Abstract
Fiberoptic endoscopic evaluations of swallowing (FEES) is as important of a swallowing evaluation as the videoflouroscopic swallow study, but far fewer speech-language pathologists are competent in its use (Ambika, Datta, Manjula, Warawantkar, & Thomas, 2019; Brady & Donzelli, 2013; Pisegna & Langmore, 2016). One hurdle in FEES training is the necessity of practicing transnasal endoscopy on volunteers. The primary aim of this study was to compare the learning effectiveness of practicing transnasal endoscopy via simulation with practice in vivo for a student’s first passes of the endoscope. The end goal of this study was to determine the most cost-effective and feasible means of teaching transnasal endoscopy to graduate clinicians. Twenty-one graduate students practiced transnasal endoscopy in one of three conditions: in vivo, high-fidelity lifelike simulation, low-fidelity non-lifelike simulation. The learning outcomes assessed were speed of endoscopy, student confidence, and simulated patients’ comfort and perception of student skill. There were no significant differences between conditions found for any of these measures. Students in all conditions became more confident after practicing endoscopy, and that confidence was predictive of procedure time. The results of this study indicate that practice with simulation may be an important first step in teaching endoscopy.
Highlights
Fiberoptic endoscopic evaluation of swallowing (FEES) has been considered a “gold standard” in dysphagia evaluation alongside videofluoroscopic swallow studies (VFSS) (Brady & Donzelli, 2013; Heijnen et al, 2020; Hiss & Postma, 2009 )
In a 2015 study conducted of Australian speech-language pathologists (SLPs) practicing in the field of dysphagia, 24 percent had completed post-graduate competencies in VFSS, but only eight percent were competent in FEES (Vogels et al, 2015)
Though twenty-one participants volunteered to participate in the study, two participants chose not to complete the test phase of the study
Summary
Fiberoptic endoscopic evaluation of swallowing (FEES) has been considered a “gold standard” in dysphagia evaluation alongside videofluoroscopic swallow studies (VFSS) (Brady & Donzelli, 2013; Heijnen et al, 2020; Hiss & Postma, 2009 ). Despite its comparable importance as a diagnostic tool, the use of FEES lags behind VFSS, and fewer speech-language pathologists are competent in this assessment. In a 2015 study conducted of Australian speech-language pathologists (SLPs) practicing in the field of dysphagia, 24 percent had completed post-graduate competencies in VFSS, but only eight percent were competent in FEES (Vogels et al, 2015). A smaller, more recent study found that fewer than half as many SLPs perform FEES when compared with VFSS (Cimoli et al, 2019). SLPs attribute the restricted use of FEES exams to the limited number of clinicians trained to complete the assessment (Rumbach et al, 2018)
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