title: Preparation, clinical support, and confidence of speech-language therapists managing clients with a tracheostomy in the UK.
abstract: BACKGROUND
  Literature regarding the education, training, clinical support and confidence of speech-language therapists (SLTs) working with patients with a tracheostomy is limited; however, it suggests that many clinicians have reduced clinical confidence when managing this complex population, many face role and team challenges practising in this area, and most are seeking more opportunities for professional development and training.
  
  
  OBJECTIVE
  To investigate the education, training, clinical support and confidence of SLTs in the UK who manage patients with a tracheostomy in order to identify current challenges and inform the future clinical training needs of this professional group.
  
  
  METHODS
  Via an online survey, the clinical training, clinical support and confidence of SLTs with more than one year of clinical experience was examined. A total of 106 SLTs from the UK completed the survey. Within the questionnaire, clinicians were also asked to identify if their workplace had a tracheostomy competency training programme (CTP) to allow further exploration of the preparation, clinical support and confidence of respondents with (43% of respondents) and without (32% of respondents) a CTP.
  
  
  RESULTS
  Most SLTs (71%) were confident managing patients with a tracheostomy. The majority were accessing professional development and receiving expert support, though many identified specific areas where more support and training was needed. Less than half the group felt up to date with the current evidence. Only 35% of clinicians felt they worked in an optimal team for tracheostomy management, and poor recognition of the role of the SLT in managing dysphagia in patients with a tracheostomy was an issue for many clinicians, particularly on more general care wards. SLTs in workplaces with a CTP were found to have received significantly more expert support, on-the-job training, access to evidence-based practice and were significantly more confident in managing ventilator-assisted patients.
  
  
  CONCLUSIONS
  SLTs are eager to access further professional development and training; however, such training needs to target specific areas of need. The significant difference in the preparation, support and confidence of SLTs with CTPs in their workplace highlights potential benefits that can be achieved through workplace training and support.
authors.affiliation: Division of Speech Pathology, The University of Queensland, St Lucia, Brisbane, QLD, Australia. liz.ward@uq.edu.au
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ward
authors.forename: Tessa
authors.initials: T
authors.lastname: Morgan
authors.forename: Sue
authors.initials: S
authors.lastname: McGowan
authors.forename: Ann-Louise
authors.initials: AL
authors.lastname: Spurgin
authors.forename: Maura
authors.initials: M
authors.lastname: Solley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D007400:Interprofessional Relations; D007808:Language Therapy / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D010348:Patient Care Team / Q000592:standards / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D013070:Speech Therapy / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data*; D014139:Tracheostomy / Q000534:rehabilitation*; D006113:United Kingdom