Standardised training and competencies for the respiratory SLT role need to be agreed to ensure professional integrity.
Continuing professional development is a requirement for all speech and language therapists.
Here you will find resources to help you to continually improve your skills and expand your knowledge.
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Knowledge and Skills
The evolution of the respiratory speech and language therapist has come about by the amalgamation of skills from a variety of other specialisms that SLTs routinely treat. This list is not exhaustive, but these may include:
- head and neck
- critical care
The appropriate speech and language therapy skill mix must be provided and reviewed to meet the needs of people requiring respiratory care. Many speech and language therapy skills are transferable from one area of current clinical practice to another, and this must be acknowledged when treating patients under the care of a respiratory physician.
Core knowledge and skills
The underpinning knowledge and skills required to work in the role of a respiratory SLT is, at minimum, core competencies in dysphagia and/or voice disorder.
This background facilitates the skill mix required to diversify into respiratory speech and language therapy. Each speech and language therapist choosing to work in this new role is ethically responsible for achieving the appropriate level of training to fulfil the role competently. The possible core requisites are:
- postgraduate dysphagia training
- postgraduate voice disorder training
- advanced clinical knowledge of normal and disordered anatomy and physiology for respiration, airway protection, laryngeal mechanisms and swallowing
- awareness and understanding of local and national related policies and guidelines, e.g. British Thoracic Society clinical guidelines
- experience and competency with relevant instrumental procedures and interpretation (e.g. nasendoscopy RCSLT Position Paper – Speech and language therapy and nasendoscopy for patients with velopharyngeal dysfunction
Additional knowledge and skills
This list is not exhaustive and acts as a guide. The additional knowledge and skills required include:
- Awareness and understanding of specialist respiratory multi-disciplinary assessments and diagnoses and how they affect speech and language therapy management, e.g. pulmonary function tests, pulse oximetry, bronchoscopy, impedance manometry.
- Awareness and understanding of common medications and use within the respiratory population, e.g. different types of inhalers and the specifics of application.
- Specialist direct speech and language therapy intervention skills, e.g. techniques to control an acute VCD attack.
- Awareness and understanding of outcome measures used within the respiratory population, e.g. Asthma Control Test.
- Training in life support in line with local trust guidelines.
Read Nicola Whiteway’s article Breathing space published in the Bulletin, February 2016, p 21.
British Thoracic Society BTS members have access to an innovative package of eLearning resources online. These elearning resources are available for BTS members to access free, and are for personal use only. You will need to log in to view the modules. In order to view the modules you will need to have an up to date browser, either Chrome or IE (version 11 or above), and flash player installed.
Acquisition of knowledge methods and skills may be acquired, using a range of learning methods. These may include:
- supervised clinical experience
- peer review of clinical practice
- attendance at relevant conferences/training days
- critical appraisal of the literature
Currently, as with many specialisms within the speech and language therapy profession, there is no widely accepted training structure to guide a clinician to become a competent practising respiratory speech and language therapist.
As this role develops, it is recommended that specific detailed training programmes are devised to ensure a competent, equitable and regulated workforce nationally.
Clinical supervision should be arranged both in-house, as well as externally, depending on clinician need. Senior members of the team should allow junior members to shadow, especially when they are new in post. It is recommended that systematic review of service planning and succession planning must be regularly undertaken.
It is the respiratory SLT’s responsibility to share knowledge and expertise with other speech and language therapy colleagues within the service and throughout local/regional networks.
Currently, there is a respiratory forum (started September 2011), where respiratory SLTs meet every six months to discuss developments/changes in respiratory speech and language therapy and support each other in the newly-developing role. There is also a respiratory speech and language therapy CEN (started March 2012), in which a variety of allied health professionals (AHPs) involved in respiratory care inform SLTs on their roles/responsibilities and ideas for the future.
Within service development, SLTs should train other professionals regarding their role and the populations they manage. Information to service users should be readily available through websites, information sheets and patient forums. There are local and national RCSLT respiratory speech and language therapy advisers to support further.
Attendance at respiratory conferences and writing peer-review abstracts for these conferences should be highly encouraged. Members of the respiratory forum have presented, nationally and internationally, at the American Thorax Society (ATS), British Thoracic Society and European Respiratory Society (ERS) conferences. Topics of research have included:
- The efficacy of the speech and language therapy role.
- The improved understanding of the presenting conditions and co-morbidities.
- The screening tools for referrers.
- The standardised symptom questionnaires for outcome measures.