{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:22:13Z","timestamp":1747182133149,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T00:00:00Z","timestamp":1594512000000},"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":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It has long been recognized that tracheoesophageal speech (TES) rehabilitation after laryngectomy is a specialized area of practice for speech and language therapist (SLTs) due to the complex nature of patient presentation and the invasive components of the SLT's role in this area. Therefore, postgraduate experience and training is required to work competently and safely in this clinical area. However, it is generally acknowledged that the steps and processes followed by individual clinicians to achieve this training and clinical skill development are inconsistent and vary widely across services. There is a need to identify critical elements deemed most beneficial to clinical skill development in order to inform future training models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore clinicians\u2019 perceptions of factors that contribute to training and clinical skills development in the area of TES rehabilitation post\u2010laryngectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>All participants were SLTs working in an Australian clinical service, with a current or recent clinical caseload that included patients using TES. 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). Each participant took part in one small focus group with other participants of similar experience level. Ten focus groups were conducted, each of approximately 60 min in duration. A semi\u2010structured interview guide was used to facilitate the discussion of issues relating to training in this area. Thematic analysis was used to analyse transcripts and identify themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Interviews identified six key themes, including: Learning with and from others; Formal programmes; Hands\u2010on learning; Processes that influence training; and Individual influences. SLTs reported both positive issues and elements that were challenging across all five themes. The final (sixth) theme was identified regarding clinician perceptions of how this area differed to specialized training in other areas of the profession. The majority of themes were discussed equally by clinicians across all three experience levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>Participants across all experience levels identified that multiple factors contributed to clinicians successfully gaining skills, understanding and competency when working in TES rehabilitation post\u2010laryngectomy. These factors, when fully considered and incorporated into future SLTs training pathways and opportunities, have the potential to optimize competency, skill acquisition and maintenance in this area.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>\n<jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on this subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>While studies have considered the training, preparation and knowledge base of SLTs working in the clinical area of TES, the focus has predominantly been at the immediate postgraduate level or assessment of university course work. No studies have used a qualitative methodology to consider the reflections and perceptions of clinicians\u2019 training pathways and training needs across all levels of experience for this clinical area.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The results of this study build upon the existing body of literature regarding education and training in this area, determining factors SLTs feel are required to successfully gain skills, understanding and competency when working in TES rehabilitation. The findings highlight that training pathways and methods in this clinical area are an ongoing consideration for SLTs regardless of experience level and have the ability to impact on future competency programmes, training opportunities and delivery methods in this area.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Effective and ongoing postgraduate training programmes and professional development opportunities have the potential to positively impact on professional competence and confidence, patient safety and overall service delivery. Hence, the themes generated from this research highlight essential factors to include within training and professional development programmes for SLTs in TES rehabilitation. This information can be used to help optimize current training pathways for all experience levels.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><\/jats:sec><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12553","type":"journal-article","created":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T12:34:25Z","timestamp":1594557265000},"page":"690-701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors contributing to clinician training and development in the clinical area of laryngectomy and tracheoesophageal voice"],"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, Metro South Hospital and Health Service  Brisbane QLD Australia"},{"name":"The University of Queensland School of Health and Rehabilitation Sciences  Brisbane QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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, Metro South Hospital and Health Service  Brisbane QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne E.","family":"Hill","sequence":"additional","affiliation":[{"name":"The University of Queensland School of Health and Rehabilitation Sciences  Brisbane QLD Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,12]]},"reference":[{"key":"e_1_2_7_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."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/AMEP.S161187"},{"key":"e_1_2_7_4_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. 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