Exploring Consistency and Variation in Fibreoptic Endoscopic Evaluation of Swallowing Practice in Australia.

Abstract

Fibreoptic endoscopic evaluation of swallowing (FEES) is an imaging technique used by speech-language pathologists (SLPs) and some other health professionals to assess swallowing. The primary aim was to gain an insight into FEES practices in Australia by characterising SLPs who use FEES and identifying areas of consistency and variation in practice. The secondary aim was to explore factors associated with variation in practice. Cross-sectional survey methodology was used. The link to a web-based survey was e-mailed to 351 SLPs who practised in adult dysphagia. The participation rate for the study was 18.8% (n = 66). Twenty-two SLPs (38.6%) used FEES. These SLPs represented a cross-section of workplace settings, caseloads, clinical and training experiences. Consistency and variation in FEES procedural and assessment practices were identified. Some procedural aspects of FEES varied according to whether a medical practitioner was present, type of FEES training, and number of FEES conducted per month. This research represents a benchmark in the knowledge of how FEES is used in Australia. Despite the small number of participants, the findings provide a foundation from which future research questions can be generated. More extensive examination of the use of FEES by SLPs is warranted. Further research is also required to establish methods for attaining and maintaining competency and to achieve consensus on which aspects of swallowing are assessed when using FEES and how the examination should be conducted.