This study retrospectively investigated the value of both endoscopically visible oropharyngeal secretions in the hypopharynx and swallowing frequency in the prediction of aspiration of food and liquid. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed on a total of 69 individuals that included hospitalized elderly, nonhospitalized elderly, and young normal subjects. A four-level rating scale for determining the severity of accumulated oropharyngeal secretions was developed and employed to rate subjects prior to the presentation of food or liquid during the FEES. Spontaneous dry swallows were also counted during the observation period of the FEES. It was found that the accumulation of endoscopically visible oropharyngeal secretions located within the laryngeal vestibule was highly predictive of aspiration of food or liquid. There were significantly fewer spontaneous swallows in hospitalized subjects when compared with nonhospitalized subjects. There was also a significant decrease in the frequency of spontaneous swallows in aspirating hospitalized subjects when compared with nonaspirating hospitalized subjects. Results are discussed in terms of integrating this information with clinical bedside examination techniques.

Like other professional disciplines, communication sciences and disorders (CSD) is faced with challenges related to maximizing student development and meeting workforce needs. Challenges include the difficulty that students experience connecting classroom experiences to clinical practice, the stress that many students feel with their first clinical experiences, and the national shortage of practitioners. Ways to address these challenges through a theoretically based examination of common educational practices in the CSD discipline are suggested. Method: Common educational practices in CSD were identified through the educational concepts of signature pedagogy (Schulman, 2005) and reflective practice (Schön, 1983, 1990). These common practices were then examined to determine if and how they may relate to challenges to the discipline.

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