Interview with a Researcher – Kendrea L. (Focht) Garand, PhD, CScD, CCC-SLP, BCS-S, CBIS, CCRE

Please give a brief background: (Employment, interests of study, special honors/certifications etc.)

Founder and Director, Swallowing Disorders Initiative (SDI) Research Laboratory, which is a lab that focuses on understanding how aging impacts swallowing function and how swallowing impairment (dysphagia) impacts patients with progressive neurodegenerative disease, particularly patients with motor neuron disease (MND) such as amyotrophic lateral sclerosis (ALS). Assistant Professor for Department of Speech Pathology & Audiology, Program Coordinator SPA PhD Program in Communication Sciences & Disorders, and Adjunct at Department of Otolaryngology-Head & Neck Surgery at Medical University of South Carolina. (I think I am the only one still in the world with a research and clinical doctorate – talk about student loan debt!)😯🤯

Also, I have NEVER stopped practicing clinically (not even during my doctoral and post-doctoral studies)! To this day, I am still in the clinic.

 

If you could conduct any research study on any topic/issue (meaning money/funding, time, subjects, IRB etc. are NOT a problem!), what would it be? In other words, what’s your dream study?!

Eek – just 1?? Can I have 3? 👩‍🔬👨‍🔬🙆‍♀️ (yes, research-fantasy land has no limits😂)

One study would be a large sample of healthy adults (at least healthy when enrolled) that I would follow for YEARS (decades) to see how aging impacts the swallow mechanism and who gets what diseases/conditions and how that impairs. It would be great to add a subsample of this cohort that also completed prophylactic swallowing exercises to see if that improved function after insult compared to those that didn’t that suffered a similar insult.

My next major one would be an ALS randomized clinical trial that would assess the effectiveness of 3 interventions, 2 used alone, and the third arm would combine the interventions (I’d rather not give those interventions that I am thinking of away just yet😉).

And lastly, a topic near and dear to my heart is dysphagia education❤️. I would love to bringAccess GIF - Find & Share on GIPHY dysphagia educators together with an adult learning specialist so we can design materials for dysphagia faculty to use that not just promotes up do date best practices, but also uses evidence-based facilitation strategies to promote student engagement, learning, and retention.

 

If you could change one thing about having to do research, what would it be?

More people would get involved. Getting participants is always hard. Whether it is out of fear for research transgressions in the past, lack of transportation, lack of childcare, etc. Then, consumers wonder why we use the words “pilot/exploratory study” and we talk about that our sample size is a limitation and limits us in analyses – it is because it is HARD getting the data!📊📈

 

What’s one thing you think clinicians should be excited about in our field regarding research?

They can be involved!       

 

What’s one thing you think researchers should be excited about in our field regarding clinical practice?

We are contributing to the best currently available evidence that clinicians are using to optimize patient care. How great is it that we can work with them to bridge the gap between lab results and clinic results?👏👏

 

I feel the Results section of studies can be the most misunderstood or difficult to navigate through, what tidbits or tips/tricks can you share to help clinicians process this section?

Even researchers have some difficulty sometimes getting through the Results section, especially if they are not familiar with that particular test or type of data (i.e., it is not used within their own research). Also, I used the Laerd Statistics website a lot. While there are some sections that you have to pay, most sections are at least partially available and should give you a good start – they also provide examples. Also, never underestimate the power of a good YouTube video!😉🤓👍

 

Could you pick one technical jargon (e.g. “ANOVA” “two-tailed test” etc.) to explain in a relatable and easily understandable way (real-life, simple examples get bonus points😉)?

There are 4 types of scales used to quantify data (nominal, ordinal, interval, and ratio). I like to use the acronym NOIR (like a pinot noir!). This is important to know because this will determine what statistical test best to use (which measure of central tendency (i.e., mean, median, mode) is used). We can absolutely have more than 1 variable type in a single study! BUT, you should pay attention to what scale is being used as the outcome measure in the study.

Nominal: categories (ex: type of fruit, severity of hearing loss, sex, age category). Can only be in one category. It cannot be ordered. Measure of central tendency [aka center point] = mode (most frequently occurring).
Ordinal: natural order but space between levels are not equal. This would be like educational level, grades (A, B, C) etc. However, is the difference between an A and B student the same between a B and C student? If there is any doubt that there is inequality between “levels,” then this is ordinal data. If there is an equal distance, then that is interval or ratio. No decimal points! Scoring of the MBSImP is ordinal (a score of 4 is “worse” than a 3, but the degree of difference between a 0 and 1 and a 2 and 3 may not necessarily be the same when considering the degree of impairment. Measure of central tendency = median (middle score when arranged in order)
Interval: differences between values are equal but there is no absolute zero. For example, the difference between 92 and 93 degrees is 1 degree. Difference between 94 and 95 degrees is 1 degree. However, the degrees in Fahrenheit do not have an absolute zero. Measure of central tendency = mean or median (depends on normality of data).
Ratio: differences between values are equal and there is an absolute zero (the presence of an absolute zero is what makes this different from interval). This would include degrees Kelvin, money, and chronological age. A scale is ratio when “multiples are meaningful,” Example: “2 feet is twice as large as 1 foot” “12 feet is three times as large as 4 feet” “Sally is twice as old as Kelly” etc. But, could you really say that a “4.0 GPA” is “twice” as good as a 2.0 GPA?” – no, so that makes GPA an interval scale. Measure of central tendency = mean or median (depends on normality of data).

As a reviewer, I have “called out” authors for applying the wrong statistical test based on their type of data (thus, they were treating an ordinal scale like an interval and then used the mean (average) within their statistical test).

(This is the stuff to be aware of 😉😉)

 

What’s the one thing you think is important for practicing clinicians to know/understand when reading research?

Reading Between The Lines: Why All Writers Should Belong To A Book ClubJust because it is in print, doesn’t mean you should NOT read it with a critical eye🧐. Reviewers, like you, are busy and they may miss something – even a fatal flaw. Be a skeptic – not a cynic.

 

What’s one thing you think is important for researchers to know/understand about clinical practice?

At the end of the day, our research should be about improving patient care. Put your research in the context of, “Can a clinician feasibly implement this in a busy clinical setting?” 👏👏👏

 

What is something you believe researchers could do better to #bridgethegap?

Participate in activities such as these! Be a guest speaker for a journal club or webinar! And push that this is part of your service effort to get support from your Institution.👍😉👍

 

What is something you believe clinicians could do better to #bridgethegap?

Never stop learning how to review the evidence!🙌

 

Can you provide your contact email if clinicians want to reach out? (Honors system for everyone to be respectful of your time)

garand@southalabama.edu


 

I want to personally thank Dr. (Focht) Garand for all of her contributions, work, courses, and accessibility! She has maany things to Google over, courses to learn from, and active participation in our field.🤓

Reese Witherspoon Thank You GIF by Team Coco - Find & Share on GIPHY

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