SPHY603 - Advanced Speech Pathology Practice 1 Optimising Swallowing Function

Year

Credit points

Campus offering

Prerequisites

SPHY612 Enhancing Clinical Reasoning in Rehabilitation for Speech Pathologists AND HLSC630 Holistic Rehabilitation and Restoration 1

Teaching organisation

Unit rationale, description and aim

The ability to comprehensively assess and manage swallowing disorders is an essential aspect of clinical practice for speech pathologists working with aging clients and clients with a range of neurological and structural impairments. SPHY603 offers post graduate speech pathology students the opportunity to update and advance theoretical knowledge and enhance their clinical skills. Advanced use, and interpretation of, clinical and instrumental assessments will form the basis for planning holistic management and care with application of the best available evidence under the ICF Framework. This unit aims to encourage students to further develop and apply to their practice, their advanced knowledge and enhanced clinical skills associated with critical analysis of swallowing, goal setting, and collaborative person-centred application of evidence-based techniques required to optimally manage swallowing disorders.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Integrate, apply and critically discuss enhanced knowledge of anatomy, physiology and the neurological control of the normal swallowing process across the lifespan to differentiate age-related and disordered swallowing including the impact of a range of neurological lesions and structural abnormalities on the swallowing process (GA3, GA4, GA5);

LO2 - Critically analyse comprehensive clinical and instrumental assessments of swallowing function to inform holistic care plans that address client-led needs and goals aimed at maximising outcomes and participation (GA3, GA4, GA5, GA7, GA8);

LO3 - Develop, justify and apply an evidenced-based and interprofessional treatment program designed to promote optimal outcomes for clients across the lifespan with swallowing disorders of a neurological or structural basis (GA3, GA4, GA5, GA7, GA8, GA9); 

LO4 - Critically discuss the ethical and medico-legal issues facing clinicians that work with people with swallowing disorders, including the the role of the speech pathologist in care of the individual with palliative care needs (GA1, GA3, GA5);

LO5 - Reflect on the application of knowledge, skills and experiential learning in the clinical setting and analyse the implications for the assessment and interventions for optimal development of swallowing rehabilitation for clients across the lifespan and with neurological disorders, as well as for your personal and professional growth as a speech pathologist (GA3, GA4, GA5, GA7, GA8, GA9).

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

Content

Topics will include: 

Assessment and management of swallowing disorders

The content for this unit will be delivered utilising four case-based modules, to provide the opportunity to expand and develop advanced knowledge and enhanced clinical skills.

• Stroke
• Acquired Brain Injury
• Progressive Neurological Disease
• Ageing and Palliative Care

For each case, the following knowledge and skills will be developed, to meet the unit’s learning outcomes.

Critical knowledge and skills

• Review of anatomy and physiology of swallowing
• The influences on feeding and swallowing, according to the ICF Framework
• The role of the interprofessional team for managing swallowing disorders
• Application of evidence-based practice for clinical assessment of swallowing
• The purpose and value of instrumental assessments for swallowing for example:
• Videofluoroscopic Swallowing Study (VFSS)
• Fibreoptic Endoscopic Examination of Swallowing (FEES)
• Advances in swallowing rehabilitation and the clinical skills required

Learning and teaching strategy and rationale

This unit is offered through multi-mode and online delivery for specific on and offshore cohorts. Both modes aim to facilitate learner centred activities and workplace learning. Learning and teaching strategies within this unit are based on a blend of constructivism, social constructivism, and experiential learning. These strategies focus on active participation and developing a community of inquiry. Purposefully designed content and activities that are the same or similar for all students regardless of the mode of delivery have been identified. This has led to the development of purposefully designed learning activities that are transferable and work well across both delivery mediums whilst maintaining the flexibility to create and deliver mode specific activities focusing on inquiry-based learning principles aimed at encouraging critical thinking, application of knowledge and skills, evidence for practice, collaborative peer learning, and critical self-reflection.  

In addition, students participate in individual and small group activities based on analysis of current practice, to assimilate application of advanced knowledge and facilitate translation of learning into practice. Engagement in extended dialogue is encouraged to guide change to a more interprofessional, person-centred practice. Unit activities include, but are not limited to: guided readings, synchronous on-line tutorials, work-based activities with reflection and use of a reflective journal during experiential learning. Where possible, workshop activities are designed as reusable learning objects able to be provided online or modified slightly as required for current information and communication technologies for online delivery. As required, for example in different time zones learning and teaching strategies will be adapted for online delivery for specific cohorts. Activities undertaken in both modes are aimed to facilitate acquisition of advanced knowledge and skills in collaborative and assessment and intervention planning strategies. Post workshop workplace activities are supported through a clinical visit and/or use of information and communication technologies. 

Assessment strategy and rationale

SPHY603 assessments have been purposefully designed to replicate authentic clinical practice. Significantly, the unit’s assessments have also been designed from an “Assessment for Learning” approach in order to not only provide evidence for judgement of learning, but also to reinforce, facilitate and support learning and application of learning. The assessment tools have been designed to provide for a broad range of tasks aligned to andragogic principles of adult learning, facilitating choice and self-direction for the post graduate student. The design enables timely judgement to ensure students have appropriate knowledge and skills prior to the workplace application segment of the unit. In addition, the range of assessment activities at the end of the unit encourage application of evidence to practice and embed clinical reasoning, problem solving and implementation of advanced knowledge and enhanced clinical skills.   

The first assessment task provides students with the opportunity to demonstrate advanced and critical analysis of a case study and to identify and apply optimal evidence-based interventions. The focus of the second and third assessment items, is to reflect on personal and collaborative practice, and communicate reflections, evidence-based reasoning and decision making, to the interdisciplinary team, speech pathology peers and management. In the second assessment task students will identify an evidence-based intervention for implementation in their work setting. Students will outline the evidence gap, appraise the relevant evidence and apply to their work setting, and communicate the implementation plan for this evidence practice gap within their work setting. The third assessment task requires students to demonstrate the application of advanced knowledge and enhanced clinical skills in the delivery of an evidence-based intervention with a client, their clinical reasoning and clinical decision making.  

In addition to assessing advanced practice, a major focus of the second and third assessment items, is the ability to reflect on personal and collaborative practice, and communicate reflections, evidence-based reasoning and decision making, to management and peers. These assessments incorporate the advanced level of professional knowledge and skills, enhanced critical analysis and professional presentation modes developed throughout the post graduate program.  Scheduling of assessments will be equitable for both modes of delivery. Assessment tasks may be delivered and assessed locally with moderateration according to University Policies and Procedures. 

Overview of assessments

Representative texts and references

Ahn, D. H., Yang, H. E., Kang, H. J., Do, K. H., Han, S. C., Jang, S. W., & Lee, J. H. (2019). Changes in etiology and severity of dysphagia with aging. European Geriatric Medicine, 11(1), 139–145.

Archer, S. K., Smith, C. H., & Newham, D. J. (2020). Surface electromyographic biofeedback and the effortful swallow exercise for stroke-related dysphagia and in healthy ageing. Dysphagia, 36(2), 281–292.

Daniels, S. K., Huckabee, M. L., & Gozdzikowska, K. (2019). Dysphagia following stroke (3rd ed.). Plural Publishing.

Easterling, C. (2017). 25 years of dysphagia rehabilitation: What have we done, what are we doing, and where are we going? Dysphagia, 32(1), 50–54.

Saitoh, S., Pongpipatpaiboon, K., Inamoto, Y., & Kagaya, H. (2018). Dysphagia evaluation and treatment: from the perspective of rehabilitation medicine (1st ed.). Springer Singapore.

Schröder, B. S., Marian, T., Muhle, P., Claus, I., Thomas, C., Ruck, T., Wiendl, H., Warnecke, T., Suntrup‐Krueger, S., Meuth, S., & Dziewas, R. (2019). Intubation, tracheostomy, and decannulation in patients with Guillain–Barré–syndrome—does dysphagia matter? Muscle & Nerve, 59(2), 194–200.

Yan, N., Jiang, J., Liu, H., Deng, L., Hu, Q., Sun, J., & Lv, M. Evidence-based bundled care for patients with dysphagia after severe traumatic brain injury: a randomized controlled trial. (2021). American Journal of Translational Research, 13(7), 7819–7828.