up to 4.63 CEUs.
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Dress code is casual and comfortable. Participants attending in person will be expected to practice and demonstrate common examination and treatment techniques, so please dress accordingly.
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Groups of three or more registrants from the same institution may receive a group discount of $500 per registrant. Students may receive a student discount of $250 per registrant upon providing proof of being a student. For more information on group or student rates, or to request the discount, please email [email protected].
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The course takes place over three days. The first day (Friday) will take place from 1 p.m. to 5 p.m. with an optional social event with the course instructors scheduled from 5 p.m. to 7 p.m. The second day (Saturday) will take place from 8 a.m. to 5 p.m. The final day (Sunday) will take place from 8 a.m. until 4 p.m. The first two days are reserved for lectures and lab, and the examinations will be held on the third day. Breakfast and lunch will be provided on Saturday and Sunday.
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Baltimore is a vibrant city with excellent food and art scenes. Get ideas for things to do during your visit.
Core Curriculum
Lecture | Length | Faculty | Description of lecture |
Introduction to Vestibular Course, Anatomy and Physiology | 1 hour, 14 minutes | Michael Schubert | Overview of the anatomy and physiology of a healthy vestibular system. Students are expected to use this as a foundation to understand vestibular pathology and symptom presentation in a dysfunctional inner ear. |
Pathophysiology of the End Organ (etiology and signs/symptoms)—Otolaryngology | 42 minutes | John Carey | Symptoms and disease processes of the inner ear that result in dizziness and imbalance. |
History and Clinical Exam for Dizziness | 1 hour, 20 minutes | David Zee | Using the clinical exam and subjective history to distinguish pathology. |
Understanding Vestibular Function Tests | 1 hour, 21 minutes | Michael Schubert |
Overview of vestibular testing and how to interpret tests and apply them to treatment. |
HINTS+/Triage in the ED | 32 minutes | Daniel Gold | Overview of the oculomotor exam and HINTS+ exam with link to pathophysiology when aberrations are observed. Discussion on the importance of ED triage program for dizziness. |
Understanding Eye Movements and Nystagmus | 52 minutes | Daniel Gold | Identifying nystagmus patterns and abnormal eye movements and linking observed eye movements to disease process. |
BPPV | 1 hour, 49 minutes | Allison Nogi | Define what BPPV is and why BPPV occurs. Review of the anatomy of the inner ear, types of BPPV and basic treatment. This lecture will focus on canal jam, light cupula and apogeotropic variants. |
Central Disorders based on Neuroanatomy | 58 minutes | Amir Kheradmand | In-depth lecture on pathology based on the anatomy of the brain and resulting vestibular symptoms. |
Vascular causes for dizziness (Stroke) | 58 minutes | Elizabeth Fracica | Stroke and vasculature impairments result in dizziness and imbalance. |
Concussion | 58 minutes | Allison Nogi | Overview of the pathology of concussion and its influence on the vestibular system. |
Gait Dysfunction in Dizzy Patients | 1 hour, 24 minutes | Colin Grove | Discussion on common gait impairments observed. |
Physical therapy management for unilateral and bilateral hypofunction | 41 minutes | Hayley Cook | Discussion on best evidence-based practice for individuals with UVH or BVH. Case-based approach. |
Physical therapy management for motion sensitivity | 45 minutes | Daniel Ludwig | Discussion on best evidence-based practice for individuals with PPPD/motion sensitivity. Case-based approach. |
Physical therapy management to the dizzy patient—Central Dysfunction | 51 minutes | Jennifer Millar | Discussion on best evidence-based approach and practice for individuals with Ataxia and individuals with dizziness related to central dysfunction. |
Neuropsychology Approach to the Dizzy Patient | 52 minutes | Kathleen Bechtold | Discussion on the influence of Neuropsychology on the perception of dizziness. |
Facilitating improvement in complex vestibular patients | 1 hour, 21 minutes | Michael Schubert, Allison Nogi, Colin Grove, Jennifer Millar, Hayley Cook, Daniel Ludwig | Case-based approach to complex patients with a history of dizziness. Using multi-faceted approaches to facilitate patient success. (PPPD, Migraine, Post-Concussion Syndrome, Central Dysfunction). |
3PD and Migraine | 1 hour, 41 minutes | Colin Grove, Nana Tevzadze | Discussion on the treatment and diagnosis of Persistent Postural Perceptual Dizziness and Vestibular Migraine—how these diagnoses can overlap and the differences between these conditions. |
Elective Curriculum
Lecture | Time | Lecturer | Description |
Cervicogenic Dizziness—Influence and management | 53 minutes | Allison Dale | In-depth discussion on the cervical spine and appropriate treatment using various techniques. |
Pediatric Dizziness | 45 minutes | Carolyn Jenks | Overview of pediatric dizziness. |
Introduction to Pediatric Vestibular Rehabilitation | 58 minutes |
Megan Drews | Overview of pediatric dizziness, role of vestibular therapy in the pediatric population and description of evidence-based treatment strategies for this population. |
Pharmacology and dizziness | 49 minutes | Aleesha Shaik | Overview of common medications to treat dizziness and the influence of polypharmacy. |
Building a vestibular clinic—introduction to the VeRT Model | 38 minutes | Allison Nogi | Description of how vestibular PTs can assist with triage and promote efficient medical utilization. |
Applied Vestibular Physiology with Reference to the Common Vestibular Diagnoses | 47 minutes | John Carey | Discussion on SCDS—In-depth view on surgery procedures and what the consequences of surgery are for the patient and the rehabilitation specialist. |
Vestibular influence on Space Flight—areas of growth into commercial space flight | 36 minutes | Mark Shelhamer | Discussion on how vestibular rehabilitation will play a role in understanding how anti-gravity environments change the vestibular system. |
Virtual Reality with Vestibular Rehabilitation | 28 minutes | Hayley Cook | Discussion on how to incorporate virtual reality to promote normalized vestibular function and the evidence behind VR. |
Update the literature—what is on the horizon in vestibular rehabilitation | 66 minutes | Anne Spar | Discussion on where the future of vestibular rehabilitation lies. |
Dizziness in the Acute Care setting | 44 minutes | Daniel Ludwig | Discussion on how to incorporate vestibular rehabilitation and triage individuals with dizziness within the acute care setting and ICU. |
Dizziness in Performing Arts | 62 minutes | Andrea Lasner, Monique DeLuca, David Mueller | Implications of vestibular rehabilitation in performers—twisties to disuse disequilibrium after injury. |
Telehealth Vestibular Rehabilitation—Optimizing assessment | 52 minutes | Yuri Agrawal | The evidence behind telemedicine in vestibular rehabilitation and vestibular evaluation. |
Telehealth vestibular rehabilitation—multi case series on best practice and lessons learned | 38 minutes | Michael Schubert, Jennifer Millar, Allison Nogi | Case-based examples on how to effectively use telehealth platforms for individuals with vestibular dysfunction. |
Facilitating mentorship with novice vestibular clinicians | 39 minutes | Allison Nogi, Hayley Cook, Colin Grove, Daniel Ludwig | Discussion on how to integrate vestibular mentorship into clinical settings to strengthen the team and clinic. |
Influence of vision therapy on the “Dizzy Patient” | 55 minutes | Gina Kim, Brittaney Colebank | Discussion on therapy approaches to address patients with vestibular dysfunction and visual perception deficits. |
3 Day In-Person Curriculum — September 13 - 15, 2024
September 13
Time | Lecture/Lab | Instructor |
1:00 - 1:30 p.m. | Registration | All faculty |
1:30 - 1:45 p.m. | Welcome and housekeeping | Michael Schubert |
1:45 - 3:00 p.m. | Oculomotor testing lecture | David Zee |
3:00 - 3:15 p.m. | BREAK | |
3:15 - 4:15 p.m. | Oculomotor testing lab | All faculty |
4:15 - 5:00 p.m. | Eye movement video lab | All faculty |
5:00 – 7:00 p.m. | Social Event |
September 14
Time | Lecture/Lab | Instructor |
8:00 – 8:15 a.m. | Welcome and housekeeping | Michael Schubert |
8:15 – 9:00 a.m. | Posterior BPPV lecture | Michael Schubert |
9:00 – 9:45 a.m. | Posterior BPPV lab (testing and maneuvers) | Michael Schubert, all lab teaching assistants |
10:00 – 10:15 a.m. | BREAK | |
10:15 – 11:00 a.m. | Anterior/Horizontal canal lecture | Daniel Ludwig |
11:00 a.m. – 12:00 p.m. | Anterior/Horizontal canal lab (testing and maneuvers) | Daniel Ludwig, lab teaching assistant |
12:00 – 1:00 p.m. | Lunch | |
1:00 – 1:45 p.m. | Gait and balance assessment lecture | Jennifer Millar |
1:45 – 2:30 p.m. | Gait and balance assessment lab | Jennifer Millar, lab teaching assistants |
2:30 – 2:45 p.m. | BREAK | |
2:45 – 3:15 p.m. | Treatment rationale lecture: UVH/BVH/3PD (gaze, gait, cognitive behavioral) | Hayley Cook |
3:15 – 4:15 p.m. | Treatment rationale lab: UVH/BVH/3PD (gaze, gait, cognitive behavioral) | Hayley Cook, lab teaching assistants |
4:15 – 5:00 p.m. | Case studies and the decision-making process | All faculty |
September 15
Time | Lecture/Lab |
8:00 – 11:00 a.m. | Competency skills testing: oculomotor exam, balance and gait assessment, posterior canal BPPV, horizontal canal BPPV, anterior canal BPPV, UVL/BVL treatments |
11:00 a.m. – 12:00 p.m. | Review, question and answer |
12:00 – 1:00 p.m. | Lunch |
1:00 – 2:00 p.m. | Online video test |
2:00 – 3:30 p.m. | Online written test |
3:45 p.m. | Adjourn |