Understanding Supervisors’ Perspective on Clinical Incompetencies and Challenges in Dysphagia Training for Speech-Language Therapy Students

Abstract

Background:  Improvements in clinical education for SLT (SLT) students can be made by identifying
common areas of clinical incompetency. This study aimed to explore supervisors’ perceptions of
undergraduate students’ clinical incompetencies and challenges during dysphagia training.
Methods: An online survey was developed and distributed to SLT supervisors in Malaysia. The
survey was designed to explore supervisors’ perceptions of students’ clinical incompetencies and
challenges during dysphagia training. The responses for 4-point Likert scale questions were
analyzed descriptively. Then, further analysis was done using repeated-measures ANOVA to
compare the mean of the categories. For open-ended questions, thematic analysis were carried
out. Results:  A total of 11 supervisors participated in the study. Findings revealed that the top two
of incompetency were reported in the categories of (1) fiberoptic endoscopic evaluation of
swallowing (FEES) (%); and (2) the management and planning (%). Statistical analysis confirmed that
(1) is actually the highest category for incompetency despite having lower percentage descriptively.
On the other hand, challenges in dysphagia training were categorized into those related to the
student and those related to the clinical environment. Contributing factors included limited
theoretical understanding, difficulty applying knowledge to practice, low confidence, and restricted
clinical exposure. Supervisors recommended enhancing training approaches, strengthening
theoretical instruction, and improving access to appropriate facilities and resources. Conclusion:
The findings highlight key areas where students face difficulties in achieving clinical competence in
dysphagia management. Strengthening theoretical foundations, expanding practical learning
opportunities, and improving access to advanced clinical facilities may help bridge the gap between
academic learning and professional practice. Future research should involve larger and more
diverse samples, incorporating perspectives from students and academic staff to further inform
curriculum development and promote safer, more effective dysphagia management practices.