Already Finished?! Spring '13 and Summa Time Freedom

Six weeks flies by way too fast! I've just finished up my (very) short spring classes today and I have to say, I fell in love with my Dysphagia class. Six weeks was not long enough for that class and I would've happily taken it over the entire summer.

There were many things I really enjoyed learning about in this class, but I want to highlight the class project for dysphagia which was to collaborate with a classmate and develop an educational material for either SLPs, other medical staff, patients/clients, teachers, or anyone we could think of (one group designed a dysphagia book for children!). My partner and I decided to research pre-treatment swallowing exercises for patients undergoing chemo-radiation for head and neck cancer.

As we started to go through the literature we found some support for these exercises, but not much that would be considered Level I EBP. Only a few were randomized-control studies and many of those journal articles we found cited sample small sizes as the biggest limiting factor to definitively supporting pre-treatment swallowing exercises. A few others that we found only performed a retrospective review of case files which is at a level III EBP, and those studies tended to show that pre-treatment exercises were more useful than not. I am discovering that case file reviews are used quite often as well as small sample sizes and not enough randomized-control studies are often the norm in our profession. A quote from an SLP who sent me some information for this project sums up the problem quite nicely,  "I think this topic really gets at what Rosenbek refers to as 'the tyranny of the randomized control trial'.  In our profession (which lacks such evidence on most topics) it would be easy to do nothing because we don't have level 1 evidence for it."

I'm keeping an eye on a study currently underway at the University of Alabama that is looking to determine if pre-treatment swallowing exercises can improve
post-treatment swallowing function. SLPs that I've contacted in the field definitely back this up and it would be great if research came out that definitively supported it as well.

What is really great is that EBP is more than just external scientific evidence, though that is a very important part of it. We also have to take into consideration clinical expertise and client/patient/caregiver perspectives. I wanted to explore the clinical expertise aspect of EBP so I posted on an SLP facebook group called Dysphagia Therapy and asked SLPs in the field if they recommend these exercises for their patients. I received many responses from SLPs all over the states who gave me a definite "YES!" and the overall consensus was "use it or lose it!" It was really great to discuss this with a large group of SLPs, so a big thank you to all who took the time to reply to my post on facebook. 

I also want to send out a HUGE thank you to Cyndee Bowen @BowenSpeech, Tiffani Wallace @dysphagiarambling, and also Tiffani Mason, who I observed during my post-bacc observation hours. I really appreciate the time you all took to look over our project and give us feedback.

Aaaand with all of that said, here is our final product. I really enjoyed working on this and I'm grateful to be able to use social media to get feedback on it.

I also took Motor Speech Disorders this semester and though this post is giving a lot of love to dysphagia, motor speech is another area I would like to explore further. Six weeks was definitely not enough time for either class so I am exploring some possible CEUs (which unfortunately won't count since I am still as student and not licensed yet) that I could take on dysphagia and motor speech. Speechpathology.com is one site I am looking into and I've seen a few posts on SLP facebook groups that say it is a great site for continuing education.

So my classes are finished for the next 2+ months and like I said I plan on looking into some CEUs, but I am also going to set up a couple of observation days with SLPs in the area. I'm going to be working at the Children's Institute this summer, but won't have a ton of hours. Other plans include netflix marathons, reading for fun, EXERCISING (seriously, the "freshman 15" has nothing on the "grad school 25"), and exploring the Ann Arbor/Ypsilanti/Detroit area a bit more. There will also be a road trip or two... ahhh, I miss traveling.

It should definitely be a very "schwa" summer.

Random SLP geek out moment: ASHA tweeted a link to my blog post on Social Media and SLP!