JCPSLP Vol 15 No 2 2013

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

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)

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

Important skills • Academic skills • Personal skills • Holistic client view • Knowledge of own skills and limitations

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

• Strong interpersonal skills • Ability to work in a team • Observational skills

Interviewees’ recommendations

Figure 3. Interviewees’ recommendations regarding the training of students in dysphagia

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JCPSLP Volume 15, Number 2 2013

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