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MBSImP Medical Diagnostic Training & Research Platform


The Medical University of South Carolina (MUSC), St. Joseph’s Voice & Swallowing Center, and Johns Hopkins university developed the Modified Barium Swallow Impairment Profile (MBSImP) as a research-informed standardization of the existing Modified Barium Swallow Study (MSS). The MBSImP empowers clinicians to precisely observe and grade swallowing disorders based on the physiological impairment of the anatomical structures responsible for swallowing. This system has provided a more accurate and reliable method of communicating MBSS results, and the need existed to teach clinicians how to use the MBSImP system to benefit their own clinical practice. DDA was chosen to meet the challenging task of creating a comprehensive education, training, testing, certification, and clinical practice platform.


The MBSImP platform's first goal is to teach the use of the MBSImP diagnostic system. To do that, DDA would create a new custom virtual learning environment that would integrate an interactive, multimedia approach to medical training that reproduced the experience of clinical practice without the inherent risks. Learning would be done with fluoroscopy videos synchronized to custom 3D animations, with training based on actual use of the MBSImP diagnostic profile when presented with real fluoroscopy videos.


DDA worked with MBSImP to conceptualize and design the MBSImP virtual medical simulation training, certification, and research platform, dividing the eLearning content into three areas: Learning, Training, and Reliability. Each section is subdivided into multiple levels, which are progressively unlocked to ensure that trainees are exposed to all eLearning materials in the optimized order for maximizing understanding. In the Learning Zone, 17 modules depict the types of swallowing dysfunction at varying impairment scores. Fluoroscopy videos portray each dysfunction and score level with accompanying 3D animations of the same revealing the underlying anatomical structures and how they are involved in the processes causing the swallowing disorder. DDA developed all 73 of the 3D medical animations of swallowing disorders for this platform from scratch to ensure that clinicians using the MBSImP virtual medical simulation have a deep and thorough understanding of swallowing disorders and the MBSImP diagnostic system. Voice-over narrations accompany the synced media presentation of swallowing disorders to explain what is being shown on screen in greater detail.

The Training Zone includes 20 swallowing studies that ask registered users to score each component of a swallow as depicted in fluoroscopy videos using the MBSImP diagnostic system.The next practice area of the Training Zone includes 15 full-length swallowing studies, each accompanied by patient history and unique study details. Users are then required to score all 17 components of the swallow using the MBSImP system. The Reliability Zone then assesses clinicians’ proficiency in diagnosing swallowing disorders by scoring 10 full studies. At least 80% accuracy is needed to pass. Upon successful completion of the Reliability Zone, users gain access to the Patient Data & Reporting section, where they can record real-world medical data on swallowing disorder patients to create the first international registry for swallowing dysfunction. This data is deidentified and hosted on DDA’s own HIPAA-compliant servers to ensure patient protection. DDA later added a dynamic query system which allows researchers to filter all the recorded information in the custom electronic health records to look at specific demographic and disease trends and further the study of swallowing disorders overall.


The MBSImP virtual medical simulation has become a widely adopted online eLearning tool for those seeking to improve their diagnostic accuracy and successful treatment of patients with swallowing disorders. With access to the platform offered through paid subscription, the MBSImP virtual medical simulation has now earned well over the costs of initial development while providing tremendous benefit to the medical community overall. The MBSImP virtual medical simulation demonstrates how powerful custom interactive multimedia eLearning tools can be when developed with the right mix of expertise and interactive multimedia proficiency that makes DDA stand apart in eLearning.

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