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The Use of Simulation in Training Graduate Students to Perform Transnasal Endoscopy

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Abstract

A challenge facing the field of speech-language pathology is how to equip students at the university level with the transnasal endoscopy skills needed to perform fiberoptic endoscopic evaluation of swallowing (FEES). The use of simulation has the potential to allow students to gain transnasal endoscopy experience with repetitive practice without compromising patients. The present study examined the effects of two different forms of simulation training on multiple transnasal endoscopic passes on healthy volunteers by graduate student clinicians as measured by procedure duration and confidence ratings. Eighteen speech-language pathology graduate student clinicians were randomly assigned to groups that utilized either a human patient simulator (HPS) or a non-lifelike simulator for transnasal endoscopy training. Using a flexible nasal endoscope, each clinician performed seven training passes on a simulator and one pass on two different volunteers. Each volunteer was endoscoped two times, once by a clinician trained using a HPS and once by a clinician trained using a non-lifelike simulator. There was no difference in pass times on volunteers between clinicians trained using the HPS and clinicians trained on the non-lifelike simulator. Both training groups were faster and more confident on the second endoscopy on a volunteer than on the first.

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References

  1. American Speech-Language-Hearing Association (2005) The role of the speech-language pathologist in the performance and interpretation of endoscopic evaluation of swallowing: position statement, 2005. Available at www.asha.org.

  2. Langmore S, Logemann J. After the clinical bedside swallowing examination: what next? Am J Speech Lang Pathol. 1991;1:13–20.

    Google Scholar 

  3. American Speech-Language-Hearing Association (2007) Graduate curriculum on swallowing and swallowing disorders—adult and pediatric dysphagia: technical report, 2007. Available at www.asha.org.

  4. American Speech-Language-Hearing Association. Knowledge and skills for speech-language pathologists performing endoscopic assessment of swallowing. ASHA Suppl. 2002;22:107–12.

    Google Scholar 

  5. Ziv A, Small S, Wolpe P. Patient safety and simulation-based medical education. Med Teach. 2000;22:489–95.

    Article  Google Scholar 

  6. Good M. Patient simulation for training basic and advanced clinical skills - Suppl 1. Med Educ. 2003;37:14–21.

    Article  PubMed  Google Scholar 

  7. Usón J, Calles MC. Design of a new suture practice card for microsurgical training. Microsurgery. 2002;8:324–8.

    Article  Google Scholar 

  8. Okuda Y, Bond W, Bonfante G, McLaughlin S, Spillane L, Wang E, Vozenilek J, Gordon JA. National growth in simulation training within emergency medicine residency programs, 2003–2008. Acad Emerg Med. 2008;15:1113–6.

    Article  PubMed  Google Scholar 

  9. Bray B, Schwartz CR, Weeks DL, Kardong-Edgren S. Human patient simulation technology: perceptions from a multidisciplinary sample of health care educators. Clin Simul Nurs. 2009;5:e145–50.

    Article  Google Scholar 

  10. Cass OW, Freeman ML, Peine CJ, Zera RT, Onstad GR. Objective evaluation of endoscopy skills during training. Ann Intern Med. 1993;118:40–4.

    PubMed  CAS  Google Scholar 

  11. American Speech-Language-Hearing Association (2005) The role of the speech-language pathologist in the performance and interpretation of endoscopic evaluation of swallowing: technical report, 2005. Available at www.asha.org.

  12. American Speech-Language-Hearing Association Special Interest Division 3 (1998) Voice and voice disorders subcommittee. Training guidelines for laryngeal videoendoscopy/stroboscopy. Available at www.asha.org.

  13. Tiffin J. Purdue pegboard. Lafayette, IN: Lafayette Instrument Company; 1999.

    Google Scholar 

  14. Potter P, Perry A. Fundamentals of nursing. 7th ed. Philadelphia: Elsevier Mosby; 2009. p. 220.

    Google Scholar 

  15. Kardong-Edgren S, Starkweather A, Ward L. The integration of simulation into a clinical foundations of nursing course: student and faculty perspectives. Int J Nurs Educ Scholarsh. 2008;5:1–16.

    Google Scholar 

  16. Davis DA, Mazmanian PD, Fordis M, Harrison RV, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence-a systematic review. JAMA. 2006;296:1094–102.

    Article  PubMed  CAS  Google Scholar 

  17. Barnsley L, Lyon PM, Ralston SJ, Hibbert EJ, Cunningham I, Gordon FC, Field MJ. Clinical skills in junior medical officers: a comparison of self-reported confidence and observed competence. Med Educ. 2004;38:358–67.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Nancy L. Potter.

Appendices

Appendix A: Clinician Survey of Fiberoptic Nasal Endoscope Experience

For each question circle only one response

  1. 1.

    I was clear in my instructions to the volunteer.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 2.

    I was confident in approaching the volunteer.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 3.

    I was competent in bracing my hands on the volunteer.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 4.

    I was confident inserting the endoscope into the volunteer’s nose.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 5.

    I was competent in passing the endoscope past the nasal turbinates.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 6.

    I was competent in viewing the pharynx.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 7.

    The volunteer was comfortable during the procedure.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 8.

    I was confident in my ability to pass the endoscope on the volunteer.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 9.

    I was competent in passing the endoscope on this volunteer.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

Answer the following after you have completed the second endoscopy procedure

  1. 10.

    I felt more confident passing the endoscope on:

________ The first volunteer or ________ The second volunteer

Appendix B: Volunteer Survey of Fiberoptic Nasal Endoscope Experience

For each question circle only one response

  1. 1.

    The clinician was clear in giving instructions.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 2.

    The clinician was confident in approaching me.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 3.

    The clinician was confident inserting the endoscope into my nose.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 4.

    The procedure was comfortable.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 5.

    The clinician was confident throughout the endoscopy procedure.

(1) Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

  1. 6.

    The clinician was competent throughout the endoscopy procedure.

  2. (1)

    Strongly disagree, (2) Disagree, (3) Neither agree or disagree, (4) Agree, (5) Strongly Agree

Answer the following after the second endoscopy procedure

  1. 7.

    If you were to be endoscoped again, which clinician would you prefer?

________ The first clinician or ________ The second clinician

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Benadom, E.M., Potter, N.L. The Use of Simulation in Training Graduate Students to Perform Transnasal Endoscopy. Dysphagia 26, 352–360 (2011). https://doi.org/10.1007/s00455-010-9316-y

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  • DOI: https://doi.org/10.1007/s00455-010-9316-y

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