Dysphagia education in Addis Ababa, Ethiopia: student self-competency ratings during their dysphagia course

Training programs focused on dysphagia have been identified as an area needing improvement due to the specialized skills required to provide clinical care to patients with dysphagia. Globally, a lack of standardized training has been recognized and has led to the introduction of competency and training frameworks in the clinical practice of dysphagia. Previous studies have explored the experiences of students in training programs and their self-perceived competency; however, none have explored this in the Ethiopian context due to the infancy of the Speech Language Therapy (SLT) profession within this region. The objectives of this study were to explore patterns in self-perceived competency ratings for SLT students at AAU and determine the impact of clinical experiences during student training.

First- and second-year students enrolled in the two-year SLT Master's program in Ethiopia were taught the dysphagia course in a combined class in English by visiting faculty. A modified Dysphagia Competency Verification Tool (DCVT) was used to assess self-perception of competency in dysphagia. The tool was administered in April 2024, before any dysphagia-related clinical exposure occurred and once again in May 2024, after clinical exposure to patients with dysphagia occurred. Generalized estimating equations (GEE) models were used for the General Skills (DCVT-GS) and Direct Patient Care (DCVT-DPC) subtests to study variations in responses for self-perceived competency. The models included covariates of sex, background in SLT, dysphagia-specific patient exposure and a repeated factor of survey timepoint.

In total, 38 responses were collected across two time points and from all 19 participants. The SLT students were mostly female (n = 16; 84%) with ages ranging from 21 to 46 years. The GEE model for DCVT-GS identified significant main effects of background in SLT (p = 0.018), dysphagia patient exposure (p = 0.019), and survey timepoint (p < 0.001). The GEE model for DCVT-DPC demonstrated significance for background in SLT (p < 0.001), dysphagia patient exposure (p = 0.009), and sex (p = 0.031).

Regardless of DCVT domain, SLT graduate student clinicians were more likely to perceive themselves as "adequate" in their ratings at the second timepoint following clinical interactions, if they had prior SLT experience, including prior dysphagia experience. Training programs exploring dysphagia competency are encouraged to provide increased exposure to patients with dysphagia to support increased self-perceived competency scores.