Stroke, commonly referred to as a cerebrovascular accident, is a matter of considerable global health importance, occupying the position of the second most prevalent cause of mortality on a global scale and the third most prevalent cause of enduring impairment [1]. Stroke is a significant contributor to mortality in Bangladesh, accounting for a considerable proportion of overall deaths. In 2018, the death rate due to stroke was recorded at 110.89 per 100,000 individuals [2]. Although there have been notable breakthroughs in the medical care of stroke, it is imperative to recognize the ongoing significance of post-stroke rehabilitation therapy [3].

The World Health Organization (WHO) has issued a plea for collaborative endeavors, referred to as “Rehabilitation 2030,” aimed at bolstering worldwide healthcare systems and rehabilitation services, with a particular focus on low middle-income countries (LMIC) such as Bangladesh, where the availability of rehabilitative interventions is constrained [4],[5]. The study highlights the importance of the Bangladeshi government giving precedence to healthcare advancement through the establishment of additional stroke rehabilitation units and tertiary hospitals [6].

The importance of effective cooperation in delivering patient-centered healthcare has been well acknowledged [7]. According to a survey, health professionals consist of a wide array of persons who possess varying tasks and responsibilities [8]. Nevertheless, the research emphasizes the presence of attitudinal obstacles that impede interprofessional interaction, including professional envy, challenges in job identity, and limited understanding [9].

The study emphasizes the significance of including training on collaborative attitudes and abilities into the education of rehabilitation professionals in Bangladesh [10]. The importance of collaboration among healthcare professionals, including doctors, nurses, and other members of the healthcare team, cannot be overstated in terms of its impact on decision-making processes and the quality of patient treatment [11]. Collaboration within the healthcare sector is the concerted efforts of professionals to together devise and execute patient care strategies [12].

The research also offers significant insights into the conditions frequently addressed by speech and language therapists in the aftermath of a stroke, encompassing aphasia, dysarthria, verbal apraxia, and dysphagia. The significance of fostering teamwork among diverse experts, such as physiotherapists, occupational therapists, and doctors, is underscored in order to effectively handle the complex dimensions of stroke recovery. This study sought to examine the knowledge and attitudes of health professional students in relation to stroke rehabilitation teams. The significance of cooperation in stroke rehabilitation, the difficulties linked to interprofessional collaboration, and the necessity for education and training to cultivate efficient teamwork among healthcare workers in Bangladesh were emphasized.

The study employed a quantitative cross-sectional survey methodology to collect perspectives from senior students in many health-related disciplines, such as MBBS, physiotherapy, occupational therapy, speech-language therapy (SLT), psychology, and nursing. The primary objective of this study was to examine the distinct contribution of speech and language therapists (SLTs) in the process of stroke rehabilitation, with a specific emphasis on the context of Bangladesh. The data gathering process encompassed two primary methodologies: the dissemination of structured questionnaires in a face-to-face manner, following the acquisition of necessary permissions, and the administration of online surveys via Google Forms. The survey instrument utilized in this study was derived from pre-existing instruments initially created [13],[14]. The survey consisted of four separate components. Demographic and biographical data were collected from the participants in Section A. In Section B, an examination was conducted to assess the students’ perspectives on interdisciplinary collaboration as well as their level of understanding regarding stroke rehabilitation. Within Section C of the study, participants were tasked with the identification of healthcare professionals who bear the responsibility of addressing a range of rehabilitation needs in stroke patients. These needs encompassed obstacles related to mobility, communication, cognition, emotional well-being, as well as family and social support. This portion also explored the perceptions of students regarding the future employment opportunities for individuals who have experienced a stroke.

Section D of the study focused on the participants’ perspectives of the roles fulfilled by speech and language therapists (SLTs) in addressing various deficiencies identified in individuals who have experienced a stroke. The objective of the study was to differentiate between the perceptions of students regarding suitable and unsuitable roles for speech and language therapists (SLTs) in the context of stroke rehabilitation. The survey was conducted in several educational institutions in Bangladesh, including public universities, medical colleges, health professions institutes, nursing colleges, and other similar establishments. The implementation of this inclusive methodology maintained the accuracy and reliability of the findings, while also offering a full portrayal of students who are actively seeking careers within the field of health professions.

The present study evaluated the respondents’ knowledge level by examining their comprehension of collaborative interprofessional work, the practice areas of speech and language therapists, and the responsibilities of other healthcare professionals. Additionally, an analysis was conducted to assess the students’ perspectives, encompassing both favorable and unfavorable opinions, about the aforementioned subjects. Moreover, the study yielded noteworthy ramifications for speech and language therapy (SLT) education at both the undergraduate and postgraduate levels. It elucidated the therapeutic responsibilities of SLTs and underscored the significance of cultivating effective public relations within the field. The findings of the investigation were presented utilizing numerical counts (n) and percentages (%). The statistical analysis encompassed a range of methodologies, such as the Kruskal–Wallis test, Spearman rank correlation, coefficient significance test, and Pearson’s chi-square test. The data analysis was conducted utilizing the Statistical Package for the Social Sciences version 20 (SPSS-20). A significance level of p < 0.05 was deemed to be statistically significant.

The vast majority of the respondents (59.3%) were women, and 40.7% were men (Table 1).

Biographical data

Only 65% (13/20) of psychology students have worked with stroke patients, compared to 100% of SLT, PT, OT, MBBS, and nursing students. Compared to 93.3% (28/30) of PT students, 52.4% (11/21) nursing, and 35% (7/20) psychology students had worked with stroke patients with communication issues. Other than 65% (13/20) of psychology students, 100% (21/21) of SLT, OT, PT, and MBBS students have experience working with stroke patients with physical limitations. All five student groups reported less contact with other professionals during clinical placements: 46.7% (14/30) PT students, 40% (6/15) OT students, 23% (8/35) MBBS students, 59.4% (11/21) nursing students, and 35% (8/20) psychology students. However, 13.8% (4/29) SLT students interact with other professionals during placement (Table 1).

Teamwork and rehabilitation

Preferred teamwork model

All students in the six groups had clinical teamwork experience.

While a high percentage of students in all six groups had experience with a Multidisciplinary Team (MDT) model for rehabilitation (MBBS=54.3%, PT=86.7%, OT=93.3%, SLT=79.3%, nursing=9.5%, psychology=45%), except nursing 9.5% (Figure 1), less experience with a Transdisciplinary Team (TDT) model (MBBS=25.7%, PT=6.7%, OT=6.7%, psychology=40%) was shown by nursing (76.2%). Interdisciplinary Team (IDT) approach for rehabilitation was least experienced by students (MBBS=20%, PT=6.7%, SLT=20.7%, nursing=14.3%, psychology=15%). The study found a significant difference in interdisciplinary team approaches among six disciplines [χ² (5, n=150)= 52.430, p < 0.05].

Here Researcher surveyed the students preferred team model for a rehabilitation setting. Students preferred Multidisciplinary Team (MDT) model for a rehabilitation setting (MBBS=54.3%, PT=86.7%, OT=93.3%, SLT=79.3%, nursing=9.5%, psychology=45%). A high percentage of students in all six groups had preferred of a multidisciplinary team.

Advantages of teamwork

We determined the students’ preferred team model and polled their views on teamwork’s benefits (Table 2). The students agreed that the main benefit of teamwork was the chance to share ideas from other perspectives, therefore there were no notable distinctions. About as many said collaboration involves participatory learning, and most said it’s holistic. Teamwork benefits include: (1) participatory learning (96%, n=144/150), (2) goal-focused efforts (82.7%, n=124/150), (3) holistic team management (92%, n=138/150), and (4) opportunity for idea exchange from diverse perspectives (89%, n=134/150) (Table 2). A Kruskal–Wallis ANOVA revealed a significant difference in perceptions of the benefits of team members performing several services [χ² (5, n=150) =13.735, p < 0.05)].

Disadvantages of teamwork

Kruskal–Wallis ANOVA showed no significant differences between professional groups in students’ view of teamwork’s drawbacks (p < 0.05). Nearly 64% (96/150) students agreed that communication issues can hinder teamwork. Role description, knowledge, time-consuming meetings, and member cooperation were issues for over 66% of students. In Table 3, less than half of students agreed or strongly agreed that leadership conflict and professional envy are drawbacks.

The result between different courses of students and disadvantage of teamwork is considerable, indicating positive knowledge and a shared mindset. There was lack of knowledge about team members’ activities [χ² (5, n=150)=16.172, p < 0.05]; professional jealousy/competition [χ² (5, n=150)=17.315, p < 0.05]; leadership disputes [χ² (5, n=150)=3.854, p < 0.05]; and lack of teamwork [χ² (5, n=150)=24.343, p > 0.05]. The result between different courses of students and disadvantage of teamwork is considerable, indicating positive knowledge and a shared mindset.

Team leadership in stroke rehabilitation

Stroke rehabilitation team leadership: The hypothetical stroke patient example showed team leadership disagreement. Students selected this patient’s stroke rehabilitation team leader. Most students (74% OT, 30% MBBS, 27% PT, 7% SLT) chose shared leadership as the best option for the patient. Occupation therapy students endorse it for professional leadership. Doctor was the second choice (50% MBBS, 50% psychology, 33% nursing, 17% PT, 13% OT). MBBS and psychology students recommend it for team-leading doctors. Compared to 90% of SLTs and 37% of PTs, 50% of MBBS and 27% of OT students choose their career. No student nominated a psychologist, nurse, or social worker as team leader.

SLT’s responsibilities

Besides surveying the attitudes of final-year students on teamwork, we wished to survey their attitudes toward the SLT’s role in particular. In this section of the survey students were asked to indicate whether they agreed, disagreed, or were undecided about the SLT’s role in the treatment of a series of impairments. Very high agreement was reached that SLTs should be involved in aphasia, apraxia of speech, dysarthria, dysphagia, and auditory agnosia (Table 4).

Despite strong agreement (>80%), acquired reading, writing, and memory difficulties were less unanimous. The views of Amnesia differed significantly among student groups (χ² (5, n=150)=25.404, p < 0.05). Most students believed these contributed to memory problems, but few agreed (Table 4). Two topics of interest were SLT students’ differing views on treating alexia (84%) and agraphia (74.7%) and proprioceptive abnormalities. As expected, SLT students did not address visual agnosia, sadness, neglect, hemiplegia, hemianopsia, or clothing apraxia (Table 3). More than a third of SLT students believed they could manage depression issues, compared to less OT, PT, MBBS, nursing, and psychology students [χ² (5, n=150)=8.925, p < 0.05].

The cross-sectional study aimed to investigate the knowledge and perceptions of medical and health professional students regarding stroke rehabilitation teams and the role of speech and language therapists (SLTs). Prior to surveying students about teamwork, their experience working with stroke patients was assessed, as it influenced their attitudes toward other professionals’ roles [13]. Notably, psychology students had limited experience with stroke patients, emphasizing the need for more exposure in their education [9]. The majority of PT and nursing students had experience with stroke patients with communication difficulties, while SLT and MBBS students had a 100% experience rate. Most students preferred Multidisciplinary Team (MDT) settings for stroke rehabilitation, highlighting their appreciation for interprofessional collaboration. Shared team leadership was favored, with SLTs often selected as team leaders [14]. Advantages of teamwork included enhanced communication and collaborative learning opportunities. However, students needed more training in teamwork guidelines to fully appreciate its benefits. There was no significant difference in students’ views on the disadvantages of teamwork, suggesting the need to emphasize interprofessional training in undergraduate programs [13]. Students generally agreed on SLTs’ role in treating stroke-related disorders like aphasia, dysphagia, dysarthria, and apraxia of speech. However, there was some confusion among PT and OT students regarding the treatment of disorders like agraphia and amnesia, which are also within SLTs’ scope [9]. Similar to the results found by Felsher and Ross (1994) and Insalaco et al. (2007), there was general agreement among the students on the role of the SLT in the treatment of disorders following stroke with which the SLT is more commonly involved (for example, aphasia, dysphagia, dysarthria, apraxia of speech, and auditory agnosia). There was, however, some confusion evident among PT and OT students with regard to the treatment of alexia and agraphia, in particular agraphia, despite these disorders being considered primary areas of the role of the SLT in stroke rehabilitation (Royal College of Speech and Language Therapists 2005). These results were also reported by Felsher and Ross (1994). In order to ensure adequate referrals and consistent evidence based practice, the role of the SLT in the impairments of alexia and agraphia may need to be more widely acknowledged by all professions working in stroke rehabilitation.

Opinions further differed between SLT students and PT and OT students as to the role of the SLT in the treatment of hemispatial neglect. While this is not typically considered as part of the role of the SLT and is included in OT clinical guidelines (National Association of Neurological Occupational Therapists 2004), it is recommended that all nursing activities and therapy sessions be modified for the person with hemispatial neglect to cue attention to the impaired side (Intercollegiate Working Party for Stroke 2000). A team approach to the management of this disorder is therefore necessary to ensure consistent, effective rehabilitation, with all professionals being aware of their own roles and responsibilities. The study emphasized the importance of interprofessional education to enhance students’ understanding of each profession’s roles, minimize challenges in collaborative work, and promote evidence-based practice [15]. It recommended modifying clinical courses and study lectures to educate students about the benefits and challenges of interprofessional teamwork, ultimately improving stroke rehabilitation in the Bangladeshi healthcare system [16]. In Bangladesh, this study suggests that all stroke rehabilitation professionals acknowledge SLTs and teamwork. Under graduation programs require collaborative practice and interprofessional responsibilities for the future. Clinical training and study seminars are designed to improve. Students can comprehend others’ roles, actions, and collaborative working benefits of collaboration and interprofessional difficulties such role overlap, miscommunication, and joyously will be minimized.

Stroke rehabilitation teams help stroke patients with complex issues. These teams’ cross-disciplinary collaboration can affect patient outcomes and care quality. This study examines health professional students’ views on stroke rehabilitation teams, focusing on the pros and cons of collaboration. This research could improve patient care and interdisciplinary teamwork. Due to its quick onset and extensive range of physical, cognitive, and emotional effects, stroke requires comprehensive rehabilitation. To satisfy stroke survivors’ complex needs, several healthcare professionals must be involved. Thus, understanding how health professional students feel about stroke rehabilitation teams and what they know about them is essential to improving healthcare education and practice.