The Advanced Practice Respiratory Therapist - Cobgrteorg

150689_7Advanced_Practice_of_Respiratory_Therapist_slides_for_CoBGRTE_Final.pdf

The Advanced Practice Respiratory

Therapist: Education, Competencies

and Curriculum Models

David C. Shelledy, PhD, RRT, FAARC, FASAHP

Professor and Dean

College of Health Sciences

Rush University

Rush University Medical Center

Chicago, Illinois

Disclaimer opinions of David Shelledy. The content is not read or approved by the Commission on

Accreditation for Respiratory Care (CoARC)

and does not necessarily represent the views

About Rush

Rush is a not-for-profit

health care, education and research enterprise established in Chicago,

Illinois in 1837, and

comprising Rush University

Medical Center, Rush

University, Rush Oak Park

Hospital and Rush Health.

Rush University: Colleges of

Medicine, Nursing, Health Sciences

and the Graduate College

Rush University Medical Center

Mission The mission of Rush University Medical Center is to provide the very best care for our patients. Our education and research endeavors, community service programs and relationships with other hospitals are dedicated to enhancing excellence in patient care for the diverse communities of the

Chicago area, now and in the future.

Vision

Rush University Medical Center will be

recognized as the medical center of choice in the Chicago area and among the very best clinical centers in the United States.

Rush Medical College ~1890

Jelke 1965 Armour 1975/1997

Cohn ~2000

2012

Atrium 1982

1837 Rush Medical College Chartered

Current academic organization

6

Rush University

Medical Center

Rush University

Graduate

College

College of

Nursing

Medical

College

College of

Health

Sciences

College of Health Sciences

Departments and Programs

Clinical Sciences

Perfusion Technology - BS, MS

Physician Assistant MS

Clinical Nutrition MS

Communication Disorders and Sciences

Doctor of Audiology AuD

Speech-Language Pathology - MS

Division of Health Sciences PhD

Health Systems Management MS

Imaging Sciences

Vascular Ultrasound - BS

Imaging Sciences - BS

Medical Laboratory Science (Medical Technology)

BS, MS in MLS

MS in CLS Management

Blood Bank Specialist (certificate)

Medical Physics

Radiation Oncology Medical Physics Residency

Occupational Therapy MS

Religion, Health and Human Values

Clinical Pastoral Education (certificate)

Research Administration MS

Respiratory Care BS, MS

Ten academic

departments

15 professional areas

20 different degrees

and certificates

2013 Rankings

Health Systems Management: #9

(out of 75)

Audiology: #10 (out of 78)

Speech Pathology: #29 (out of 250)

OT: #36 (out of 156)

24 programs in 17 different professional areas

Audiology

Speech Pathology

Cytotechnology

Dental Hygiene

Diagnostic Medical Sonography

Dietetics & Nutrition

Emergency Medical Sciences

Genetic Counseling

Health Information

Management

Medical Dosimetry

Medical Technology

Nuclear Medicine

Ophthalmic Medical

Technology

Radiation Therapy

Radiologic Imaging Sciences

Respiratory Care

Surgical Technology

Objectives

s

1.Describe the evolution of the health professions and the

development of the mid-level provider in nursing and allied health. 2. programs in respiratory care.

3.Explain the roles and associated competencies needed by

an advanced practice respiratory therapist (APRT) to function as mid-level provider (pulmonary physician assistant). 9

Upon conclusion of this presentation, you

will be able to:

Slide requests: David_Shelledy@Rush.edu

Merriam-Webster's Collegiate Dictionary

Function: noun Etymology: Middle English professioun, from Anglo-French profession, from Late Latin & Latin; Late Latin profession-, professio, from Latin, public declaration, from profitri Date: 13th century

1 : the act of taking the vows of a religious community 2 : an act of openly declaring or publicly claiming a belief, faith, or opinion 3 : an avowed religious faith

Definition of a Profession

To Profess

Merriam-Webster's Collegiate Dictionary

4 a : a calling requiring specialized

knowledge and often long and intensive academic preparation

4b : a principal calling, vocation, or

employment

4c : the whole body of persons engaged in

a calling

Definition of a Profession

What is a profession?

Classically, there were only three professions:

ministry, medicine, and law

Each have a specific code of ethics

members are almost universally required to swear some form of oath to uphold those ethics, therefore "professing" to a higher standard of accountability.

Each requires extensive training in the meaning,

value, and importance of its particular oath in the practice of the profession.

History of the Professions

Medicine dates back to ancient times

Early cultures developed herbal treatments for many diseases Surgery may have been performed in Neolithic times Physicians practiced medicine in ancient Mesopotamia, Egypt and China

Foundations of modern western medicine

Ancient Greece

Hippocrates (460-360 BC)

Hippocratic Corpus

Four essential humors blood, phlegm, yellow bile and black bile

Four elements earth (cold, dry), fire (hot, dry), water (cold, moist), air (hot, moist)

Hippocratic Oath ethical principles of behavior

History of the Professions

Associated with the development of the universities in the middle ages

Salerno School of Medicine 9th century

University of Paris (around 1150-1170)

1231 four faculties

Theology

Canon law (ecclesiastical law)

Medicine

The Arts

Oxford (1096-1167) and Cambridge (around 1226)

13th -15th centuries Italian Universities

Civil or canon law

Harvard in 1636

Medical School in 1782; Law in 1817

History of Respiratory Care

, describes an ancient Egyptian inhalational treatment for asthma

1774 Joseph Priestley, usually credited with the discovery of oxygen, three months after Scheele

1798 Thomas Beddoes establishes the Pneumatic Institute in Bristol and uses oxygen to treat a variety of disorders.

Early 20th Century. Christian Bohr, K.A. Hasselbach, August Krogh, John Scott Haldane, Joseph Barcroft, John Gillies Priestly, Yandell Henderson, Lawrence J. Henderson, Wallace O. Fenn, Herman Rahn, and others make great strides in respiratory physiology and the understanding of oxygenation, ventilation, and acid-base balance.

History of Respiratory Care

1947 Inhalational Therapy Association (ITA) is formed in Chicago, Illinois.

1973 The AAIT becomes the AART

1984 The AART is renamed the AARC

1960 American Registry of Inhalation Therapists

1968 Technician Certification Board

1974 National Board of Respiratory Therapy (NBRT)

1983 NBRT becomes the National Board for Respiratory Care (NBRC)

1963 Board of Schools formed to accredit educational programs

1968 JRCITE

1977 JRCITE becomes the Joint Review Committee for Respiratory Therapy Education (JRCRTE)

1998 The Committee for Accreditation for Respiratory Care (CoARC) is formed, replacing the JRCRTE

AMA 1847

ANA 1896

AOTA 1917

ASRT 1920

APTA 1921

AARC 1947

AAPA 1968

Characteristics of a Profession

Requires specialized knowledge, methods,

and skills

Preparation in an institution of higher

learning in the scholarly, scientific, and historical principles underlying these skills

The work is complex, esoteric and

discretionary

Requires theoretical knowledge, skills and

judgment that ordinary people do not possess Mishoe, SC, MacIntyre NR, Resp Care, 1997, 42(1), 71-86

Integrated Postsecondary Education

Data System (IPEDS)

Definition of first professional degree

Since the 1950s

Academic requirements precede practice

At least 2 years of college prior to entry

At least 6 years (total) to complete

Law, medicine, other health fields, theology

Discontinued in IPEDS (2010-11 data collection)

-professional practice The Integrated Postsecondary Education Data System (IPEDS) Statistical Data and Information on Postsecondary Institutions

First Professional Degrees

Chiropractic (D.C. or D.C.M.)

Dentistry (D.D.S. or D.M.D.)

Law (J.D.)

Medicine (M.D.)

Optometry (O.D.)

Osteopathic Medicine (D.O.)

Pharmacy (Pharm.D.)

Podiatry (D.P.M., D.P., or Pod.D.)

Theology (M.Div., M.H.L., B.D., or Ordination)

Veterinary Medicine (D.V.M.)

* OTD, DPT, DNP Not recognized by IPEDS as first professional degrees

Term discontinued in IPEDS as of

the 2010-11 data collection, when use of the new postbaccalaureate award categories became mandatory.

Characteristics of a Profession

Summary Constructs

Knowledge and skills

Education

Recognition and authority

Professionalism and ethics

The Allied Health Professions

©2007 RUSH University

Medical Center

Definition of Allied Health

Allied Health professionals are involved with the delivery of health or related services pertaining to the identification, evaluation, treatment, and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, among others.

Allied health professionals, to name a few, include dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapists, and speech language pathologists.

Association of Schools of Allied Health Professions

(ASAHP 112 academic institutions) and

National Commission on Allied Health, 1995

The Center for Health Professions

University of California, San Francisco 2005

All Health Services:

13,062,000 in 2004

increase to 16,627,900 in 2014 (up 27.3%- BLS)

Nursing shortfall of 800,000 by 2020

4,270,000 nurses and related personnel (all levels - 2002)

Severe shortages in pharmacy, medicine, and

dentistry

850,000 physicians and surgeons (2002)

Over 200 allied health and related professions

7,780,000 workers in 2002 - many are projected to

have severe shortages

60% of the

workforce

©2007 RUSH University

Medical Center

BLS Projections 2008-2018

Employment Numbers

Occupation 2008 2018 2018 Replacement Total

Audiologists 12,800 16,000 25.0% 5,800

Clinical laboratory technologists and technicians 328,100 373,600 13.9% 107,900 Diagnostic medical sonographers 50,300 59,500 18.3% 16,500 Emergency medical technicians and paramedics 210,700 229,700 9.0% 6,200 Home health aides 921,700 1,382,600 50.0% 552,700

Medical assistants 483,600 647,500 33.9% 217,800

Medical records and health information technicians 172,500 207,600 20.3% 70,300 Nuclear medicine technologists 21,800 25,400 16.3% 6,700 Nursing aides, orderlies, and attendants 1,469,800 1,745,800 18.8% 422,300 Occupational therapists 104,500 131,300 25.6% 45,800

Physical therapists 185,500 241,700 30.3% 78,600

Physicians and Surgeons 661,400 805,500 21.8% 260,500 Physicians Assistants 74,800 103,900 39.0% 42,800

Radiation therapists 15,200 19,400 27.1% 6,900

Radiologic technologists and technicians 214,700 251,700 17.2% 6,800 Registered Nurses 2,618,700 3,200,200 22.2% 1,039,000 Respiratory therapists 105,900 128,100 20.9% 41,400 Speech-language pathologists 119,300 141,400 18.5% 43,800 Surgical technologists 91,500 114,700 25.3% 46,300

Affordable Care Act

COMPILATION OF PATIENT PROTECTION AND AFFORDABLE CARE ACT [As Amended Through May 1, 2010] INCLUDING PATIENT PROTECTION AND AFFORDABLE CARE ACT HEALTH-RELATED PORTIONS OF THE HEALTH CARE AND EDUCATION

RECONCILIATION ACT OF 2010

PREPARED BY THE Office of the Legislative Counsel

FOR THE USE OF THE U.S. HOUSE OF REPRESENTATIVES

MAY 2010

VerDate 0ct 09 2002 14:17 Jun 09, 2010 Jkt 000000 PO 00000 Frm 00001 Fmt 6012

Sfmt 6012 F:\P11\NHI\COMP\PPACFRN.001 HOLCPC

June 9, 2010

Affordable Care Act

974 pages in length

Physician assistant referred to 42 times

Allied health referred to 33 times

Occupational therapy referred to 4 times

Physical therapy referred to 3 times

Respiratory therapy (or RC or RT) referred to 0 times

Allied Health Education

Entry Level Educational Requirements

Pharmacist Doctorate (PharmD -1997)

Audiologist Doctorate (AuD c 1997)

Physical Therapist Doctorate (DPT c1998) Doctorate (DPT) n=197; Masters n=1 Occupational Therapist Graduate degree effective 1/1/2007 Doctorate (OTD 5 2012); Masters (154 2012) Masters degree AE 112/136 (82%)

Medical Technologist Bachelors degree

Registered Nurse Associate degree

Respiratory Therapist Associate degree

Radiologic Technologist Certificate/Associate Degree

Mid-Level Providers

Advanced Practice Nurses (APNs)

Nurse anesthetists

US: Certified Registered Nurse Anesthetists or CRNAs

Nurse midwives

US: Certified Nurse Midwives or CNMs

Clinical nurse specialists (CNSs)

Nurse practitioners (NPs)

Physician Assistants (PAs)

Primary care

Specialty practice

Radiologist Assistants (RAs)

Nuclear Medicine Advanced Associate

American Association of Colleges of Nursing (AACN)

October 2004

Specialization in nursing to occur at the doctoral level by 2015

Doctor of Nurse Practice (DNP) is the degree

associated with practice-focused doctoral education

Clinical nurse specialist

Nurse anesthetist

Nurse midwife

Nurse practitioner

AD programs: 691

MS/Doctorate: 688

BS: 800

PhD 87

DNP 104

Masters 497

Baccalaureate 800

Associate 691

Diploma 50

Practical 167

Advanced Practice Nursing (APN)

Nurse Practitioners

Acute Care NP

Adult NP

Adult-Gerontology Acute Care NP

Adult-Gerontology Primary Care NP

Adult PsychiatricMental Health NP

Diabetes Management - Advanced

Family NP

Family PsychiatricMental Health NP

Gerontological NP

Pediatric NP

School NP

Clinical Nurse Specialists

Adult-Gerontology CNS

Adult Health CNS

Adult PsychiatricMental Health

CNS

Child/Adolescent PsychiatricMental

Health CNS

CNS Core

Diabetes Management - Advanced

Gerontological CNS

Home Health CNS

Pediatric CNS

Public/Community Health CNS

Rush University Phases Out BSN

BSN replaced by the entry-level Masters Degree in nursing (summer of 2008)

Rush advanced clinical specialist and nurse

practitioners degrees 8 ranked in top 10 Acute care, pediatrics, neonatal, family, gerontological, mental health

Anesthesia ranked 3rd in the US

Doctor of Nursing Practice (DNP) in place

PhD program in nursing in place

The Physician Assistant

Physician assistants (PAs) practice medicine under the supervision of physicians and surgeons. Licensed to practice in every state in the US including the District of

Columbia.

PAs have prescriptive rights

PAs are recognized under Medicare Part B for reimbursement PAs are formally trained to provide diagnostic, therapeutic, and preventive healthcare services, as delegated by a physician. Take medical histories, examine and treat patients, order and interpret laboratory tests and x-rays, and make diagnoses PAs are often based in primary care - licensed to practice medicine with physician supervision.

Primary care setting (31% of the workforce)

obstetrics, and gynecology, surgery and the surgical subspecialties. Surgical subspecialties second most common setting (23% of the workforce)

History and Development of the PA Profession

military medics. In 1940, a physician by the name of Dr. Amos N. Johnson, who ran a rural based primary care clinic in Garland, North Carolina, employed the Treadwell performed minor medical procedures, suturing, and ran laboratory examinations Relationship between Treadwell and Johnson was brought to light at Duke

University where Dr. Eugene Stead practiced

In 1964, Dr Stead identified former military corps men that had much state side medicine as suitable candidates for the initial class of physician assistants. The first formal physician assistant training program began in 1965 at

Duke University.

History and Development of the PA Profession

First PA began practicing in 1967 (first graduating class of PAs from

Duke).

In 1968, at Alderson-Broaddus College in West Virginia developed the first baccalaureate degree training program for PAs.

1972 first baccalaureate trained PAs graduate.

1970 the American Registry of Physician Associates (ARPA)

developed in North Carolina. Certification examination for graduates of approved programs

1973 first American Academy of Physician Assistant meeting.

1975, the National Commission on Certification of Physician

Assistants was developed and assumed sponsorship of the certification examination for physician assistants.

2010 PA workforce in the U.S. totaled 83,466.

PA Education

159 accredited physician assistant programs (2011)

132 (83%) are masters degree programs

19 are baccalaureate degree programs

4 are associates degree programs

4 are certificate programs

All accredited programs are required to convert to a Most programs are two years (24-33 months) in length First year of education is comprised of a variety of laboratory activities and classroom work based on the medical sciences such as pharmacology, clinical medicine, physical diagnosis, and medical

PA Education

Second year at least 2000 hours of supervised clinical work prior to successful completion of an accredited physician assistant program medical and surgical subspecialties such as: family medicine, internal medicine, obstetrics and gynecology, pediatrics, general surgery, emergency medicine and psychiatry

28 post graduate residency programs for physician

assistants across the U.S. for medical and surgical specialties including: dermatology, emergency medicine, family medicine, oncology, orthopedics, pediatrics, psychiatry, rural medicine, surgery, cardiovascular surgery, and urology

PA Competencies: Medical Knowledge

Table 1. Physician Assistant Competencies: Medical Knowledge Understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions Identify signs and symptoms of medical conditions Select and interpret appropriate diagnostic or lab studies Manage general medical and surgical conditions to include understanding the indications, contraindications, side effects, interactions and adverse reactions of pharmacologic agents and other relevant treatment modalities Identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission Identify appropriate interventions for prevention of conditions Identify the appropriate methods to detect conditions in an asymptomatic individual Differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings and other diagnostic data Appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis Provide appropriate care to patients with chronic conditions

Adopted from: NCCPA Core Competency:

http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies%203.5%20for%20Publication.pdf PA Competencies: Interpersonal and Communication Skills Table 2. Physician Assistant Competencies: Interpersonal and

Communication Skills

Create and sustain a therapeutic and ethically sound relationship with patients Use effective listening, nonverbal, explanatory, questioning, and writing skills to elicit and provide information Appropriately adapt communication style and messages to the context of the individual patient interaction Work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional group

Apply an understanding of human behavior

Demonstrate emotional resilience and stability, adaptability, flexibility and tolerance of ambiguity and anxiety Accurately and adequately document and record information regarding the care process for medical, legal, quality and financial purposes

Adopted from: NCCPA Core Competency:

http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies%203.5%20for%20Publication.pdf

PA Competencies: Patient Care

Table 3. Physician Assistant Competencies: Patient Care Work effectively with physicians and other health care professionals to provide patient-centered care Demonstrate caring and respectful behaviors when interacting with patients and their families Gather essential and accurate information about their patients Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment

Develop and carry out patient management plans

Counsel and educate patients and their families

Competently perform medical and surgical procedures considered essential in the area of practice Provide health care services and education aimed at preventing health problems or maintaining health

Adopted from: NCCPA Core Competency:

http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies%203.5%20for%20Publication.pdf

PA Competencies: Professionalism

Table 4. Physician Assistant Competencies: Professionalism Understanding of legal and regulatory requirements, as well as the appropriate role of the physician assistant Professional relationships with physician supervisors and other health care providers

Respect, compassion, and integrity

Responsiveness to the needs of patients and society Accountability to patients, society, and the profession Commitment to excellence and on-going professional development Commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices Sensitiǀity and responsiǀeness to patients͛ culture, age, gender, and disabilities Self-reflection, critical curiosity and initiative

Adopted from: NCCPA Core Competency:

http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies%203.5%20for%20Publication.pdf PA Competencies: Practice-Based Learning & Improvement Table 5. Physician Assistant Competencies: Practice-Based Learning &

Improvement

Analyze practice experience and perform practice-based improvement activities using a systematic methodology in concert with other members of the health care delivery team Locate, appraise, and integrate evidence from scientific studies related to their patients͛ health problems Obtain and apply information about their own population of patients and the larger population from which their patients are drawn Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness Apply information technology to manage information, access on-line medical information, and support their own education Facilitate the learning of students and/or other health care professionals Recognize and appropriately address gender, cultural, cognitive, emotional and other biases; gaps in medical knowledge; and physical limitations in themselves and others

Adopted from: NCCPA Core Competency:

http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies%203.5%20for%20Publication.pdf

PA Competencies: System Based Practice

Table 6. Physician Assistant Competencies: Systems Based Practice Use information technology to support patient care decisions and patient education Effectively interact with different types of medical practice and delivery systems Understand the funding sources and payment systems that provide coverage for patient care Practice cost-effective health care and resource allocation that does not compromise quality of care Advocate for quality patient care and assist patients in dealing with system complexities Partner with supervising physicians, health care managers and other health care providers to assess, coordinate, and improve the delivery of health care and patient outcomes Accept responsibility for promoting a safe environment for patient care and recognizing and correcting systems-based factors that negatively impact patient care Apply medical information and clinical data systems to provide more effective, efficient patient care Use the systems responsible for the appropriate payment of services

Adopted from: NCCPA Core Competency:

http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies%203.5%20for%20Publication.pdf

Other Educational Trends

Radiologic Imaging Sciences

Masters degree programs to prepare Assistants

12 RA programs already

UAMS began Masters of Imaging Sciences in 2004

Nuclear Medicine Advanced Associate

2007 competencies published (first draft)

Entry level masters degree program in Clinical Laboratory Sciences (medical technology)

Rush began in 2004

Master of Science degree in Perfusion Technology

17 programs in the US; 7 grant masters degree (40%)

Rush switched from BS to MS in 2004

Volume 94 - Winter 2006

NAACLS Approves Standards for the Clinical Doctorate by David D. Gale, PhD, Chair, NAACLS Graduate Task Force

At the September 30, 2006 meeting of the NAACLS Board of Directors, the Standards of Accredited Educational Programs for the Clinical Doctorate in Clinical Laboratory Sciences were approved.

This effort was the culmination of more than six years of study and planning on the part of NAACLS in cooperation with NAACLS stakeholder organizations.

Medical Laboratory Science

AOTA Defends the Occupational Therapy Doctorate

AOTA President Penny Moyers responded to an article about the emergence of professional doctorates in The Chronicle of Higher Education - 6/29/07

The degree addresses the continually "changing body of knowledge" required in today's practice environments.

Entry into the profession of occupational therapy is at the post-baccalaureate level (master's or doctoral degree levels)

Doctoral degree programs resulted from the need for practitioners to have more in-depth education to address the ever changing body of knowledge required for practice

January of 2008, the occupational therapy doctoral programs were required to meet a separate set of accreditation standards from those required for master's degree programs.

APTA Vision 2020

APTA Vision Sentence for

Physical Therapy 2020

By 2020, physical therapy will be

provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health.

Provided by doctors of

physical therapy

Direct access

Autonomous practice

Other Educational Trends: AARC 2015 and Beyond

1. Creating a Vision for Respiratory Care and Beyond; RC 54(3), 2009

What will the future health care system look like? What will be the roles and responsibilities of RTs in the future system? AARC BOD accepted the direction for the future of health care as recommended. April 2012

2.Competencies Needed by Graduate Respiratory Therapists in 2015 and Beyond.; RC 55(5), 2010

AARC BOD accepted the competencies needed by future RTs as recommended. July 2012

Competency Area I: Diagnostics

Competency Area II: Disease Management

Competency Area III: EBM and RC Protocols

Competency Area IV: Patient Assessment

Competency Area V: Leadership

AARC 2015 Competencies

AARC 2015 Competencies

Table 3. Competency Area II: Disease Management*

A.Chronic Disease Management

1. Understand the etiology, anatomy, pathophysiology, diagnosis, and

treatment of cardiopulmonary diseases and comorbidities.

2. Communicate and educate to empower and engage patients.

3. Develop, administer, and re-evaluate the care plan

B. Acute Disease Management

1. Develop, administer, evaluate, and modify respiratory care

plans in the acute-care setting, using evidence based medicine, protocols, and clinical practice guidelines.

2. Incorporate the patient/therapist participation principles listed in

chronic disease management (see IIA.).

AARC 2015 Competencies

Table 4. Competency Area III: Evidence-Based Medicine and RC Protocols

A. Evidence-Based Medicine

1. Review and critique published research.

2. Explain the meaning of general statistical tests.

3. Apply evidence-based medicine to clinical practice.

B. Respiratory Care Protocols

1. Explain the use of evidence-based medicine in the development and

application of hospital-based respiratory care protocols.

2. Evaluate and treat patients in a variety of settings, using the

appropriate respiratory care protocols.

Table 5. Competency Area IV: Patient Assessment

1. Patient assessment (chart review, interview, history) 2. Diagnostic data 3. Physical examination Table 6. Competency Area V: Leadership: team member, healthcare regulatory systems, communications, healthcare finance, team leader

AARC 2015 Competencies

Survey of Directors of Respiratory Therapy Departments Regarding the Future Education and Credentialing of Respiratory Care Students and Staff; Kacmarek RM, Barnes TA, Durbin CG. RC, MAY 2012, 57 (5) 663 responses (28.0%)
Responses by directors on 66 competencies the 2015 report: 90% agreement on 37
50%-90% agreement on 25
< 50% agreement on 4 (ECMO, sleep, research/statistics) Education preparation: 36.8% BS or MS; 36.7% AD, 26.5%) no preference.

41.8% indicated that a BSRT or MSRT should be required to qualify for a

license to deliver respiratory care.

81.2in favor of the RRT being required to practice

Strong evidence supports the need by 2015 and beyond for graduate RTs to master 66 competencies in 7 major areas. AARC BOD accepted the competencies needed by future RTs as recommended. July 2012

Other Educational Trends: AARC 2015 and Beyond

1.Creating a Vision for Respiratory Care and Beyond; RC 54(3), 2009

What will the future health care system look like? What will be the roles and responsibilities of RTs in the future system? AARC BOD accepted the direction for the future of health care as recommended. April 2012

2.Competencies Needed by Graduate Respiratory Therapists in 2015 and Beyond; RC 55(5), 2010

AARC BOD accepted the competencies needed by future RTs as recommended. July 2012

3.Transitioning the Respiratory Therapy Workforce for 2015 and Beyond:

RC 56(5), 2011

The third task force conference was charged with creating plans to change the professional education process so that RTs are able to achieve the needed skills, attitudes, and competencies identified in the previous conferences.

BS entry level

RRT

By 2020

Examination launched Tuesday, July 17, 2012.

Applicants are now able to sit for the examination. Applicants who schedule to test before 9/1/2012 will receive the ACCS Self-Assessment Examination for free (a $40 value)! Candidates can visit the ACCS page for more information on this new examination www.nbrc.org www.nbrc.org North Carolina Respiratory Care Board Issues Open Letter - July

19, 2012, http://www.ncrcb.org/index.asp (Accessed August 8, 2012)

The increasing demands on the practice of RC require careful attention to the clinical skills that will be necessary for future practice. RCPs are expected to participate in the development, modification and evaluation of care plans, protocol administration, disease management and patient education. There is an increasing need for RCP's with advanced credentials and education who can take on leadership roles, including research, education, management, as well as advanced clinical diagnostic skills.

Therefore, the Board supports the development of

baccalaureate and masters level education in respiratory care. Coalition for Baccalaureate and Graduate Respiratory Therapy Education August

14, 2012 Volume 1 (8)

The AD graduate should pass the RRT exam and complete a baccalaureate degree in RC within a set period of time, such as 5 years. RCP's who have passed the RRT exam and completed a BD in RC may practice advanced procedures such as ECMO, protocol development, respiratory care consult, ventilation management, and advanced medication administration such as moderate sedation, nitric oxide administration, and prostaglandin administration.

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