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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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Author information

Authors and Affiliations

  1. Department of Speech and Hearing Sciences, Washington State University Spokane, Box 1495, 310 N. Riverpoint Blvd, Spokane, WA, 99210, USA

    Elise M. Benadom & Nancy L. Potter

Authors
  1. Elise M. Benadom
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  2. Nancy L. Potter
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Corresponding author

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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