Are ICU physiotherapists missing a critical skill? What the latest European research tells us about dysphagia education

A major European survey across 33 countries has found that 75% of ICU physiotherapists never assess for dysphagia, despite it being a common and serious complication in critically ill patients. This post explores what the research reveals about the training gap, and how physiotherapists can build the knowledge and skills to address it in their practice. 

A landmark European survey published in Intensive & Critical Care Nursing (2026) has shed new light on the state of physiotherapy practice across ICUs in 33 countries, and one finding in particular should make us stop and reflect.

Of the 740 physiotherapists surveyed, only 30% reported receiving any training in dysphagia assessment, and a striking 75% said they never assess for it in clinical practice. In a setting where patients are frequently intubated, mechanically ventilated, and at high risk of swallowing dysfunction, this is a gap we simply cannot afford to ignore.

Dysphagia (difficulty swallowing) is common in critically ill patients, particularly following prolonged intubation or tracheostomy. It can lead to aspiration pneumonia, malnutrition, dehydration, and in severe cases, life-threatening choking. Beyond the physical dangers, it profoundly affects quality of life, since eating and drinking are central to wellbeing and social connection. Alarmingly, one in six adults experience difficulty swallowing, yet only half ever seek help.

The PEAiCE survey confirms that while European ICU physiotherapists are highly active in respiratory management and early mobilisation, dysphagia remains a blind spot. Without the training to recognise and assess it, physiotherapists risk missing patients who urgently need support.

Physiotherapists are ideally placed to contribute to dysphagia management in the ICU. They already work closely with mechanically ventilated patients, they understand the anatomy, and they are skilled in rehabilitation. What many physiotherapists need is structured education to build confidence and competence in this area.

The Physiopedia Plus Dysphagia Programme is designed specifically for physiotherapists who want to build that confidence, covering everything you need to get started.

The programme covers four courses:

• Anatomy and Physiology of Swallowing is a solid foundation in how swallowing works, so you can understand what goes wrong and why.
• Overview of Dysphagia defines the condition and explores the mechanisms and clinical features of both oropharyngeal and oesophageal dysphagia.
• Assessment of Dysphagia is a practical overview of the most widely used non-instrumental and instrumental assessment approaches, helping you navigate an area where no single gold-standard screening tool currently exists.
• Dysphagia Rehabilitation Management covers the full range of strategies used in clinical practice, from swallowing rehabilitation and reeducation to dietary modifications and alternative nutritional support.

For ICU physiotherapists, the Nutrition and Dysphagia Considerations in Function Based Rehabilitation course adds important context around the multidisciplinary dimension of dysphagia care. It covers key features of oropharyngeal dysphagia, its assessment and management in the context of functional rehabilitation, and places particular emphasis on the distinct but complementary roles of different members of the healthcare team. Optimal dysphagia care is never delivered in isolation, and this course reflects that.

The PEAiCE study calls for standardised training pathways and clearer scope of practice definitions for ICU physiotherapists across Europe. Dysphagia is one area where targeted, accessible education can make a real and immediate difference to patient outcomes. Whether you work in critical care, acute medicine, or rehabilitation, this programme will give you the knowledge and frameworks to contribute meaningfully to dysphagia assessment and management.