Tips for Trainers Continued
Tips for trainers: checking knowledge, attitudes and practice

The primary purpose of this Toolkit is to help with teaching and learning. It is not about the assessment of dysphagia knowledge or skills or competence. 

However, you may wish to know whether the learning opportunities you have created are useful.  You can do this in many different ways.  

In our research, we wanted to know whether training local trainers made any difference to the knowledge, practice and attitudes of their colleagues in the workplace (Ilott et al, 2013).   We used a questionnaire survey, interviews and observations at mealtimes, before and after the train-the trainer sessions.  These tools are included in the Toolkit, as Word documents, so you can amend and use them.  

Please acknowledge the South Yorkshire Dysphagia Toolkit if you use these resources.

Knowledge and attitudes

A short, two page questionnaire was used to check the acquisition and retention of knowledge, and changes in attitudes towards dysphagia, see

There are six knowledge questions: the first is about the swallowing process and the others are about practice.   These questions were taken from the Dysphagia Quiz (Payne 1994).    

There is a 21 item scale about attitudes toward dysphagia developed and validated in America by Colodny (2001). The attitude scale was adapted to the UK context by Bev Bennett with the kind permission of the author.  


Interviews and mealtime observation were used to investigate whether the new knowledge and skills were being put into practice when caring for people with swallowing problems.

During the interviews we asked for specific examples of using the new learning with patients, their families, colleagues or students.   Open questions which start with ‘what,’  ‘when,’  ‘who,’ ‘how,’ ‘why’ and ‘where’ are good for eliciting details.   These examples were sought from the trainees and other members of the ward team. Sabrina Eltringham created a structured observation form to capture whether staff followed the patient specific recommendations at mealtimes.  The form, with the guidance notes is available here  

Only observe staff-patient interactions if you have permission to do so. The observer should be respectful and as unobtrusive as possible.  In some circumstances the observer may need to intervene to protect patient safety.

Tips for trainers: further learning

If you are trainer, what else do you need to know?

As a trainer providing Awareness and Assistant Dysphagia Practitioner competence training, we recommend you look at the case study about Connie.  It covers screening for dysphagia and malnutrition, medicines management, and has a video about good and undesirable practice at mealtimes.   This extra information may help you answer trainees’ questions. 

Case 1: Connie of STARS: Stroke Advancing Modules. No 3 Feeding, hydration and nutrition following a stroke.  This is available here.


Taken from stroke advancing modules developed by NHS Scotland, NHS Education for Scotland, Chest Heart & Stroke Scotland and the University of Edinburgh.

Further resources

Please see our Hand out: some more resources, for some more excellent resources about dysphagia and add your own.

See here for a comparison of the key features of the dysphagia e-learning programmes.

On-line resource

The University of Adelaide has a guide to assessment, see here