What am I looking at? Graduate student accuracy in identification of anatomic structures/landmarks on swallow imaging.

Abstract

Speech-language pathologists need to accurately identify structures/landmarks on swallow imaging. Foundational learning begins in graduate training. This study aimed to determine graduate student accuracy at identifying anatomical structures/landmarks during swallow evaluations and to determine if accuracy was predicted by type of imaging, anatomical structure, case type (i.e., normal/abnormal). Researchers recruited first-year graduate speech-language pathology students. Each participant reviewed five static images from lateral radiographic swallow studies and five static images from endoscopic swallow studies across 10 cases. Participants identified key anatomic structures and landmarks by clicking on the structure/landmark within a web-based platform. Two experienced speech-language pathologists reviewed and coded participant responses for accuracy. Sixteen graduate speech-language pathology students participated in a within-subjects design. Overall participant accuracy in identification of structure/landmarks was 69% (range 46%-88%). Binomial logistic regression was performed to study the effects of anatomical structure, case type (i.e., normal/abnormal), and image type on likelihood of participant accuracy in identifying anatomical structures (X²(4) = 143.65, p < 0.001). Only anatomical structure was statistically significant (X²(4) = 187.729, p < 0.001). The model explained 23.2% (Nagelkerke's R squared) of the variance in accuracy and correctly classified 78.4% of cases. Sensitivity was 92.1%, specificity was 47.3%, positive predictive value was 79.84%, and negative predictive value was 72.50%. The area under the ROC curve was 0.754, 95% CI [0.716, 0.791]. Graduate student's ability to correctly identify structures/landmarks overall was lower than desired and accuracy varied per structure. Results have implications for improving graduate student training for identification of structures/landmarks on swallow imaging.