Bridging the Dysphagia Education Gap Ianessa Humbert’s ASHFoundation-funded research uncovers gaps in SLPs’ dysphagia education, and identifies ways to close them. Foundational Questions
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Foundational Questions  |   April 01, 2018
Bridging the Dysphagia Education Gap
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Swallowing, Dysphagia & Feeding Disorders / ASHA News & Member Stories / Foundational Questions
Foundational Questions   |   April 01, 2018
Bridging the Dysphagia Education Gap
The ASHA Leader, April 2018, Vol. 23, online only. doi:10.1044/leader.FQ.23042018.np
The ASHA Leader, April 2018, Vol. 23, online only. doi:10.1044/leader.FQ.23042018.np
Name: Ianessa A. Humbert, PhD, CCC-SLP, Associate Professor, University of Florida Department of Speech, Language, and Hearing Sciences
ASHFoundation Award: 2014 Clinical Research Grant
What is the focus of your research?
The overarching focus of my research is swallowing and swallowing disorders. But under that broader category I have two subcategories. One pertains to swallowing function in healthy adults and in adults with neurogenic disorders—especially stroke—but also including Alzheimer’s disease and ataxia. In these groups I’m interested in how the brain controls swallowing, especially as it relates to learning novel swallowing movements, and how people can correct errors that occur during swallowing.
The other subcategory is clinical decision-making in dysphagia management. This is a newer interest of mine, and it has been growing steadily.
How did your award from the ASHFoundation lead to your current work?
The ASHFoundation Clinical Research Grant award launched the second line of research in my lab—understanding clinical decision-making in dysphagia management. This award was timely, because there are very few studies in the research literature that investigate practice patterns among speech-language pathologists, especially for swallowing and swallowing disorders. It should be noted that it would have been difficult to find any other funding opportunity to support a study that focused on both SLPs and swallowing, so the ASHFoundation award truly made this work possible!
What do you hope to demonstrate through your research—or what has it already demonstrated?
The primary goal of this study was to understand the level of agreement among SLPs who manage dysphagia. This research question was justified because of published and unpublished concerns about SLPs’ formal and informal academic and clinical training in swallowing.
We attempted to address this concern by identifying the problem and proposing a solution:
  • In a large online survey, SLPs viewed modified barium swallowing studies (X-ray movies of swallowing) and identified the swallowing impairment and the treatments they would use to target any disorders that they identified.

  • With Emily Plowman, I conducted in-person and online conferences, called “Critical Thinking in Dysphagia Management,” to assess the effects of training on clinical reasoning in dysphagia management.

Our preliminary data indicate that many practicing SLPs who manage dysphagia vary widely in their knowledge base about normal and disordered swallowing and have relatively poor agreement in the identification of many swallowing impairments and treatments. The good news, however, is that short, intense training periods may be sufficient to “jump-start” SLPs’ knowledge base across many clinically relevant topics in swallowing, and may provide motivation for continued self-study learning among busy clinicians.
Why did you choose this particular research focus?
I am convinced that this research focus on SLPs’ practice patterns chose me. After years of giving presentations on swallowing to practicing SLPs and students, I was struck by the range in knowledge across all attendees. Subjectively, I noted that those with superior knowledge trained with an instructor or professor who had expertise in swallowing and was well-versed in the research literature. Furthermore, very few attendees reported having had any instruction on swallowing in their undergraduate courses (including anatomy and physiology). This observation prompted me to collect preliminary survey data from approximately 50 SLPs to justify a larger study that might be funded by ASHFoundation to identify and characterize the problem, then test a potential solution.
How has ASHFoundation funding affected your professional life?
The positive findings from the study’s online and in-person training have encouraged me to create free or low-cost, widely available learning resources for students and clinicians involved in dysphagia, including:
  • A new online resource, Swallowing Training and Education Portal (STEP), with co-creator Rinki Varindani Desai (www.stepcommunity.com).

  • An online Dysphagia Grand Rounds (www.dysphagiagrandrounds.com), also with Rinki Desai, to encourage clinicians to read the swallowing research literature.

  • The first swallowing podcast, “Down the Hatch” (iTunes),initiated with doctoral student Alicia Vose.

These new ventures exist because conducting the ASHFoundationfunded research required me to significantly expand my collaborator base, from primarily researchers to clinicians and students. And these new, nontraditional learning platforms (online courses, podcasts) for training students and clinicians might be as effective as in-person meetings and/or formal academic curricula reform and are less expensive, widely available and easily instituted.
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April 2018
Volume 23, Issue 4