Profession-specific training on decision-making and capacity assessment in aphasia for speech-language therapy students

Abstract

Background: Speech and Language Therapists (SLTs) play a vital role in supporting people with aphasia to communicate. Recent studies have shown that despite SLTs’ expertise, skills, and knowledge to support people with aphasias’ communication needs; they are not regularly involved in the decision-making and capacity (DMC) assessments for people with aphasia. Literature suggests three key contributors to this under-involvement: (1) SLTs do not feel they understand their role in a DMC assessment, (2) they do not feel there is enough profession-specific training, and (3) they feel members of the multidisciplinary team do not fully understand their role and responsibilities to involve them in the process. Aims: This research reports the development of a profession-specific DMC training programme for SLT trainees, and its implementation to document change in their confidence, knowledge and understanding of the DMC process in people with aphasia. Methods & Procedures: Thirty-nine SLT students attended a two-hour DMC training session conducted in three phases: pre-training questionnaire, the training programme, and the post-training questionnaire. Topics in the training programme included: the knowledge and tenets of the Mental Capacity Act (MCA); DMC for people with aphasia, focusing specifically on the barriers faced by people with aphasia and professionals; the SLTs’ role within a multidisciplinary team regarding DMC assessments; and resources available for facilitating DMC assessments. The change in participants score from pre- to post-training questionnaire was taken as a measure of efficacy of the training programme. Outcomes & Results: Following training there was a significant increase in the confidence levels of SLT students in terms of ability to complete capacity assessments and train others in their role within a capacity assessment. Participants also had a better understanding of the MCA and an increased knowledge of resources available to support people with aphasia in these assessments. These results demonstrate a crucial need for profession-specific training, which has implications for inter-professional education. Conclusions: The findings highlight the effectiveness of a short training session in increasing SLT trainees’ knowledge and confidence in DMC for aphasia, and improving their understanding of SLTs’ role and responsibilities. It is anticipated that this type of training will place SLTs in a better position for future clinical practice, reducing the risks currently present not only to patients, but also to staff themselves. We propose that similar training programmes should become mandatory for SLT trainees as part of their clinical training.