Original Research

Contextualising clinical reasoning within the clinical swallow evaluation: A scoping review and expert consultation

Thiani Pillay, Mershen Pillay
South African Journal of Communication Disorders | Vol 68, No 1 | a832 | DOI: https://doi.org/10.4102/sajcd.v68i1.832 | © 2021 Thiani Pillay, Mershen Pillay | This work is licensed under CC Attribution 4.0
Submitted: 18 March 2021 | Published: 29 July 2021

About the author(s)

Thiani Pillay, Discipline of Speech-Language Pathology, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Mershen Pillay, Discipline of Speech-Language Pathology, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Speech and Language Therapy, Massey University, Auckland, New Zealand; and, Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom


Background: This study explored the available literature on the phenomenon of clinical reasoning and described its influence on the clinical swallow evaluation. By exploring the relationship between clinical reasoning and the clinical swallow evaluation, it is possible to modernise the approach to dysphagia assessment.

Objectives: This study aimed to contextualise the available literature on clinical reasoning and the CSE to low-middle income contexts through the use of a scoping review and expert consultation.

Method: A scoping review was performed based on the PRISMA-ScR framework. The data was analysed using thematic analysis. Articles were considered if they discussed the clinical swallow evaluation and clinical reasoning, and were published in the last 49 years.

Results: Through rigorous electronic and manual searching, 12 articles were identified. This review made an argument for the value of clinical reasoning within the clinical swallow evaluation. The results of the study revealed three core themes related to the acquisition, variability and positive impact of clinical reasoning in the clinical swallow evaluation.

Conclusion: The results of this review showed that the clinical swallow evaluation is a complex process with significant levels of variability usually linked to the impact of context. This demonstrates that in order to deliver effective and relevant services, despite challenging conditions, healthcare practitioners must depend on clinical reasoning to make appropriate modifications to the assessment process that considers these salient factors.


clinical reasoning; dysphagia; clinical swallow evaluation; speech-language pathology; contextualisation


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Crossref Citations

1. Exploring clinical reasoning in child language assessment through decoloniality
Buddhima P. Samaraweera, Mershen Pillay, Nimisha Muttiah, Legini Moodley
International Journal of Speech-Language Pathology  first page: 1  year: 2024  
doi: 10.1080/17549507.2023.2296864