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JCPSLP Volume 15, Number 2 2013 83
by the participants as it could lead to greater collaborative
practice in the clinical environment which should result in
improved patient care and a reduction in anxiety about
dysphagia practice as each team member would know
what was expected of them:
So, I think there should be more of focus on that
[interdisciplinary learning] at undergrad level and I
think there is a huge opportunity there with the OT
department being so close to you guys, to do a lot
more work on training together...I think a lot more
focus on that, on the practical side, would be really
useful. (SLP2)
As dysphagia practice involves issues of mortality,
it is closely bound with bioethics. Hence there is a
responsibility to ensure that knowledge of the policies and
procedures surrounding this area is current and adequate,
but due to the individuality and variation in cases it must
be acknowledged that experience and support is also
required (Body & McAllister, 2009). Ethical and clinical
reasoning require careful deliberation and consideration
of multiple viewpoints while being aware of one’s own
(Barnitt, 1993). Opinion was split regarding where best to
acquire knowledge related to ethical, legal and moral issues
regarding dysphagia. Some participants felt that this could
be taught at university via case studies and problem-based
learning, while others felt the majority of learning occurred
in practice.
There was consensus regarding what education should
be covered in the clinical environment. It was felt that
new graduates needed a strong understanding of clinical
policies and departmental guidelines, which could be
obtained from their academic preparation but the skills and
management of complex cases were best learnt “on the
job”:
We wouldn’t be expecting the new grad to manage
complex cases on their own or making life-changing
decisions for clients etc. but I would be expecting
that they’d come out of college having a good overall
picture of what a client’s needs were. (SLP2)
While the value each of the interviewees placed on
skill sets differed depending on their clinical setting, five
skills were mentioned by all participants: academic skills,
personal skills, ability to take a holistic view, self-awareness
of own abilities and limitations, and observational skills (see
Table 3).
Table 3. Important skill sets for new graduates
working with dysphagia
Academic skills Basic theoretical knowledge of disorders,
anatomical knowledge
Exposure to adult and paediatric dysphagia
cases (at undergraduate level)
Personal skills Imparting information, team work, gaining
rapport
Holistic client view Flexible open thinking, bio-psycho-social view
Knowledge of own Understanding role/limitations of SLP,
skills and limitations understanding roles of MDT members
Observational skills Learning from seniors/other MDT team
members, gaining information about the
client/carers
Interviewees’ recommendations
The interviewees spoke favourably about the decision to
include dysphagia education at professional entry level (as
compared with postgraduate qualifications), endorsing the
fact that Irish standards would match best practice in the
international community. Interviewees frequently offered
recommendations for improving university education and
professional development (Figure 3). At professional entry
level, participants advocated for the standardisation of
university curricula and education provision, working
towards eliminating the fear associated with dysphagia and
giving students a greater understanding of their role and
those of the team members through interdisciplinary
learning. Interprofessional education enhances motivation
to collaborate, changes attitudes and perceptions,
cultivates interpersonal relationships and establishes
common knowledge and values (Baxter & Brumfitt, 2008).
Interprofessional learning at university was recommended
Important skills
• Academic skills
• Personal skills
• Holistic client view
• Knowledge of own skills and limitations
• Strong interpersonal skills
• Ability to work in a team
• Observational skills
Training
Undergraduate
• Eliminating the fear associated with
dysphagia
• Undergraduates knowing and
understanding their role and the
limitations of same
• Ethical issues addressed in case
studies and problem-based learning
• Consensus across universities to
provide standardised training
In practice
• New graduates understanding
clinical policies and departmental
guidelines
• Understanding expectations
Support system
• Period of monitoring necessary
for all new staff
• Eliminating the fear associated
with dysphagia
• Ensuring new graduates feel supported
and able to seek guidance
Interviewees’ recommendations
Figure 3. Interviewees’ recommendations regarding the training of students in dysphagia