The use of simulation in training graduate students to perform transnasal endoscopy

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.