Communication partner training (CPT) in Australian post-stroke aphasia services: a national survey investigating implementation barriers, facilitators and training needs

Communication Partner Training (CPT) is an intervention where multidisciplinary healthcare staff are trained to use supportive strategies to communicate with people with communication disabilities such as aphasia. CPT is an evidence-based recommendation in high-quality international stroke guidelines, but there are large evidence-practice gaps that need to be addressed. This study explored a) current CPT practice, b) barriers and facilitators influencing CPT implementation, and c) preferences on ideal CPT. Australian stroke clinicians (speech pathologists: SLPs; the multidisciplinary team: MDT) working with people with aphasia across acute, rehabilitation and community settings completed an online cross-sectional survey based on the Theoretical Domains Framework. Data were analyzed using descriptive statistics, frequency distributions, total barriers scores and qualitative content analysis. Final analyses included 206 surveys (105 SLPs 105; 101 MDT). Both groups (SLP 98%; MDT 71%) agreed CPT is beneficial to patients with aphasia. However, less than 20% of MDT respondents reported receiving CPT. While 87% of SLPs reported providing CPT, only 36% reported alignment with best practice. Key barriers included insufficient systems-level support, training opportunities and staff availability, and the MDT lacked knowledge and confidence in using communication strategies. Training preferences included flexible delivery, interactive approaches, and protected time. Current Australian CPT practice does not align with best practice guidelines and the stroke MDT have unmet training needs. Despite SLPs valuing interactive training with demonstration and practice, time constraints often reduce CPT to basic education. A targeted implementation strategy addressing key barriers is needed to sustainably improve healthcare experience and communication outcomes.