How often have you gone to see a patient and she or her family tell you, “I heard I failed the video swallow study”?

There is something to this poor word choice and at times, I notice it is an epidemic slowly spreading and catching fire.

I find myself educating, educating, educating, non stop. I often debunk the words “pass/fail” by stating:  “This is not a test.” If you think about it: No one fails physical therapy. No one fails occupational therapy. No one fails an MRI or Ultrasound.

There’s somehow a huge gap between SLPs as clinicians who only “test” swallowing and clinicians who treat swallowing. I find it helpful to soften the storm before it gets out of control and say to the patient, “When I come to see you it is not to see if you are failing. No one fails in my therapy. I am coming to work with you so you can achieve your goals.” Maybe it just makes me feel better as a therapist, but it seems to be working.

Anyone have any different experiences or suggestions?


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  1. I hear that term frequently from the nurses or the PCA’s I work with. Common dialogue:

    RN: So did they pass or fail?
    Me: Well there are somethings that we need to change to their diet and some strategies to be put in place.
    RN: So they passed?

    • I will try to educate in a nice way on how those terms can create some confusion, as passing/failing is not well defined. I may lead with a joke, “No one ever ever fails my swallow eval” : ) One MD may have the idea that passing is not aspiration on a video swallow study, while someone else may define it as being on a regular diet. The best straightforward and simple response I can think of is: “The patient is safe for…” or “The patient is unsafe for…” It is the small victories that will hopefully lead to change.


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