Evidence Based Videofluoroscopy: Moving Beyond Fear 

The Modified Barium (Videofluoroscopic) Swallow Study enables skilled clinicians to assess the physiology of a patient’s swallowing patterns; identifying pathological physiological processes and determining the effect of these processes on swallowing safety and efficiency. Standardization in the radiology suite, including appropriate materials and recording systems, helps clinicians determine routes of oral intake, compensatory strategies, and overall patient safety. Real-time decision-making, combined with review of the recorded study, provides a comprehensive assessment of swallowing issues, including aspiration or residue during the pharyngeal phase. Clinicians must also consider patient preferences, diagnoses, and the risks of aspiration pneumonia when developing a care plan.

This session challenges clinicians to move away from fear-based decision-making, rooted in their initial training and comfort zones, and toward evidence-based practices. The text explores how automatic thinking, confirmation bias, and stereotypes can limit a clinician’s ability to provide optimal care, especially in situations involving the MBSS. Instructors play a crucial role in preventing outdated beliefs, like the assumption that all aspiration is fatal, from persisting in clinical practice. By examining new insights and questioning long-held practices, clinicians can provide higher quality care and reduce the risk that dysphagia shortens a patient’s life. The session will also focus on safety versus efficiency terminology, highlighting best practices in the radiology suite with case studies.

Slides Available!
ASHA Brand Block
No partial credit offered for this course.
Gap Education - Swallow the Gap

Course Schedule

  • Welcome and Introductions: 00:00:00 – 00:10:22

    Foundations of Videofluoroscopic Swallow Studies (MBSS): 00:10:22 – 00:36:17

    Transitioning from Fear-Based to Evidence-Based Practices: 00:36:17 – 01:07:24

    Case Study Analysis and Tools for Practice: 01:07:24 – 01:38:30

    Normal Variability and Swallowing Safety vs. Efficiency: 01:38:30 – 01:54:03

    Q&A and Reflection: 01:54:03 – 02:04:26

Learning Objectives:

  • 1. Describe normative data range for levels of penetration & aspiration of liquid material.
  • 2. Describe 2 reasons we need to utilize standardization in the Radiology Suite.
  • 3. Describe what swallowing safety means versus efficiency.
  • 4. Combine the strongest predictors of aspiration pneumonia with results of MBS studies to formulate a plan designed to mitigate pulmonary adverse events.

James Coyle PhD, CCC-SLP, BCS-S, ASHA Fellow 

Dr. Coyle is a Board Certified Specialist in Swallowing Disorders. He teaches courses in the University of Pittsburgh's Masters in SLP and PhD programs, and he supervises undergraduate (BPhil) and graduate (MS, PhD) student dysphagia research. Dr. Coyle evaluates patients and teaches clinical practicum in UPMC hospitals (adult diagnostics) and is funded by the NIH to investigate the use of technology and signal processing in the screening and treatment of dysphagia. Other research includes the effects of exercise in relating dysphagia caused by radiation therapy for head and neck cancer, and investigation of brain networks related to swallowing function. He's a Fellow of the American Speech-Language and Hearing Association and received the University of Pittsburgh Chancellor's Distinguished Teaching Award in 2016.

Financial Disclosures
Speaking Fee & Royalties: Gap Education, LLC

Non-financial Disclosures
​None

Jo Puntil, MS, CCC-SLP, BCS-S, ASHA Fellow 

Jo Puntil is a Board-Certified Specialist in Swallowing and Swallowing Disorders.  She is the Past ASHA Chair of the CCFC which oversees the implementation of certification and standards of care in Speech Pathology and Audiology.  She has specialized in managing communication/cognitive and swallowing disorders for over 35 years in critical and acute care. Jo has extensive experience in developing interdisciplinary rehab programs, has lectured extensively, and has numerous publications.

Financial Disclosures
Speaking Fee & Royalties: Gap Education, LLC

Non-financial Disclosures
None

To earn a certificate, and ASHA CEUs if desired, eligible learners must do the following before course expiration (December 31, 2029):

  • View the entire recorded course
  • Obtain 100% on a quick, 5 question multiple choice exam (may be retaken as needed)
  • Complete required items in a learner survey
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