Enhancing the learning and supervision framework for training in flexible endoscopic evaluation of swallowing

Delivering a bespoke education programme and learning framework for the integrated speech & language therapy head and neck cancer service across Cheshire and Merseyside, within the UK

PURPOSE OF REVIEW

The Cheshire and Merseyside (C&M) integrated head and neck cancer (HNC) speech and language therapy (SLT) service based in Liverpool in the UK successfully developed and delivered an in house, fast-track education programme for the primary purpose of advancing SLT clinicians from specialist to highly specialist roles to deliver care to the C&M HNC population as part of a novel integrated service. The bespoke curriculum, competency and assessment framework were intensively delivered through a range of workplace-based training.The aim of this review is to share the principles underpinning the developed frameworks.

RECENT FINDINGS

The development of the bespoke SLT HNC education programme and competency framework was informed by Macmillan AHP competencies, the Aspirant Cancer Career Education and Development (ACCEND) programme and with reference to the four pillars of practice as described in the advanced clinical practitioner framework. The C&M framework was centred around evidence based principles of medical education specifically Constructivist Learning theory and included foundation theory teaching, self-directed learning, technical skills mastery, delivered by blended and workplace-based learning events. The assessment framework incorporated peer and clinical supervision, viva and case reviews and workplace-based assessment including Direct Observation of Procedural Skills (DOPS) with entrustable professional activities (EPA).

SUMMARY

The education programme was successful in progressing SLT staff within 18 months to achieve appropriate competencies to deliver a new integrated service across C&M. The detailed competency and assessment frameworks developed spans the whole of the HNC patient pathway. Next steps are sharing the success of this work and further development of the learning programme for C&M and other services.

Training to Analyze Functional Parameters with Fiberoptic Endoscopic Evaluation of Swallowing: A Scoping Review

Analyzing fiberoptic endoscopic evaluation of swallowing (FEES) is challenging and requires training to ensure the proficiency of health professionals and improve reliability. This scoping review aims to identify and map the available evidence on training health professionals to analyze FEES functional parameters. The method proposed by the Joanna Briggs Institute and the PRISMA-ScR guidelines were followed. The search was performed in MEDLINE, Cochrane Library, Embase, Web of Science, Scopus, CINAHL databases, and in the gray literature. Two blinded independent reviewers screened articles by title and abstract. Then, they read the full text of the included reports, considering the eligibility criteria. Data were extracted using a standardized form. Six studies met the established eligibility criteria, published between 2009 and 2022, with few participants. All these studies addressed training as part of the process to validate a rating scale. No standardized criteria were observed regarding the selection of experts and participants, training structure, and outcome measures to assess participants' competence. The reviewed literature indicates that training must be developed to equip students and health professionals who treat dysphagia, enabling them to analyze the functional parameters of the FEES, considering variables that may influence the participants' performance.

Tutorial on Clinical Practice for Use of the Fiberoptic Endoscopic Evaluation of Swallowing Procedure With Adult Populations: Part 1

PURPOSE

Representatives of the American Board of Swallowing and Swallowing Disorders (AB-SSD) and American Speech-Language-Hearing Association (ASHA) Special Interest Group (SIG) 13: Swallowing and Swallowing Disorders (Dysphagia) developed this tutorial to identify and recommend best practice guidelines for speech-language pathologists who conduct and interpret fiberoptic endoscopic evaluation of swallowing (FEES) procedures in adults. This document also includes proposed training needs and methods for achieving competency. Expert opinion is provided regarding indications for performing the FEES exam, potential contraindications, adverse effects and safety, equipment and personal protection, the exam protocol, interpretation and documentation of findings, and training requirements to perform and interpret the exam.

CONCLUSIONS

This tutorial by the AB-SSD and SIG 13 represents the first update about the FEES procedure since ASHA's position paper and technical report published in 2004. Creation of this document by members of the AB-SSD and SIG 13 is intended to guide professionals who are training for or practicing FEES in the adult population toward established best practices and the highest standards of care.

Treinamento para análise de parâmetros da videoendoscopia da deglutição: um protocolo de revisão de escopo

RESUMO Objetivo: apresentar um protocolo de revisão de escopo para identificar e mapear as evidências disponíveis sobre treinamento para a análise de parâmetros da videoendoscopia da deglutição. Métodos: o protocolo seguirá o método proposto pelo Joanna Briggs Institute e as diretrizes PRISMA-P para relato de protocolos de revisão. A busca será feita na MEDLINE, Cochrane Library, Embase, Web of Science, Scopus, CINAHL e literatura cinzenta. Uma estratégia de busca foi desenvolvida para a MEDLINE, que será adaptada para cada base de dados. Dois revisores independentes rastrearão os artigos pelo título e resumo. Em seguida, farão a leitura do texto completo dos artigos incluídos, considerando os critérios de elegibilidade. Os dados serão extraídos com um formulário padronizado. Os resultados serão apresentados em fluxograma e resumo narrativo, seguindo as diretrizes do PRISMA-ScR. Revisão da literatura: há escassez de pesquisas que descrevam métodos de treinamento perceptivo-visual para analisar parâmetros da VED e dados inconsistentes para orientar a tomada de decisão clínica. Esta revisão fornecerá informações abrangentes sobre o desenvolvimento de treinamento para esse tipo de análise. Conclusão: este protocolo de revisão de escopo apresentará o estado geral das pesquisas sobre o tema e identificará as lacunas existentes na base de evidências.

Training for fiberoptic endoscopic evaluation of swallowing parameter analysis: a scoping review protocol

ABSTRACT Purpose: to present a scoping review protocol to identify and map available evidence on training for fiberoptic endoscopic evaluation of swallowing parameter analysis. Methods: the protocol follows the method proposed by the Joanna Briggs Institute and the PRISMA-P guidelines for review protocol reports. The survey will be made in MEDLINE, Cochrane Library, Embase, Web of Science, Scopus, CINAHL, and grey literature. A search strategy has been developed for MEDLINE, which will be adapted for each database. Two independent reviewers will screen the articles by title and abstract. Then, they will read the full text of the included articles, considering the eligibility criteria. The data will be extracted with a standardized form. The results will be presented in a flowchart and narrative summary, following the PRISMA-ScR guidelines. Literature Review: there is a scarcity of research describing visual-perceptual training methods to analyze FEES parameters and inconsistent data to guide clinical decision-making. This review will provide comprehensive information on developing training for this type of analysis. Conclusion: this scoping review protocol will present the overall state of research on the topic and identify existing gaps in the base of evidence.