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Sharp, H. M., & Bryant, K. N. (2003). Ethical issues in dysphagia: when patients refuse assessment or treatment. Seminars in Speech and Language , 24 (4), 285–297. Stansfield, J. (2004). Education for competent speech and language therapy practice. In S. Brumfitt (Ed.), Innovations in professional education for speech and language therapy (pp. 3–28). London: Whurr Publishers. Toal-Sullivan, D. (2006). New graduates’ experiences of learning to practise occupational therapy. British Journal of Occupational Therapy , 69 , 513–524. Weiner, K. (2004). Exemplar: Professional confidence. British Journal of Perioperative Nursing , 14 , 298–299. Wolff, A. C., Pesut, B., & Regan, S. (2010). New graduate nursing practice readiness: Perspectives on the context shaping of understanding and expectations. Nurse Education Today , 30 , 187–191. Wolff, A. C., Regan, S., Pesut, B., & Black, J. (2010). Ready for what? An exploration of the meaning of new graduate nurses’ readiness for practice. International Journal of Nursing Education Scholarship , 7 (1), 1–14. World Health Organization (WHO). (2001). International classification of functioning, disability and health (ICF). Geneva: Author.

World Health Organization (WHO). (2007). International classification of functioning, disability and health – Children and youth version (ICF-CY). Geneva: Author. 1 All Irish SLP students must now demonstrate 25 different competencies in the area of dysphagia before graduation (see Appendix 1). These are determined by clinical educators to be either at novice (typically second year), transition (typically third year) or entry (typically fourth year) level. On graduation, the student must have any 21 of the 25 at entry level while the final four can be at transition level. Since graduating in 2011 Trudy Olwen Smith has been working in Singapore with paediatric therapy services. Nicola Bessell facilitates SLP student learning as a PBL tutor and works in clinical and non-clinical phonetics/phonology. Dr Ingrid Scholten’s academic expertise relates to swallowing disorders, with a special interest in curriculum development.

Correspondence to: Dr Ingrid Scholten, Ed.D. Flinders University, South Australia GPO Box 2100, Adelaide, South Australia 5001. Email: Ingrid.scholten@flinders.edu.au

Appendix 1. Entry-level feeding, eating, drinking and swallowing competencies specified by Irish Association of Speech and Language Therapists (IASLT, 2012) Competent across a range of clinical contexts. Integrated knowledge and experience results in efficient performance in routine procedures. Specific direction and/or demonstration required for complex or novel presentations/conditions. Assessment 1. Recognize signs and symptoms of feeding, eating, drinking and swallowing disorders 2. Identify social, cognitive, behavioural, and psychological factors contributing to feeding, eating, drinking and swallowing and/or feeding status 3. Identify atypical structure and function, medical conditions and medications which may be indicative of dysphagia 4. Obtain details related to client’s current oral intake situation (e.g. positioning, feeding dependency, environment, diet modification, compensations) 5. Identify appropriate feeding, eating, drinking and swallowing assessment procedures 6. Conduct an oral examination to assess oral, pharyngeal, laryngeal and respiratory structures and functioning for speech and swallowing and relate it to neurological function 7. Administer, record and evaluate appropriate clinical feeding, eating, drinking and swallowing (FEDS) assessment 8. Identify potential aspiration risks 9. Identify need for objective/instrumental swallowing assessment 10. Communicate findings and recommendations to client, family and other health professionals orally and in writing 11. Identify values and attitudes of client/significant other to feeding and swallowing 12. Identify indicators for swallowing therapy and show awareness of non oral intake options Management and intervention 13. Identify the need for consultation/referral to other team members (e.g. clinical nutrition/dietetics) 14. Support client and caregivers in decision-making 15. Recommend appropriate oral intake method(s) and quantities, taking into account the client’s medical, swallowing, feeding, cognitive, and behavioural status and psychosocial factors 16. Set measurable short and long-term treatment goals targeting appropriate feeding and swallowing outcomes 17. Recommend appropriate postural, sensory, cognitive, visual and/or perceptual strategies to enhance feeding and swallowing function 18. Recommend appropriate food and fluid consistencies 19. Identify appropriate compensatory and/or rehabilitative management techniques to improve efficacy of feeding and swallowing

20. Provide effective education and/or training to clients and carers using selected management techniques 21. Maintain collaborative working relationships with other health professionals involved in the client’s care 22. Select and modify appropriate assistive feeding utensils 23. Evaluate the client’s response to treatment 24. Identify need for review assessment 25. Revise treatment/discharge plan as appropriate

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JCPSLP Volume 15, Number 2 2013

Journal of Clinical Practice in Speech-Language Pathology