{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:57:22Z","timestamp":1788429442934,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The management of tracheoesophageal speech (TES) rehabilitation is an area of speech and language therapists\u2019 (SLTs) clinical practice where knowledge and skills are primarily developed through postgraduate workplace experience and training. Although recent research suggests clinicians in Australia perceive there is adequate access to workplace training, little is known about how clinicians develop and\/or maintain clinical confidence when working in this specialist caseload.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate factors that contribute to development of clinician confidence as well as the factors that impact on improving and maintaining confidence when working in the clinical area of TES rehabilitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>SLTs working in an Australian clinical service and in a current or recent caseload including patients using TES were eligible to participate. A total of 36 SLTs were recruited and then grouped by level of experience (novice <jats:italic>n<\/jats:italic> = 15, intermediate <jats:italic>n<\/jats:italic> = 7, experienced <jats:italic>n<\/jats:italic> = 14). Ten focus groups of 60\u2010min duration were conducted each with three to four participants from the same experience level. A semi\u2010structured interview guide was used to facilitate the discussion of issues relating to training and confidence; however, only the content pertaining to clinical confidence is reported. Thematic analysis was used to analyse the transcripts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Four themes were identified as contributing to the development of confidence: training, exposure, accessing support and mentorship, and leadership opportunities. Three themes were identified as critical for improving or maintaining clinical confidence: ongoing management of a caseload, ongoing support and further learning. An additional overarching theme was the desire for SLTs to classify or quantify their level of confidence, typically using a numeric scale or in years of clinical experience. The impact of varying contexts and caseloads on confidence levels was highlighted by all participants, but particularly those in the novice focus groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The findings highlight the fact that the acquisition and maintenance of confidence is an ongoing consideration for SLTs, both those starting out and those with years of clinical experience. With patient presentation increasing in complexity, the importance of understanding contributing factors for gaining and maintaining confidence should be considered alongside postgraduate training and the provision of ongoing support for SLTs working in this specialized clinical area, regardless of experience level.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12505","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T04:19:00Z","timestamp":1571113140000},"page":"85-96","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Speech and language therapists\u2019 reflections on developing and maintaining confidence in tracheoesophageal speech rehabilitation"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0372-216X","authenticated-orcid":false,"given":"Kelli L.","family":"Hancock","sequence":"first","affiliation":[{"name":"Speech Pathology Department Princess Alexandra Hospital  Brisbane QLD Australia"},{"name":"The University of Queensland School of Health and Rehabilitation Sciences  Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth C.","family":"Ward","sequence":"additional","affiliation":[{"name":"The University of Queensland School of Health and Rehabilitation Sciences  Brisbane QLD Australia"},{"name":"Centre for Functioning and Health Research Queensland Department of Health  Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E.","family":"Hill","sequence":"additional","affiliation":[{"name":"The University of Queensland School of Health and Rehabilitation Sciences  Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American Speech\u2013Language Hearing Association (ASHA) 2004 Roles and responsibilities of speech\u2013language pathologists with respect to evaluation and treatment for tracheoesophageal puncture and prosthesis(ASHA)."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/AMEP.S161187"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.84.2.191"},{"key":"e_1_2_8_5_1","first-page":"13","article-title":"An education and training survey of speech\u2013language pathologists working with individuals with cancer of the larynx","volume":"27","author":"Beaudin P. G.","year":"2003","journal-title":"Journal of Speech\u2013Language Pathology and Audiology"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1044\/0161-1461(2009\/09-0032)"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_8_8_1","volume-title":"Head and Neck Cancer: Treatment, Rehabilitation and Outcomes","author":"Burns C. L.","year":"2014"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1258\/jtt.2012.GTH104"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1747-0080.12294"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.11.4.358"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TME.0000319926.97473.8d"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781446216064.n12"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/17549507.2016.1143974"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2013.08.009"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000608"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X17733020"},{"key":"e_1_2_8_18_1","article-title":"Tracheostomy and laryngectomy survey: do front\u2010line emergency staff appreciate the difference?","volume":"126","author":"Darr A.","year":"2012","journal-title":"Journal of Laryngology and Otolaryngology"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aenj.2014.03.003"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/2050571X.2017.1344814"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1108\/09654281111123475"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3283604001"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/11038128.2011.583939"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/10376178.2018.1530945"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21399"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1037\/10518-189"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2018.10.016"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812438170"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1011404132508"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2016.08.003"},{"issue":"2","key":"e_1_2_8_31_1","first-page":"129","article-title":"Speech\u2013language pathologist preparation for evaluation and treatment of patients with tracheoesophageal puncture","volume":"9","author":"Melvin C.","year":"2001","journal-title":"Journal of Medical Speech\u2013Language Pathology"},{"key":"e_1_2_8_32_1","first-page":"166","article-title":"A study of the knowledge of health care providers regarding laryngectomee care","volume":"33","author":"Mosters\u2010Benoit M.","year":"2009","journal-title":"Canadian Journal of Speech\u2013Language Pathology and Audiology"},{"key":"e_1_2_8_33_1","volume-title":"Qualitative Research & Evaluation Methods: Integrating Theory and Practice","author":"Patton M. Q.","year":"2015"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6198.2011.00230.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1044\/2017_AJSLP-17-0011"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.12422"},{"key":"e_1_2_8_37_1","volume-title":"Clinical Guidelines: 5.13 Head and Neck Cancer","author":"Royal College of Speech and Language Therapists (RCSLT)","year":"2005"},{"key":"e_1_2_8_38_1","volume-title":"Clinical Guideline: Laryngectomy","author":"Speech Pathology Australia","year":"2013"},{"key":"e_1_2_8_39_1","volume-title":"Clinical Guideline: Tracheostomy Management","author":"Speech Pathology Australia","year":"2013"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.168"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2923.2000.00728.x"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jradnu.2018.01.003"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3283610060"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2008\/024)"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1044\/2014_AJSLP-13-0050"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-6984.2011.00103.x"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187-010-0106-x"}],"container-title":["International Journal of Language &amp; Communication Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1460-6984.12505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.12505","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1460-6984.12505","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.12505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T09:14:06Z","timestamp":1694164446000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1460-6984.12505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,14]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1111\/1460-6984.12505"],"URL":"https:\/\/doi.org\/10.1111\/1460-6984.12505","archive":["Portico"],"relation":{},"ISSN":["1368-2822","1460-6984"],"issn-type":[{"value":"1368-2822","type":"print"},{"value":"1460-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,14]]},"assertion":[{"value":"2019-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}