SLT experience
Results show that patients in the oral trials group were more likely to
be assessed by ‘mixed SLTs’, suggesting a degree of supervision or
shared-working between SLTs in the team. When controlled for
neurological diagnosis, SLT experience is no longer significant. This
suggests that SLT experience is related to types of patients being seen
or ward speciality rather than being a predictor for treatment decisions
made. SLT experience can influence dysphagia treatment taken and less
experienced SLTs may lack the confidence to try novel dysphagia
therapies 28,29. A variety of patients and
availability of clinical supervision has been recognised as essential
for the development of dysphagia skills 30. Results
may reflect how supervision is used in the hospital studied to support
dysphagia management in more complex cases.
Videofluoroscopy was not a significant factor between treatment groups
and had only been carried out on 11.0% of patients on the caseload.
This may highlight the clinical decision-making process taking place at
bedside assessment or may reflect resource limitations. Over half of
SLTs working in stroke rehabilitation report using instrumental
assessments ‘rarely or never’ before recommending exercises6. This suggests that decision-making around dysphagia
therapies relies on other clinical measures and judgments within
practice.