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JCPSLP Volume 15, Number 2 2013 81
using content analysis (Graneheim & Lundman, 2004). See
Table 2 for an example of content analysis.
Decisions were made on the main themes as they
emerged during the analysis. Emerging data were then
compared to current literature in dysphagia regarding SLP
education, practice and regulation.
Results and discussion
Four main themes permeated the data: perceived new
graduate feelings about dysphagia, the importance of
taking a holistic and client-centred view, the importance of
a requisite skill base for dysphagia practice, and
interviewees’ recommendations for improving new graduate
SLP readiness for practice.
Perceived new graduate feelings about
dysphagia
In keeping with the literature (Anderson, 2005; Dawson,
1996; Parr & Dobinson, 1991), lack of confidence and fear
were the dominant themes arising throughout these
interviews (see Figure 1). Participants mentioned these in
relation to how prepared new graduates were by their
pre-professional education to deal with clinical situations,
complex ethical, legal and moral issues, family-centred
care, support systems within the clinical settings and the
need to structure the learning environment to reduce new
graduates’ fear.
I think EDS [eating, drinking, and swallowing], because
it is potentially life-changing, people are very anxious
about getting involved in it and I think it needs to
be kept in perspective, so that it doesn’t become
the focus of therapy and we don’t forget about
communication and other aspects of clients too.
(SLP1)
dysphagia supervisory position with graduates with less
than two years of dysphagia experience. Five participants
were recruited from a variety of practice settings in the
Munster region of Ireland. Participants were a mixture of
senior SLPs and SLP managers, whose experience working
with swallowing disorders ranged from 7 to 19 years, and
whose exposure to supervisory positions with new
graduates spanned 5 to 16 years.
Table 1. Participant details
Participant Participant setting Years
identifier code experience
SLT1 Complex disabilities 19
SLT2 Intellectual disability and autistic 10
spectrum disorder
SLT3 Acute care 15
SLT4 Acute care 8
SLT5 Acute care 10
Ethics and confidentiality
Ethical approval for this study was granted by the Clinical
Research Ethics Committee of the Cork Teaching Hospitals,
Ireland. Participants were fully informed of the procedures
and could withdraw from the study at any time. Participants
were identified by a generic code. As work setting may
influence participant responses, the interviewees’ coding in
relation to setting is provided: SLP1 – Complex disabilities;
SLP2 – Intellectual disability and autistic spectrum disorder;
SLP3-5 – Acute care (predominantly adult).
Procedure
Convergent semi-structured interviews were undertaken,
allowing for collection of broad information as well as
permitting probing for specific information (Dick, 1998).
Interviews took place in the participants’ work premises, at
a time of their choosing, for up to an hour. The interviews
were audio-recorded and transcribed verbatim for later
analysis. In keeping with this semi-structured interview
approach there were no predetermined questions; rather
the interviewee established the information to be gathered.
However, there were certain key areas of interest, such as
skill levels and departmental guidelines, which were
intentionally targeted during the interviews (Brumfitt,
Enderby, & Hoben, 2005). Field notes were prepared
immediately after each interview by the first author. Once
collected, all material was de-identified and participants
were referred to via code. Transcriptions were returned to
participants for their consideration and agreement that they
contained a true and accurate account of the interview.
Following transcription of the digital recordings, broad
concepts and categories were inductively generated by the
first author, and checked by the research supervisor (NB),
Table 2. Example of content analysis
Meaning unit Condensed meaning unit Condensed meaning unit Sub-theme Theme
(description close to the text) (interpretation of underlying
meaning)
...I think EDS [eating, drinking, Because of the connection between New graduates are Fear (Perceived) new
and swallowing], because it is EDS and mortality, new graduates apprehensive of dealing with graduate feelings
potentially life-changing, can be afraid to get involved in the the ethical/moral issues about dysphagia
people are very anxious about area associated with dysphagia,
getting involved in it...(SLP1) e.g. mortality.
Encountering more complex cases
Leaving medical model for more
quality of life measures
Feeling apprehensive of
consequences
Leading to communication
disorders being ignored
Disregarding holistic client view in
favour of medical model
Fear
Lack of
confidence
Perceived new
graduate feelings
about dysphagia
Needing support and mentoring
for confidence building
Different education at University
leading to lack of exposure in
various areas
Figure 1. Perceived new graduate feelings about dysphagia