Yes, I attended the MBSImP seminar over one year ago. And I signed up for the online course (to get certified) while I was at the seminar.

I wanted to write a blog post about how great MBSImP training is and how it has been incredibly useful to my practice. We all want to write positive reviews, right? But more than that, we want to show where we’ve been successful. I can’t write that post though. I haven’t finished the training…

The seminar was great. I totally respect Bonnie Martin-Harris. Her team’s effort to standardize the procedure and documentation of MBSS is very needed. As an SLP working in the skilled nursing setting, I rely on other therapists to complete MBSS assessments on patients I recommend. And I rely on their documentation to determine what we’ll do next in therapy. I often didn’t get the information I wanted, not because the therapist did anything wrong. They just seemed to be looking for different things than I wanted.

So even though I wasn’t actually doing MBSS myself, I felt that it was a valuable tool and signed up to the complete the online training to become certified.

When it came time to do my online training I became frustrated, not because the material was poor or the technology was poor. Everything was fine there. Dysphagia is just difficult for me to study online independently. I found myself being just slightly off when judging aspects of the swallow. Maybe it is my computer screen, but I frequently missed the “trace” residue on studies.

I’d get frustrated and I’d quit. Then I’d pick it up again a month or two later. Rinse and repeat. I’m still not finished.

The training is good. This student doesn’t learn dysphagia well online. The nuances are too difficult to discern. Ideally the MBSImP training would be a part of a dysphagia course in graduate school or would be completed by a group of colleagues who could study and implement practices together.

I want to finish the training. (I’m a perfectionist –  must have that success!) Anyone in the Boulder/Denver, Colorado area and want to get together to hammer this out?

Join the conversation. Tell us about your experiences with MBSImP.


  1. I have wondered about that training. As the hospital SLP doing the MBSS, I like it when the SNF SLP sends a note or calls to tell me her thoughts so that I can make sure to document what is needed to assist her in tx. great post

    • I always appreciated the notes as not to be “blind-sided”. There’s calling the study as you see it, but it also really helps to know the primary SLPs thoughts.

  2. Ugggh! That training made my life miserable for weeks. I have done weekly swallow studies for the past 9 years and took dysphagia in grad school and it still took me several tries to pass! Keep persevering! And when in doubt, give the more severe score!

    • I had no idea, it was this challenging. I went to a course with a review of the concept and research, but never did the training. It’s a great concept and great blog to put it into perspective.

    • I TOTALLY AGREE! I purchased the online course thinking it would be a great way to better my mbss skills! I do mbss’ almost every day! I do appreciate what I’ve learned this far but passing the reliability test has become the bane of my existence!!!!! It’s so difficult to pass and I don’t appreciate how difficult it is when swallow is a pretty subjective area!!!!!! I’m regretting every taking this course!!!!! If you’re reading this: DO NOT TAKE THE ONLINE COURSE!! Go to a seminar if you’re THAT interested!!!

  3. I did not have such a negative experience with the training-I agree it was time consuming, but for me, it was a great way to consolidate skills after a few years of completing MBS’s in clinical settings and I found I now look for things on MBS that I wasn’t really looking at before in the same way!

  4. I would love for the MBSS to be more “standardized” that way we would know what to expect in reports. I find that when patients have them in the hospital, the reports are “lacking” for lack of a better term. We use a swallow study bus for most of our patients and I love it. I get to get on the bus, participate in the study, and I get a video copy of the study. It’s great. If I have a patient who needs a study before the bus can get here I usually just go to the hospital with the patient to be sure what I want I tested and we agree on the study results.

    • Ruth – I’m right there with you. I’ve worked for facilities where we had a mobile MBSS van and that gave me the best results when ordering MBSS for my SNF patients. Even though the time spent in the van wasn’t productive by my company’s standards, I’d spend my “lunch” in the van.

  5. My graduate dysphagia course last year required us to complete and pass the MBSImP training before the course started. I really enjoyed the student version, but found it incredibly difficult because I had only learned the anatomy up to that point and had not yet learned about swallow physiology. Eventually, I got the hang of it and still go back to my account to watch videos and re-train.
    If this training is to be used for graduate students, I would recommend that it be done after students have learned both anatomy and physiology of the swallow mechanism in their dysphagia course to better avoid random guessing and mislearning of information.
    I’m excited to see what is beyond the student version!

  6. I’m about to start my test for the THIRD TIME. So frustrated! Everyone I know who has taken the course, from new clinicians to SLPs with 10 years of MBSS under their belts, has struggled to pass. I found your blog when I was trolling the internet to find tips on how to pass this beast. My question is, if so many of us are having a hard time passing, that must not bode well for interrater reliability, ya know? Ugh.

  7. We did the training online in our graduate coursework last semester. I attend graduate school online and certain aspects of online learning are very difficult at times. However, the MBSS was the worst experience I’ve ever had. The trace residue was also my downfall. Not sure what the solution is but honestly it just was not a great learning tool for me.

  8. Not useful at all. I have worked as a medical SLP for 21 years and I am a BCS-S. Training is totally subjective with NO input. Just kept retaking, retaking, and did I say retaking

  9. As a previous commenter stated, the analysis is completely subjective! I emailed the course for help but that just led to more confusion. I can’t believe I spent all this money on what I thought would be an informative course that has turned into nothing more than a headache.

    • I was trained to interpret VFSS using the MBSImP as a graduate student. Yes, learning to objectively identify and describe physiologic swallowing impairment was an arduous process… but it should be! As speech-language pathologists, we are recognized within the medical profession as experts in the diagnosis and treatment of swallowing disorders. Swallowing is not a simple process. The ability to safely consume an oral diet results from complex sensori-motor events that are dependent on intact neural control and anatomic function. I can empathize with the frustrations expressed in this article regarding the grueling training process required to achieve MBSImP reliability. However, we owe it to our patients to further our understanding of the complexities of swallowing function, no matter how difficult. The clinical decisions we make based on our knowledge of the physiologic components of oropharyngeal swallowing can be life changing and, in some cases, life threatening. With that being said, interpreting a VFSS should be anything but subjective! The MBSImP is designed to ensure that clinician’s are able to reliably interpret and report swallowing impairment in a thorough, standardized and objective way. Achieving those skills should not be an easy process. To offer some insight, Northern Speech Services reports that it takes clinicians, on average, 2.5 attempts to pass the MBSImP reliability testing. Think of the test as continued learning! The MBSImP is not perfect – scales rarely are, however it is the first and only standardized method of quantifying radiographic observations during VFSS derived from over 15 years of study and field tested now in over 2000 clinicians. Because I understand that this is a rigorous process, I’d like to share what I and other clinicians have found useful while working towards reliability. The MBSImP website offers several different teaching tools for a variety of learning styles. There are audio guided animations and fluoroscopic examples of each component and associated scores, two training zones that provide immediate feedback when scores are selected, a written guide describing the MBSImP protocol, individual components/scores and scoring nuances, a forum for open discussion with other users and MBSImP/NSS representatives, and a collection of “scoring help” files that provide additional images and scoring tips (e.g. common scoring errors) for each of the 17 physiologic components outlined in the MBSImP. In addition to the Learning and Training Zones, these tools can be accessed on the MBSImP homepage via the “Training & Reference Documents” and “Scoring Help” links. If online training proves difficult, Dr. Martin-Harris continues to travel for live courses that provide direct instruction on use of the tool and hands on scoring practice. I wish the author of this article and those expressing frustration within the comments all the best as they continue their journey towards becoming reliable MBSImP clinicians. It is truly a rewarding process.

  10. I know this is an old post but I AM COMPLETELY FRUSTRATED!!! My hospital gave me a deadline to finish the course and I can’t pass the stupid thing! I’m so glad I found others that are having a hard time- I was starting to think I was just a lost cause. Looks like I’ll get back at it and try, try again.