JCPSLP Vol 15 No 2 2013

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.

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

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),

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)

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

Perceived new graduate feelings about dysphagia

Lack of confidence

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

Table 2. Example of content analysis Meaning unit

Condensed meaning unit (description close to the text)

Condensed meaning unit (interpretation of underlying meaning)

Sub-theme Theme

...I think EDS [eating, drinking, and swallowing], because it is

Because of the connection between New graduates are

Fear

(Perceived) new graduate feelings about dysphagia

EDS and mortality, new graduates can be afraid to get involved in the

apprehensive of dealing with the ethical/moral issues associated with dysphagia,

potentially life-changing,

people are very anxious about getting involved in it... (SLP1)

area

e.g. mortality.

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JCPSLP Volume 15, Number 2 2013

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