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影响视频荧光吞咽造影检查所需言语病理学技能发展的因素。

Factors that influence development of speech pathology skills required for videofluoroscopic swallowing studies.

作者信息

Edwards Ann, Holm Alison, Carding Paul, Steele Michael, Froude Elspeth, Burns Clare, Cardell Elizabeth

机构信息

School of Health Sciences and Social Work, Griffith University, Nathan, Brisbane, Australia.

School of Allied Health, Australian Catholic University, Banyo, Brisbane, Australia.

出版信息

Int J Lang Commun Disord. 2023 Sep-Oct;58(5):1645-1656. doi: 10.1111/1460-6984.12892. Epub 2023 May 15.

Abstract

BACKGROUND

Perceptual, cognitive and previous clinical experience may influence a novice Videofluoroscopic Swallowing Study (VFSS) analyst's trajectory towards competency. Understanding these factors may allow trainees to be better prepared for VFSS training and may allow training to be developed to accommodate differences between trainees.

AIMS

This study explored a range of factors previously suggested in the literature as influencing the development of novice analysts' VFSS skills. We hypothesised that knowledge of swallow anatomy and physiology, visual perceptual skills, self-efficacy and interest, and prior clinical exposure would all influence VFSS novice analysts' skill development.

METHODS & PROCEDURES: Participants were undergraduate speech pathology students recruited from an Australian university, who had completed the required theoretical units in dysphagia. Data assessing the factors of interest were collected-the participants identified anatomical structures on a still radiographic image, completed a physiology questionnaire, completed subsections of the Developmental Test of Visual Processing-Adults, self-reported the number of dysphagia cases they managed on placement, and self-rated their confidence and interest. Data for 64 participants relating to the factors of interest were compared with their ability to accurately identify swallowing impairments following 15 h of VFSS analytical training, using correlation and regression analysis.

OUTCOMES & RESULTS: Success in VFSS analytical training was best predicted by clinical exposure to dysphagia cases and the ability to identify anatomical landmarks on still radiographic images.

CONCLUSIONS & IMPLICATIONS: Novice analysts vary in the acquisition of beginner-level VFSS analytical skill. Our findings suggest that speech pathologists who are new to VFSS may benefit from clinical exposure to dysphagia cases, sound foundational knowledge of anatomy relevant to swallowing and the ability to see the anatomical landmarks on still radiographic images. Further research is required to equip VFSS trainers and trainees for training, to understand differences between learners during skill development.

WHAT THIS PAPER ADDS

What is already known on the subject The existing literature suggests that no vice Video fluoroscopic Swallowing Study (VFSS) analysts training may be influenced by their personal characteristics and experience. What this study adds This study found that student clinicians, clinical exposure to dysphagia cases and their ability to identify anatomical landmarks relevant to swallowing on still radiographic images prior to training best predicted their ability to identify swallowing impairments after training. What are the clinical implications of this work? Given the expense of training health professionals, further research is required into the factors that successfully prepare clinicians for VFSS training, including clinical exposure, foundational knowledge of anatomy relevant to swallowing and the ability to identify the anatomical landmarks on still radiographic images.

摘要

背景

感知、认知和以往的临床经验可能会影响新手视频荧光吞咽造影研究(VFSS)分析人员达到胜任水平的进程。了解这些因素可以让学员为VFSS培训做好更充分的准备,并使培训得以改进以适应学员之间的差异。

目的

本研究探讨了文献中先前提出的一系列影响新手分析人员VFSS技能发展的因素。我们假设吞咽解剖学和生理学知识、视觉感知技能、自我效能感和兴趣以及先前的临床接触都会影响VFSS新手分析人员的技能发展。

方法与步骤

参与者是从一所澳大利亚大学招募的本科言语病理学学生,他们已完成吞咽困难所需的理论课程。收集了评估相关因素的数据——参与者在静态X光图像上识别解剖结构、完成一份生理学问卷、完成成人视觉处理发育测试的子部分、自我报告他们在实习期间处理的吞咽困难病例数量,并对自己的信心和兴趣进行自我评估。使用相关性和回归分析,将64名参与者与感兴趣因素相关的数据与其在15小时VFSS分析培训后准确识别吞咽障碍的能力进行比较。

结果

VFSS分析培训的成功最能通过对吞咽困难病例的临床接触以及在静态X光图像上识别解剖标志的能力来预测。

结论与启示

新手分析人员在获得初级VFSS分析技能方面存在差异。我们的研究结果表明,刚接触VFSS的言语病理学家可能会从对吞咽困难病例的临床接触、与吞咽相关的扎实解剖学基础知识以及在静态X光图像上识别解剖标志的能力中受益。需要进一步研究,以使VFSS培训师和学员为培训做好准备,了解技能发展过程中学员之间的差异。

本文补充了什么

关于该主题已知的信息 现有文献表明,新手视频荧光吞咽造影研究(VFSS)分析人员的培训可能会受到其个人特征和经验的影响。本研究补充的内容 本研究发现,临床学生、对吞咽困难病例的临床接触以及他们在培训前在静态X光图像上识别与吞咽相关解剖标志的能力,最能预测他们在培训后识别吞咽障碍的能力。这项工作的临床意义是什么?鉴于培训卫生专业人员的成本,需要进一步研究成功使临床医生为VFSS培训做好准备的因素,包括临床接触、与吞咽相关的解剖学基础知识以及在静态X光图像上识别解剖标志的能力。

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