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Video

Care Equity, Quality, and Safety

(A152) The Role of Speech-Language Pathologists in Tracheostomy Care: Addressing Educational Gaps and Enhancing Competence

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Nicholas DiStefano, BA

    Medical Student
    University of Miami Miller School of Medicine
    Hollywood, Florida, United States

  • Eve Bowers, MD

    Chief Resident
    Department of Otolaryngology, University of Miami Miller School of Medicine
    Miami, Florida, United States

    • Co-Author(s)

  • RS

    Rachael Silveira, CCC-SLP

    Department of Rehabilitation, Jackson Memorial Hospital, United States

  • Allison Oliva, MD

    Resident
    Department of Otolaryngology, University of Miami Miller School of Medicine
    Miami, Florida, United States

  • PK

    Pavan Krishnan, MD

    Department of Otolaryngology, University of Miami Miller School of Medicine, United States

  • SD

    Stuart Duffield, BA

    Emory University School of Medicine, United States

    • Senior Author(s)

  • Bjorn S. Herman, MD

    Assistant Professor of Otolaryngology
    University of Miami Miller School of Medicine
    Palm Beach Gardens, Florida, United States

Disclosure(s):
Nicholas DiStefano, BA: No relevant relationships to disclose.
Eve Bowers, MD: No relevant relationships to disclose.
Allison Oliva, MD: No relevant relationships to disclose.
Bjorn S. Herman, MD: No relevant relationships to disclose.


Introduction: Speech-Language Pathologists (SLPs) play a key role in tracheostomy patients’ progression of care related to speech, dysphagia, and education. However, many SLPs lack adequate training and confidence in managing emergencies and ventilator-dependent patients. This study examines educational gaps, perceived competence, and the effects of a targeted tracheostomy training program for SLPs.

Methods: Seventeen SLPs from an academic center completed pre-tracheostomy training surveys. Most worked in acute care (59%) or inpatient rehab (29%) and managed ≤10 tracheostomy patients monthly. The majority reported 0-3 hours of formal tracheostomy training by otolaryngologists (ENTs). Surveys assessed comfort in scenarios like dislodgement management, capping trials, and patient education using a 10-point Likert scale, along with views on training adequacy and SLP roles. ENT physicians led simulation-based and didactic training, followed by post-tracheostomy training surveys. Paired t-tests analyzed results for statistical significance.

Results: Post training, SLPs demonstrated significant improvements in tracheostomy care confidence across all domains. Comfort in managing dislodgements increased from 4.76 to 7.94 (p < 0.001), and confidence in providing patient/family education rose from 5.35 to 8.53 (p < 0.001). In agreement statements rated out of ten, SLPs recognize their vital role in tracheostomy care (9.06/10) and actively seek external resources to enhance skills (8.18/10), but feel their formal education inadequately prepared them for managing tracheostomies (1.24/10). Qualitative feedback emphasized the value of hands-on practice and highlighted increased confidence in clinical decision-making as a result of the program.

Conclusions: SLPs are vital to tracheostomy care but often underutilized due to educational gaps. ENT-led tracheostomy training improves SLP competence and confidence, enabling expanded roles in management. Standardized simulation-based training and curriculum updates at graduate and post-graduate levels are critical for better outcomes and collaboration.