Swallow the Gap: Dysphagia and Medical SLP

Dr. Julie Barkmeier-Kraemer discusses the transformative impact of learning from failure, managing self-expectations, and imposter syndrome. She draws from her experience as a clinician, instructor, researcher, administrator, and more to provide insights into developing oneself and revolutionizing education for speech-language pathologists. With brief tangents about cranial nerves and clinical swallow evaluations, the conversation navigates topics such as critical thinking, the strengths of case-based learning, and viewing clinical supervision as a partnership.


Julie Barkmeier-Kraemer, PhD, CCC-SLP, ASHA Honors
Dr. Julie Barkmeier-Kraemer is a tenured professor in the Department of Otolaryngology – Head and Neck Surgery, Director of the Voice, Airway, Swallowing Translational (VAST) Research Lab, Clinic Director for the Utah Voice Disorders Center, and Adjunct faculty to the Department of Communication Sciences and Disorders (CSD) at the University of Utah (U of U). She has enjoyed faculty positions at the University of Arizona and UC Davis prior to joining the faculty at the University of Utah. She has also enjoyed several administrative and leadership roles through the American Speech-Language-Hearing Association (ASHA), ASHFoundation, Dysphagia Research Society (DRS), International Parkinson and Movement Disorders Society (MDS), Feeding Matters, Dysphonia International, and the National Institutes of Health. She has participated as a research faculty mentor through the ASHA Pathways, ASHA Lessons for Success and the Grant Review and Reviewer Training (GRRT) programs and also enjoyed teaching, training, and collaborating with colleagues from multiple disciplines as well as working with students from undergraduate to graduate school and junior faculty levels.

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

This episode is essential for anyone struggling with conflicting expectations from their education, patients, administration, and personal goals. Our guest, Ed Bice, delves into how we can reconcile differences when we are faced with competing ideas. We explore strategies for navigating challenging situations and enhancing communication skills. Additionally, the episode focuses on the importance of leveraging the knowledge of those you are negotiating with, especially when advocating for more reasonable productivity standards and the adoption of new diagnostic and treatment equipment. 

Guest bio:
Ed Bice is currently working as a Clinical Consultant for IOPI Medical. He is the co-founder of Appalachian-Zenith Training and Education Courses (A-ZTEC). He has experience in various settings, including acute care, outpatient, home health, and skilled nursing. Ed has held various leadership positions, including a Regional Manager, Vice President of Clinical Services, and Chief Operating Officer.  Ed has been a guest on national and international dysphagia podcasts and has numerous publications in peer-reviewed journals. Ed was an invited member of the committee that developed the Adult Dysphagia Practice Portal for the American Speech Hearing and Language Association. She serves as the co-coordinator of the Speech and Hearing Association of Virginia’s special interest group for Feeding and Swallowing Disorders and currently assesses and treats patients at a nonprofit speech and hearing center. He teaches an introductory and advanced swallowing course at the University of Maryland as adjunct faculty. Ed has served as an expert witness in court cases related to swallowing and swallowing disorders. Ed has been an invited speaker for universities, state, national and international conventions on various topics in dysphagia. 

Resources:
https://pubs.asha.org/doi/abs/10.1044/2019_PERSP-19-00022

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

On today's episode, we scratch the surface on variables beyond aspiration that impact dysphagia-related pneumonia in our patients. Our guest, Dr. John R. Ashford, Ph.D., brings a wealth of knowledge from his experience in clinical practice, academia, and research. Furthermore, we discuss lab values,  education, life-long learning, and how SLPs can become more medically-focused in their patient care. Join us as Dr. Ashford provides valuable insights to help bridge the gap between research and practical clinical application. 

“What I know doesn’t belong to me; what people know really doesn’t belong to them; we’re nothing but conduits; we simply are passing along what others have taught us, and we’ve made sense out of it.” 
-Dr. John Ashford

Bio
John R. Ashford, Ph.D., is Education Director/Co-Owner of SA Swallowing Services, Nashville, TN. He is retired from the Department of Veterans Affairs as a Medical Speech-Language Pathologist, and as a Professor at Tennessee State University and the Vanderbilt University School of Medicine. Professional interests include understanding factors associated with pneumonia development in patients with dysphagia, and educating and training providers of FEES services.

Episode Resources:

https://www.sasspllc.com/ 

https://www.sasspllc.com/three-pillars-of-pneumonia

Immune: A Journey into the Mysterious System that Keeps You Alive (Book)

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

Raele Donetha Robison, PhD, CCC-SLP of University of Wisconsin-Madison offers her perspectives on healthcare inequities faced by individuals with dysphagia. With her rich understanding of complexities in patient care - such as the concepts of functional reserves and homeostasis - she provides enlightening comparisons between the challenges encountered in healthcare on both individual and societal scales.


Bio:
Dr. Robison is a Speech-Language Pathologist and current postdoctoral fellow at the University of Wisconsin-Madison (UW-Madison) in Dr. Nicole Rogus-Pulia’s Swallowing and Salivary Bioscience Laboratory. Dr. Robison is currently supported by a NIH specialized D-SPAN pre- to postdoctoral K00 fellowship grant. Under this NIA-supported K00 grant mechanism, Dr. Robison is sponsored by Drs. Nicole Rogus-Pulia and Nadine Connor. The overarching aim of this work is geared towards understanding how interrelated physiologic capacities throughout the body contribute to the development of dysphagia in frail older adults. Dr. Robison is also passionate about understanding how health disparities preclude equity surrounding the eating experience. She is an affiliate member of the UW-Madison Center for Health Disparities Research and hopes to identify barriers and expand access to swallowing care among socioeconomically disadvantaged groups.


Episode resources:

Contact: [email protected]

Health Equity Tourism: Ravaging the Justice Landscape (Lett et al., 2022): https://pubmed.ncbi.nlm.nih.gov/35150324/

Fried Frailty Index derived from Cardiovascular Health Study: https://bmjopen.bmj.com/content/bmjopen/6/8/e012091/DC1/embed/inline-supplementary-material-1.pdf?download=true

Swallowing and Salivary Biosciences Lab: https://ssbl.wisc.edu/ 

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

Dr. Vose touches on the importance of nuance while reflecting on her 2018 paper, "A Survey of Clinician Decision Making When Identifying Swallowing Impairments and Determining Treatment," and why understanding the methodology in research is a key element of evidence based practice. This episode also discusses translating science outside of speech-language pathology into our practice, the need for more treatment research, and our motivation to keep growing as a profession.

"By acknowledging the gap, it promotes promise for the future." - Alicia K. Vose, PhD, CCC-SLP
 
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242916/

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

Dr. Carly Barbon from M.D. Anderson Cancer Center (Houston, TX) and Faith Hoelzel-Lemke from Huntsman Cancer Center (Salt Lake City, UT) provide a glimpse into specialized dysphagia care for patients with - and survivors of - cancers of the head and neck (HNC).

Join us in this jovial dialogue and learn makes care for this population so memorable!
Go Pack... Go?!

Bios:
Carly E. A. Barbon, PhD
Dr. Carly Barbon is an Assistant Professor in the Department of Head and Neck Surgery at The University of Texas MD Anderson Cancer Center. She completed a PhD in Rehabilitation Sciences from the University of Toronto where she investigated evaluation pathophysiologic and mechanistic drivers of dysphagia after radiotherapy. After her PhD she completed a postdoctoral research fellowship in Head and Neck Surgery at The University of Texas MD Anderson Cancer Center, with a focus on clinician-and patient-reported functional outcomes in oropharyngeal cancer patients. Her research is focused on modeling objective functional outcomes in oral cavity and oropharynx cancers and characterizing swallow pathophysiology to better identify rehabilitative targets in head and neck cancer survivors.

Faith Hoelzel-Lemke, MS, SLP
Faith Hoelzel-Lemke is a speech-language pathologist at the University of Utah Huntsman Cancer Institute. Her clinical and research interests largely focus on dysphagia related to head and neck cancer and voice restoration in the laryngectomee population. She is passionate about HNC education and serves part-time at the graduate level targeting this initiative.

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

Dr. Jeanette Benigas shares her insight into ethical dysphagia intervention that exemplifies patient-centered care.

What do you do when a patient is not agreeable to your recommendations?

How do we be sure to not undermine patient autonomy when a patient wants something that we may not consider to be "safe"?


Bio:
Jeanette E. Benigas, PhD
Dr. Jeanette E. Benigas owns Safe Swallowing Diagnostics, a mobile FEES company serving Eastern Ohio and Western Pennsylvania. Her extensive clinical experience has included work with adults in the acute care, inpatient rehabilitation, post-acute rehabilitation, long-term care, home health, and outpatient settings. Dr. Benigas's research interests include improving the quality of life for people with dementia, specifically those who have difficulties eating and swallowing. Her research has incorporated the use of spaced retrieval to teach swallowing strategies so individuals with dementia can avoid unwanted dietary modifications. She has traveled nationally to consult and speak with other professionals in the medical field who work with people with memory loss or dysphagia. Dr. Benigas received a master's degree in speech-language pathology from Eastern Michigan University and a Ph.D. in speech and hearing science with an interdisciplinary specialization in aging from The Ohio State University. She is a Professor at Thiel College and has taught as an adjunct professor at several universities across Ohio, Indiana, and New York. She co-authored Spaced Retrieval Step by Step: An Evidence-Based Memory Intervention and is the co-host of the podcasts Fix SLP and Other SLPs' Pockets. Dr. Benigas can be found on social media on Instagram (@Fix.SLP or @MedSLPadvocate) or Facebook (@FixSLP and @MedSLPadvocate).

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho

Guests: Dr. Martin Brodsky, & Jo Puntil

 Join us in a conversation exploring what it means to be your authentic self while providing patient-centered care in a high-stakes medical setting.
 
Bios
Martin Brodsky, PhD, ScM, CCC-SLP, ASHA Fellow
Dr. Martin Brodsky is the Section Head for Speech-Language Pathology in the Head and Neck Institute at Cleveland Clinic and Adjunct Associate Professor of Physical Medicine and Rehabilitation and Pulmonary and Critical Care Medicine at Johns Hopkins University. His publications largely focus on swallowing and swallowing disorders and laryngeal injury after endotracheal intubation. He is an ASHA Fellow. 

Jo Puntil, MS, CCC-SLP, BCS-S, ASHA Fellow
Jo Puntil is a Board-Certified Specialist in Swallowing Disorders with extensive experience in building integrated patient focused rehab teams throughout the continuum of care, especially in critical care. She has lectured throughout the country and is a former Chair of the Council for Clinical Certification in Audiology and Speech-Language Pathology. Jo is also an ASHA Fellow.

Gap Education:
https://swallowthegap.com

Instagram:
https://www.instagram.com/swallowpatho