One of the great things about the field of speech-language pathology, and incidentally one of its biggest challenges, is that you never really stop learning. Just when you think you've gotten the hang of something, a new idea or presentation comes along that turns your understanding on its head and makes you rethink just about everything. This is always a good thing, but that doesn't mean it isn't frustrating. I've been following my own learning path with video swallow studies. I had minimal exposure during my CF, and at that they weren't even proper fluoro, so when I took this position I asked that I be retrained so I could learn "from the ground up" to do them well. My learning curve has gone roughly as follows:
- Observe the process and work with supervisor to interpret results.
- Learn procedure and setup, as well as progression of studies.
- Start to perform studies with supervision, and notice that they're agonizingly slow when you do them.
- Notice that you gradually start to get the hang of things.
- Feel comfortable going through the motions, and starting to also catch more instances of penetration and aspiration.
- Realize that there's more to swallowing than those two favorite things.
- As you start to observe the "bigger picture" of swallowing, realize that you're slipping in terms of efficiency.
- Work to integrate knowledge of swallowing function into study to make for more complete evaluation.
I have had to remind myself in recent weeks that this is perfectly normal. It helps to lay it out as I have above, to really see the trajectory and remind myself that I am, indeed, making progress. I had found I was getting down on myself for things that, when I look at them this way, are not actually issues. As my supervisor said very well, "We've all been there".
When she said that, it made me think back to my days learning ASL and on the road to becoming an interpreter. I've been an interpreter for going on six years now, and realize now just how far I've come.
I was thinking about learning my second language. It dawned on me that as I was learning, I would take things in, acknowledge them, and try to incorporate it into my use of the language. I could go through the motions, but I didn't really *get it*. After some time (days, week, or even months later), it would suddenly click, and I would find myself actually *over*using it. Eventually, I would tone it down as it fully sank in and use it appropriately.
With regard to my clinical skills as an SLP, and to video swallow studies in this case, I'm still in the middle of this process. Nothing happens overnight. I think back to nearly one year ago, at the ASHA Convention in San Diego last year, and conversations I had with Tiffani Wallace from Dysphagia Ramblings. She helped me rethink my perspective, encouraged me to keep going out and doing and re-learning. Nearly one year later, I realize that I *have* made progress. I'm on the right track. I keep challenging what I think I know, and when I don't, a new patient puts me in check to keep thinking critically.
It's a process. A difficult one with an enormous learning curve, but one that is very much worth the time and effort. I can only imagine where I'll be in another year.