Training the allied health assistant for the telerehabilitation assessment of dysphagia

Abstract

SummaryThe present study examined the impact of knowledge and task specific training provided to a certified allied health assistant (AHA), prior to their involvement in facilitating assessments of dysphagia (swallowing disorders) via telerehabilitation. The AHA received four hours of training which included basic theoretical information regarding dysphagia as well as hands-on training with simulated patients prior to commencing the telerehabilitation trials. A written test examining swallowing function and its evaluation was completed preand then immediately post-training and again after the 15 th and 30 th of 31 consecutive patient assessments to assess theoretical knowledge (n = 4). Additionally after each set of 5 clinical dysphagia assessments completed with patients following the training (n = 6 assessments), two speech pathologists rated the AHA's competency in relation to performing the tasks and activities required of them during the telerehabilitation swallowing assessment session. The AHA also self rated the perceived level of confidence at these time points. Minimum acceptable standards of at least 80% were achieved on the knowledge tests and the AHA's performance was rated as competent on each evaluation post-training. The AHA also expressed overall satisfaction with the initial training provided and reported to feel confident after the initial sessions with patients. This study provides insight into the training and preparation needs of AHAs involved in assisting dysphagia assessments via telerehabilitation.Future research should expand on this current work to explore the training needs of individuals who have no prior healthcare training. This evidence is required to fully understand the training needs of assistants who help to facilitate telerehabilitation assessment for dysphagia and to progress towards defining the role and level of professional knowledge and skills required by healthcare personnel involved in this form of service delivery.

Impact of Dysphagia Severity on Clinical Decision Making via Telerehabilitation

“…As described in prior studies, 15,16,28 an assistant was also involved at the patient end. This professional was an allied health assistant (Technical and Further Education Level IV Certificate in Allied Health Assistance; HLT424507) working in a cognate field who had no prior understanding of dysphagia or its assessment.…”

Telehealth Stroke Dysphagia Evaluation Is Safe and Effective

“…In addition to evaluation, tele-rehabilitation for swallowing has been successful in head and neck cancer patients [4]. In recent years, SLPs and patients have become interested and feel comfortable in using telehealth [4,8,9]. …”

Expanding speech pathology delegation practices: engaging Allied Health Assistants (AHAs) in dysphagia management in the acute hospital setting

“…In addition to a lack of literature and evidence to support the role of AHAs in speech pathology practice generally, to our knowledge there is limited published article describing the role of AHAs in dysphagia management (Sharma, Ward, Burns, Theodoros, & Russell, 2012). In that study, Sharma and colleagues (2012) utilised an AHA as an assistant during dysphagia assessments performed via telehealth after providing specialised training for this role.…”

“…In that study, Sharma and colleagues (2012) utilised an AHA as an assistant during dysphagia assessments performed via telehealth after providing specialised training for this role. The AHA was noted to increase their knowledge of dysphagia and reported feeling confident completing the assessment under the direction of the SP (Sharma et al, 2012), suggesting that dysphagia could be an area for AHA role expansion. Similarly, in a study by colleagues (2012a, 2012b) the AHA was noted to be instrumental in managing patient factors such as hearing impairment, movement disorders and emotional issues in order to contribute to successful completion of a telehealth dysphagia assessment.…”

“…Sharma and colleagues (2012) reported that training of the assistant included both content learning and clinical observations taking approximately four hours with one assistant. Content information (using both written and video) included material on the normal swallow, anatomical structures, description of the normal swallow and signs and symptoms of dysphagia (Sharma et al, 2012). Further "hands on" training was provided by two SPs who acted as standardised patients and provided an opportunity to practice set up, positioning and the completion of oromotor tasks (Sharma et al, 2012).…”