<p>  </p> <p>With fewer speech-language pathology (SLP) clinical training opportunities, it is difficult for students to gain the experience necessary to display proficiency and confidence in treating patients with dysphagia. To address this gap, many educators have turned to simulation-based training (SBT). This project examined the impact of a novel computer-based simulation dysphagia training implemented into Purdue University’s core Dysphagia course on students’ confidence and competence. During this training, students completed a comprehensive bedside swallowing evaluation and analysis of a videofluoroscopic swallow study (VFSS) of 2 simulated patients. </p> <p>A repeated measure design was utilized. Data were collected on 27 SLP graduate students (n=27; 26 females, 1 male; age range: 21-27 years) at baseline, Post-Simulation 1 and Post-Simulation 2. We evaluated confidence and clinical knowledge through the following outcome measures: students’ self-rated confidence levels rated using an adapted Self-Efficacy survey, and agreement levels with our gold standard rater on clinical evaluation forms. Data for students’ self-rated confidence were collected at three time points (baseline, Post-Simulation 1, Post-Simulation 2), and organized into three composite areas (Treatment, Evaluation, and Personal & Interpersonal Skills). Clinical knowledge was measured at two time points (Post-Simulation 1 and Post-Simulation 2 ) using clinical evaluation forms, which were completed for each of our two simulated patients. Clinical evaluation forms included a cranial nerve exam form, a videofluoroscopic swallow study (VFSS) analysis form, and an Overall Impressions and Recommendations form, including the Functional Oral Intake Scale (FOIS) and a recommendation list. </p> <p>Significant increases in confidence in the Evaluation (t(26)= -8.22, p < .0001), Treatment (t(26)= -5.06 , p < .0001) and Personal & Interpersonal (t(26)= -10.31, p < .0001) composite areas of the Self-Efficacy survey were seen from baseline to Post-Simulation 2. While students did not show significant improvements in clinical performance for FOIS ratings and VFSS analysis, they did show significant improvements in their ratings for the cranial nerve exam (t(26)= -5.728, p < .0001), and in their choice of recommendations (t(26) = -5.247, p < .000 1) between the first and the second simulation. </p> <p>In this sample of participants, students had significant improvements in confidence and clinical competence in several clinical knowledge areas. These paired results suggest that these participants benefitted from completing our SBT dysphagia training. Although our findings provide some initial insight into the impact of this novel computer-based SBT for graduate dysphagia education, additional research is required to further validate these findings. </p>

No / Attendance of adult patients to the Emergency Department (ED) with acute abdominal pain is a frequent event. Abdominal X-ray imaging (AXR) is commonly the first line of investigation but previous studies have suggested that the AXR has no place in assessing acute abdominal pain because of its low diagnostic yield and limited contribution to direct clinical decision making. However, no evaluation of the impact of a negative AXR on the clinical confidence and decision making of emergency clinicians has been undertaken. This study aims to fill this gap. Method: A self-designed paper questionnaire was distributed to medical clinicians on ED placement at a single NHS trust in the South of England. The survey sought to explore the impact of the negative AXR on clinical confidence and decision making and compliance with iRefer guidelines for referring to alter-native imaging modalities (ultrasound and computed tomography) should the option to refer for AXR be restricted. Results: A total of 28 (n¼28/41; 68.3%) completed questionnaires were returned. Most clinicians(n¼18/28; 64.3%) indicated that negative AXR had little impact on their clinical decision making although a small majority (n¼10/18; 55.6%) acknowledged it provided greater clinical confidence in their decision making. Variable compliance with iRefer guidelines for referral to ultrasound and computed tomography was noted. Conclusion: Whilst the negative AXR did not impact on the clinical decision making of most ED clinicians,it did increase clinical confidence. Consequently, the AXR should remain a referral option in the workup for adult patients presenting with acute abdominal pain to the emergency department. / This publication is the output of the Formal Radiographer Research Mentorship (FoRRM) scheme, funded by the Society and College of Radiographers.