Getting FEES trained can seem overwhelming at first. Before you get started, take a deep breath and get excited…you are about to embark on a journey that will provide you with a wonderful skill that will improve your patients’ access to care, save your institution money, and diminish the wait time to return your patients to eating by mouth.
Step 1: Gather Information.
First take a look at ASHA’s Guidelines on FEES training. ASHA does not require a certification to perform FEES. ASHA does have a document that outlines what an SLP should know before performing FEES entitled Knowledge and Skills for Speech-Language Pathologists Performing Endoscopic Evaluations of Swallowing. There is not a specific number of scope passes recommended by ASHA prior to a clinician becoming FEES competent; however, there may be a specific number of passes required by your state or included in your facility’s competency document.
Next, check out your state requirements for FEES training. Most states defer to ASHA for guidance on FEES training. Some states do have specific language on becoming FEES competent, such as requiring a specific number of scope passes under supervision. ASHA has a list of states with specific guidelines . At this time, there is only one state that requires a certification to perform FEES, Tennessee.
You should check your facility’s protocol for FEES training. Many facilities have a checklist or competency requiring a specific number of scope passes under direct supervision or indirect supervision. You may be familiar with similar facility competencies for MBSS, as well as other skills. If you are starting a FEES program from scratch, you can find resources from ASHA in the Dysphagia Competency Verification Tool .
Step 2: Consider a FEES training course.
Taking a FEES training course is an excellent early step in FEES training. Is it required? Not in most states, but it really is a wonderful way to get lots of FEES knowledge by skilled and experienced FEES clinicians. A FEES course should include the training curriculum outlined in the document cited above, Knowledge and Skills for Speech-Language Pathologists Performing Endoscopic Evaluations of Swallowing.
Step 3: Find a mentor.
After completing a FEES training course, you will likely begin to feel comfortable with the mechanics of passing the scope, but it doesn’t stop there. You will need to perform FEES on patients under supervision prior to beginning to perform FEES independently. Recall that ASHA’s code of Ethics states, “Individuals shall provide all clinical services and scientific activities competently.” In order to make sure you are fully competent in passing the scope safely and comfortably, and accurately interpreting deficits, you will need additional supervision following a FEES training course. Having your mentor lined up before you undergo training will help keep the flow and momentum going. If you have difficulty finding a mentor in your area, please reach out to us, as this is a service we can offer you.
Step 4: Make sure your interpretation skills are excellent.
A good mentor will help you learn to safely, efficiently, and comfortably pass the scope on patients. In addition, there is a level of online processing required to determine which consistencies to test, which compensatory techniques to consider, and which exercises to trial during the exam. Your mentor will help you with this. Be patient, as it can take a while to be able to quickly use these cognitive skills while performing the new motor skill of maneuvering the endoscope. If you are interested in working on your interpretation skills without the stress of scoping at the same time, we recommend taking our online interpretation courses while working toward improving this skill. Honestly, the more FEES exams you are exposed to, the better you’ll get at identifying what you see and making clinical decisions in real time.
We hope you found this blog post helpful! Stay tuned for our next post which will include tips for selecting FEES equipment!