If a client can do the Q-Sin (scoring better than/less than 8 dB SNR) I wouldn’t complete the BKB. I start with the QSIN – and for clients who scored in the 8-10 dB range or worse, I would follow the Q-Sin with the BKB. I would ask the client to pay attention as I will be "quizzing" them afterwards as to the big differences between the two tests. Afterwards, I’d ask which test was easier, harder, and why? The differences are: Male vs. Female, short sentences vs. longer, cue vs. no cue, slower more deliberate and familiar speech vs. fast more unfamiliar speech etc.
I have given the tests in the sound field at normal speech level with the hearing aids
in vs. out and ask the family to listen in - as it settles the issue that the hearing aids are or are not helping the person hear better. Doing that also lets you set realistic expectations. Afterwards I counseled at length about hearing vs. understanding. This is a great lead in to recommend LACE (if feasible), use of a remote microphone, TV streamer, hearing loops and counseling on the modifications family can make in the interaction with the client (often I would share “Clear Speech and “Communication Strategies” handouts.) I'd counsel family members to talk in the manner of the "BKB presenter" and to get mom’s/dad's attention by getting in the habit of using a "carrier phrase" before speaking.
Some family members who accompanied mom or dad to their hearing appointments made me cringe (often daughters or d-in-l) who wanted me to "fix" mom with hearing aids. They would complain that these new, expensive high tech hearing aids were not working or not any better than the old ones. Yet the daughters would keep talking way too fast, without pausing, or intonation and then when they did talk to mom they raised their voices to an almost anger level, with a tone of annoyance because mom is "just not getting it".
I would keep the Oticon “Clear Speech” brochure handy and hand out HLAA (Hearing Loss Association of America) membership brochures, or extra Hearing Life Magazine copies.