Respiratory Care Education Research Articles

Prospective evaluation of extended reality for neonatal intubation education

Purpose360° immersive videos may be useful in procedure-based healthcare settings. We hypothesized that extended reality (XR) neonatal intubation education is a feasible alternative to live demonstration in skill and knowledge transfer.MethodsThis was a prospective single center evaluation of an educational XR intubation video using Premature Anne™ (Laerdal Medical, Stavanger, Norway) comparing to a live demonstration. Participants were randomly allocated to either live demonstration or XR group. Each group received 20 min of teaching from the pediatric respiratory care education specialist, either in person or in video format. Intubation success, knowledge and skill acquisition were measured using a questionnaire and checklist.ResultsWe had a total of 23 participants, XR (n = 11) and live demonstration (n = 12). The groups were heterogeneous in experience level.The XR group was successful at intubating 73% of the time (n = 8), which was not significantly different to the live demonstration group 58% (n = 7) (p = 0.667). For patients who achieved intubation, there was no difference between groups in the mean time to successful intubation; 98 s (SD 73) for the XR group and 65 s (SD 22) for the live demonstration group (p = 0.685).When comparing scores between groups there were no statistically significant differences regarding knowledge scores (p = 0.514), skill scores (p = 0.826) and total scores (p = 0.926).ConclusionThese preliminary findings indicated no significant differences between the XR and live demonstration groups in terms of intubation success, knowledge acquisition, skill performance, total scores or time to successful intubation.

Simulation-Based Teaching and Learning in Respiratory Care Education: A Narrative Review.

Simulation-based pedagogy has become an essential aspect of healthcare education. However, there is a significant gap in the literature regarding the application of simulation-based modalities in respiratory care education. This review aims to address this gap by providing insight into the theory and current uses of simulation, its effectiveness in respiratory care education, and strategies to enhance faculty development. The study utilizes a narrative synthesis approach to review relevant literature and provide a comprehensive understanding of the topic. The research involved comprehensive searches of electronic databases, including PubMed and Google Scholar, to identify relevant literature, encompassing original articles, reviews, and other pertinent content, focusing on simulation-based teaching and learning in respiratory care education published between 1990 and 2022. Findings suggest that simulation-based education is an effective tool for improving respiratory care education and can enhance the clinical skills of learners. The study concludes by discussing the future of simulation in respiratory care education and the potential benefits it may offer.

The Continuum of Research in Entry-Level Education and Post-Graduate Clinical Respiratory Care.

The greater and stronger your knowledge about a subject, the more you will be able to address a new problem in that subject. In entry-level respiratory care education, incorporating research into curricula can be challenging due to the limited time to cover all necessary topics. This is also true in clinical post-graduate respiratory care practice. This paper addresses the need and the rationale for research integration into respiratory therapy education and post-graduate respiratory care practice as a continuum. Without learning the importance of being a consumer of research and being immersed in research-oriented teaching and practice, the respiratory care profession cannot provide evidence-based care to patients. Devoting resources to develop research expectations and priorities should be a joint effort of educators and leaders. Mentorship is critically important to guide and nurture those with an inquisitive mindset. However, first, educators must cultivate an interest in research.

The Status of Respiratory Care Education in Saudi Arabia: A National Survey of Program Directors.

BackgroundRespiratory Care Practitioner (RCP) is a vital healthcare professional in Saudi Arabia (SA). Many factors regarding the education of RCPs in SA are unknown, including the number of active institutions, levels of education and barriers to promoting the profession.MethodsA cross sectional-based survey was conducted between June 1st, 2020 and September 20th, 2020 in SA to explore the status of RCPs education. Institutions that offered RCP programs were identified through the Ministry of Education and Ministry of Defense academic programs websites. The RCP program directors were invited to participate in an electronic survey.ResultsAmong the 74 institutions searched, 23 indicated that they offered RC programs. Only 13 (56.52%) responded to the survey. Among all programs, four (17.39%) were inactive, 17 (73.91%) were governmental institutions, and only one (4.35%) obtained a national accreditation. From the 13 respondents, there were 1297 students enrolled and 123 full-time faculty members. None of the institutions reported offering postgraduate RC degrees. The respondents reported many barriers; however, shortage of staff (76.92%), lack of postgraduate programs (69.23%), lack of research activity (69.23%), and ineffective communications between institutions (61.54%) were the most reported barriers.ConclusionThe RC education in SA is developing but not well distributed throughout the country. The shortage of staff and the limited number of postgraduate degree holders potentially contributed to the delay in establishing postgraduate RC degrees, obtaining accreditation, and implementing subspecialties to advance the profession in terms of research and quality of care.

Exploring the Critical Thinking Skills of Respiratory Care Students and Faculty

Background: Critical thinking is an essential skill for respiratory therapists to provide competent patient care. However, limited evidence of respiratory care students' critical thinking levels and no empirical evidence assessing that of respiratory care faculty exists. This study aims to assess the overall critical thinking levels of respiratory care students and faculty, determine whether faculty have stronger overall critical thinking skills than students, and investigate students' and faculty's perceptions regarding what critical thinking is and how it develops. Methods: An E-mail invitation was sent to all accredited US respiratory care education program directors asking for their participation and forwarding the solicitation letter to students and faculty. Participants completed a two-section online survey first requesting demographic information and presenting three open-ended questions and then providing the health sciences reasoning test (HSRT) to assess participants' critical thinking. Quantitative data were analyzed using descriptive statistics and one-tailed independent t-test (P

Respiratory Care Education and Clinical Practice in Mainland China

Compared with 10 years ago when our last survey was completed, the number of respiratory therapists (RTs) has increased markedly in mainland China. In addition, the education systems for RTs and the working environment have also changed. We aimed to describe the current status of respiratory care in mainland China. A nationwide survey was initiated from August 15, 2016, to September 2, 2016, through network platforms. We obtained responses from 196 RTs, of whom, 30.6% graduated from a bachelor's degree program, 25.5% graduated from an associate's degree program, and 43.9% were nurses who transitioned to be RTs through 6-month on-the-job training programs. Among the 3 groups, no significant differences existed in the basic job responsibility, such as mechanical ventilation and aerosol therapy; however, bachelor's degree RT graduates participated more in bronchoscopy assistance (96% vs 78%, P = .002), extracorporeal membrane oxygenation management (42% vs 25%, P = .02), and pulmonary ultrasound (40% vs 15%, P < .001). There was no RT certification or licensure in mainland China at the time of the survey, so only 23% of bachelor's degree graduates and 42% of associate's degree graduates received a license through other professions. For the respondents' opinions on the obstacles of respiratory care profession development, the lack of licensure was a profound barrier for both degree graduates, whereas on-the-job training RTs deemed that insufficient recognition of the value of the respiratory care profession was the main obstacle. In mainland China, degree programs for students and on-the-job training for Experienced ICU nurses were 2 major ways to train RTs. The absence of credential and/or licensure and the lack of recognition of the value of an RT were deemed as the 2 key obstacles in the development of respiratory care profession.

Future of Respiratory Care Education Around the World

Future of Respiratory Care Education Around the World

Thomas L Petty's lessons for the respiratory care clinician of today.

Because of the importance of his original contributions and their practical relevance today, Thomas L Petty (1932-2009) was arguably the most important physician in the history of respiratory care. As much as any single individual, he was responsible for the concept of intensive and multidisciplinary respiratory care. In the 1960s and 1970s, he made key observations and introduced pioneering therapies in the ICU and in the home. He was the first to describe and name ARDS and to show how to use PEEP to treat life-threatening hypoxemia. He was one of the first anywhere to organize a pulmonary rehabilitation program and to show the beneficial effects of long-term oxygen therapy in COPD. Dr Petty emphasized the importance of practical, hands-on respiratory care education for both physicians and non-physicians using a collaborative team approach. He targeted educational activities and practical resources specifically to patients, and he showed how researchers and clinicians could interact responsibly with innovators in industry to the benefit of both. His life and career provide 6 important lessons for respiratory clinicians today and in the future: (1) whatever their roles, RTs and other clinicians in this field need to be experts in its core areas, such as mechanical ventilation, ARDS, and COPD; (2) respiratory care is a team activity: every member is important, and all the members need to communicate well and work together; (3) education needs to be targeted to those in the best position to benefit the patient, including primary care providers and family members; (4) everyone in the field needs to understand the important role of the respiratory care industry and to deal with it responsibly; (5) it must never be forgotten that it is all about the patient; and (6) respiratory care should be exciting and fun.

Development of an assessment tool to measure students′ perceptions of respiratory care education programs: Item generation, item reduction, and preliminary validation

Objectives:Students who perceived their learning environment positively are more likely to develop effective learning strategies, and adopt a deep learning approach. Currently, there is no validated instrument for measuring the educational environment of educational programs on respiratory care (RC). The aim of this study was to develop an instrument to measure students’ perception of the RC educational environment.Materials and Methods:Based on the literature review and an assessment of content validity by multiple focus groups of RC educationalists, potential items of the instrument relevant to RC educational environment construct were generated by the research group. The initial 71 item questionnaire was then field-tested on all students from the 3 RC programs in Saudi Arabia and was subjected to multi-trait scaling analysis. Cronbach's alpha was used to assess internal consistency reliabilities.Results:Two hundred and twelve students (100%) completed the survey. The initial instrument of 71 items was reduced to 65 across 5 scales. Convergent and discriminant validity assessment demonstrated that the majority of items correlated more highly with their intended scale than a competing one. Cronbach's alpha exceeded the standard criterion of >0.70 in all scales except one. There was no floor or ceiling effect for scale or overall score.Conclusions:This instrument is the first assessment tool developed to measure the RC educational environment. There was evidence of its good feasibility, validity, and reliability. This first validation of the instrument supports its use by RC students to evaluate educational environment.

Respiratory Care Year in Review 2011: Long-Term Oxygen Therapy, Pulmonary Rehabilitation, Airway Management, Acute Lung Injury, Education, and Management

For the busy clinician, educator, or manager, it is becoming an increasing challenge to filter the literature to what is relevant to one's practice and then update one's practice based on the current evidence. The purpose of this paper is to review the recent literature related to long-term oxygen therapy, pulmonary rehabilitation, airway management, acute lung injury and acute respiratory distress syndrome, respiratory care education, and respiratory care management. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of Respiratory Care.

Impact of Offering Continuing Respiratory Care Education Credit Hours on Staff Participation in a Respiratory Care Journal Club

Journal clubs are employed by education and healthcare institutions to facilitate learning about study design, to teach critical reading of the literature, and to help trainees and practitioners keep abreast in their fields. Our respiratory care department initiated a journal club that was open to all respiratory therapists in the community. The articles were selected by the journal club coordinator and posted on the club's web site. However, attendance remained poor despite changes in venue, time, and day of the week. In Washington State, respiratory therapists are required to obtain continuing respiratory care education credits (CRCEs), so we hypothesized that offering American Association for Respiratory Care CRCEs for journal club attendance would increase participation. We measured journal club attendance during the 8 months preceding and the 8 months following introduction of CRCE credit for journal club attendance. The journal club meetings were held during same time frame, on the same day of the week, and in the same geographic region during the pre-CRCE and CRCE periods. Advertising for the journal club was the same during both periods as well. Pre-CRCE attendance ranged from 5 to 8 persons per meeting (mean ± SD 6 ± 1 persons), and CRCE-period attendance ranged from 7 to 10 persons (mean ± SD 8 ± 1) (P = .01). Providing CRCE credits for attendance was associated with increased participation in our departmental journal club.

Respiratory care manpower issues

Although respiratory care is a relatively new profession, its practitioners are deeply involved in providing patient care in the critical care. In preparation for writing this article, we sought to explore the respiratory therapy manpower needs and activities designed to fulfill those needs in critical care practice. We began by delineating the historical development of respiratory care as a profession, the development of its education, and the professional credentialing system. We then conducted several literature reviews with few articles generated. We requested and received data from the American Association for Respiratory Care (AARC), The National Board for Respiratory Care (NBRC), and the Committee on Accreditation of Respiratory Care education (CoARC) relative to their membership, number of credentialed individuals, and educational program student and graduate data for 2000 through 2004. We then conducted two electronic surveys. Survey 1 was a six-item survey that examined the use of mandatory overtime in respiratory care departments. We used a convenience sample of 30 hospitals stratified by size (<or=200 beds, 201-499 beds, >or=500 beds). Survey 2 was a five-item instrument distributed by blast E-mail to the Society of Critical Care Medicine's Respiratory Care Section members and members of the RC_World list serve. This survey elicited 51 usable and non-duplicative responses from geographically and size-varied institutions. We analyzed these data in several ways from distribution analysis to one-way analysis of variance procedure and appropriate post hoc analysis techniques. Where appropriate, a matched-pairs analysis was performed and these were compared across the variables intensive care unit (ICU) beds per actual number of respiratory care practitioners (RCPs) and ICU beds per preferred number of RCPs. The data gathered from the professional organizations indicated a relatively stable attrition rate (35.2%+/-1.7-3.1%), even in the face of varying enrollments (6,231 in 2004 vs. 4,589 in 2002). In survey 1, we looked at the institution of mandatory overtime policies and their use in 30 size-stratified hospitals. Mandatory overtime was selected as a survey topic under the supposition that manpower shortages might lead to the development of such procedures and also to their utilization. Fourteen of the 30 hospitals responding indicated that they had a policy addressing mandatory over time. Of the 14 hospitals with policies, only ten had disciplinary actions specific to refusing the overtime. Seven of the 30 hospitals indicated that they used mandatory overtime monthly of more frequently. Survey 2 data revealed that there was a wide variation in bed size, number of ICUs, and number of RCP staff assigned to the ICU. Serendipitously, our 51 responding centers were distributed among small (16), medium (19), and large (16) hospitals in a manner that appeared to reflect the national distribution pattern. We were able to use these data to develop a closeness of fit diagram ICU beds to preferred numbers of RCPs (DF=48; p<.0001; RSq=0.77; RMSE=4.114). The number of beds per preferred number of RCPs was 9.445 to 1.0 while the actual bed to RCP ratio was 10.75 to 1. This article provides a short history of the development of respiratory care and its historical relationship with critical care. We have, perhaps for the first time, provided a unified data set of key demographic information from the three professional bodies guiding the development of the respiratory therapy profession. This data set provides time-linked data on admissions and graduations from the CoARC, membership numbers for the AARC, and the numbers of active credentialed RCP from the NBRC. By two focused surveys, we were able to show that while mandatory overtime is a common practice in respiratory care departments, it was not overwhelming utilized. We also learned that in most hospitals, regardless of bed size, there is a perceived need for 1.3 RCPs more than the actual staff and that it appears that the critical staffing level between actual to preferred RCP to beds is between 9 and 11 beds.

The Next Generation of Respiratory Therapists: Student Recruitment and Selection

Successful outcomes are vital for respiratory care education programs. These outcomes rely heavily on student recruitment and selection. Future graduates practicing respiratory care must have a basic understanding of respiratory care and possess the advanced skills that enable them to problem solve, communicate effectively, and become active leaders in the health care team. It is the responsibility of respiratory care educators to produce the respiratory therapists of the future. It is crucial for the faculty of respiratory care education programs to recruit and select candidates who will complete the educational program and develop the technical and critical-thinking skills needed to pass the advanced level credentialing examinations and succeed in the respiratory care profession.

Characteristics of a Successful Respiratory Therapy Education Program

Because of the increasing demand for program effectiveness, program outcomes have become important for quality assessment in respiratory care education. Respiratory care programs and their institutions must ensure that programs in which they invest their time, energy, and money have there sources necessary to provide quality preparation of program graduates. To determine how well an educational program achieves its goal in producing competent respiratory therapists, respiratory therapy programs must be assessed through key personnel, teaching, clinical education, and enrollment management. The processes such as developing faculty,improving instruction and enhancing students' learning, and strengthening the structure of the respiratory therapy program with competent personnel and effective enrollment management practices determine the direction and rate of success of the respiratory care program at GSU.

Problem-based and Case-based Learning in Respiratory Care Education

Problem-based learning has been used in respiratory therapy education for a relatively short time. The purpose of PBL is to produce a graduate who has improved critical thinking and life-long learning skills. On a practical note, another goal is to help the graduate pass the NBRC Clinical Simulation examination. PBL is the use of cases to provide a stimulus for the specification of learning issues, or objectives, which the students research and discuss. The heart of the PBL process is the tutorial group, composed ofa group of five to seven students and a faculty facilitator. Students work through the case, listing facts, testing hypotheses, learning pharmacology,and studying the learning issues of the case. Information is learned in thecontext of the patient case, rather than in isolated classes. Cases are presented in the progressive-disclosure model. Student evaluation consists of written examinations, self- and peer evaluation, and with an independent case study process. Program evaluation has shown that students enjoy the process and think that they are performing clinically better than their non-PBL peers. Pass rates for the Clinical Simulation examination are above the national average. A more in-depth study of program outcomes is indicated.

State-of-the-Art Respiratory Care Education

State-of-the-Art Respiratory Care Education

State-of-the-Art Respiratory Care Education

State-of-the-Art Respiratory Care Education

Distance Education in Respiratory Care

This study would not have been possible without the valuable insight of program directors across the country who were willing to share their experience. Although not conclusive, the results of the survey of program directors indicate that online education is being used in a small number of respiratory care education programs. The benefits and difficulties related by these program directors are similar to those found in the larger body of literature in higher education. The authors agree with most survey respondents that online education is a critical long-term strategy for programs of respiratory care education. Further investigation and better understanding of the various issues affecting online learning for respiratory care students are needed, however.

Laying the groundwork for successful intubation.

Associate Professor School of Allied Health, Department of Respiratory Care Education The University of Kansas Medical Center Kansas City, Kan.

Safely delivering a breath of fresh air.

Associate Professor School of Allied Health, Department of Respiratory Care Education The University of Kansas Medical Center Kansas City, Kan.