Enhancing the Science and Practice
of Respiratory Care Through
Academic Progression and Life-long
Learning
Toni L. Rodriguez Ed.D, RRT FAARC
2007-08 President of the AARC
Program Director Respiratory Care Gateway
Community College, Phoenix AZ
Dr. H. Fred Helmholz Education Lecture
Series
Conflict of Interest
I have no real or perceived conflict of interest
that relates to this presentation. Any use of
brand names is not in any way meant to be an
endorsement of a specific product, but to
merely illustrate a point of emphasis.
Objectives
Learning objectives for this presentation:
Objective 1
Objective 2
Objective 3
Objective 4
What defines a profession?
Link lifelong learning to professional
development
Benefits of the AARC Leadership
institute
Personal responsibility in professional
advancement
What Makes a Profession?
Profession
Work experiences range on a continuum
from occupations to full fledged
professions.
WORKERS
PRACTITIONERS
Professional
Practitioners
•JOB
•Emerging profession
•Full Fledged Profession
Profession
• Placement on the continuum is determined by
an occupation's degree of adherence to six
basic features:
autonomy
commitment
collegiality
extensive education
service orientation
special skills and knowledge
(Dean,1979)
Profession
• How does one move from amateur to
professional?
– The professional role is more than what one
does; it is what one is!
• Formal education
• Socialization
Respiratory Care Profession
• What value is the profession of respiratory
care to the health care team and society in
general?
– Competence in a specialized body of knowledge
and skill.
Professional Competence
• National Association for Medical Direction
statement:
“ The hours of education and curriculum
required for credentialing of a RCP should be
the standard for all non-physician providers of
respiratory care services”
Professional Competence
• 1994 report by Indiana University comparing
respiratory and nursing curriculum.
– Less than 2% of curriculum devoted to respiratory
therapy proceedures
• Lewin Group, 1997
– Use of RCP’s is cost-efficient for services within
their specialty area
Professional Competence
• Dr. James Stoller, 1998
– RCP’s excel over nurses and physicians in
performing routine respiratory procedures.
– Protocol based respiratory care reduce
misallocation of in-hospital respiratory care.
Professional Competence
• The Muse Study, 1999
– Medicare beneficiaries treated by RCP’s had
better outcomes and lower costs than those not
treated by RCP’s.
PURPOSE
• So why respiratory therapy?
To fulfill a need for:
1.
2.
3.
Advanced therapeutic knowledge of the physiology and
pathology of respiratory disease
Implementation and operation of complex medical
equipment
Monitoring critically ill patients and the highly complex
medical equipment around the clock.
PURPOSE
• Purpose: Called to provide patient
advocacy in the area of maintaining
and restoring normal function of the
respiratory system.
Respiratory Therapists are the
primary health care professionals
with the education and training to
facilitate patient care in the areas of
oxygenation, ventilation and
bronchial hygiene.
DRIVERS OF PROFESSIONAL
GROWTH
You are living in the period of time that will produce
more change for humanity than any previous era in
history. It is a time of extraordinary importance that
will fundamentally reshape almost every aspect of
your life during the next two decades. Wholesale
change is taking place in almost every segment of
your reality-and the pace will only increase in the
coming years.
John Peterson, The Road to 2015
External Drivers
• External Factors:
– Changing demographics
– Environmental issues
– Socioeconomic factors
– New and re-emerging infections
– New Healthcare Reform Legislation
– CMS Mandates
Internal Drivers
• Internal factors - paradigm shifts in health
care:
– Evidence based medicine replaces traditional
medicine
– Consumer driven, patient centered healthcare
– Prevention of disease with emphasis on healthy
aging
Internal Drivers
• Internal factors - paradigm shifts in health
care:
– Greater emphasis placed data related to the
quality of care provided.
– Cross-training of non-physician healthcare workers
– Shifts in reimbursement mechanisms inevitable.
Internal Drivers
In Change There is Opportunity!
“It’s not the strongest species that survive, nor
the most intelligent, but the ones most
responsive to change.”
Charles Darwin
BUT ONLY IF YOU ARE WILLING
AND PREPARED TO TAKE
ADVANTAGE OF YOUR
OPPORTUNITIES!
Sony engineers came up with the equivalent of the iPod long
before Apple but internal culture focused on next generation
of CD player
Kodak engineers invented the digital camera but saw it as a
threat to their film culture.
Predicted Changes in Health Care
• Acute care facilities more integrated while outpatient
facilities become focal of growth
• New models of health-care delivery
• Increased emphasis on coordination of care throughout
system
• Continued Advances in Medical Technology
• Evidence Based Medicine becomes the norm
• Electronic Medical Records
• Fewer Primary Physicians
• Disease prevention
• Disease management
CURRENT PRACTICE
FUTURE PRACTICE
Lifelong Learning
• Definition
Lifelong learning is equipping yourself to deal
with the new normal while maintaining your
core values.
Toni Rodriguez
Continuing Education
• Prepares practitioners to function in the ever
changing healthcare environment and to
contribute to the further advancement of the
profession.
• Provides a forum for the profession to
examine its problems and identify appropriate
solutions.
• Offers a setting in which the professional
culture can be modified and developed.
It is not enough to anticipate our future role,
competencies and skills. If our profession is
unable to transition from where we are today
to where we need to be tomorrow, we will fail.
Some Points to Ponder: Sam P. Giordano Respiratory care May 2011 Vol 56
No 5
FOSTERING A CULTURE OF
LEADERSHIP AND LIFELONG
LEARNING
AARC Leadership Institute:
Fostering a culture of leadership.
Leadership is Everyone’s
Responsibility
Leadership:
•
•
•
•
•
. . . is not a position
. . . is not about power
. . . is not about following someone
. . . is not about causing fear
. . . is not about giving orders
“Leadership
is influence nothing more, nothing less."
John Maxwell, 21 Irrefutable Laws of Leadership
Leader 360°
Leadership Attributes x 360° Achievement
• If you don’t think of yourself as a leader,
then you’re limited in your thinking.
Leading is the way we help move people
into action, including ourselves. The
question is not whether you are a
leader, but how WELL you lead.
• Bruce D. Schneider, Energy Leadership
Three essentials necessary
to the success and
longevity a profession:
Education: Links theory to
practice in new and veteran
practitioners.
Management:: Facilitate
fiscally responsible patient
care that maximizes human
and material resources to the
betterment for the healthcare
organization and staff.
Research: The interpretation
and derivation of the
evidence that supports the
efficacy and safety of the
therapy we apply.
Education
Management
Research
AARC Leadership
Institute
• Respiratory Care clinical experts may
not possess the foundation knowledge
to move into different positions in
management education and/or
research.
•Promotion based upon excellent
clinical skills does not necessarily
translate into success outside of that
role without foundation knowledge or
skills.
•Provides real-world education for RT’s
with the desire to provide a
foundation for career growth.
Education Curriculum Competencies
• Principles & Methods of Respiratory Therapy
Adult Education
• Developing Respiratory Therapy Courses
and Evaluation of Learning
• Clinical Instruction Techniques for Students
and Employees
• Classroom and Laboratory Instruction Techniques
• Educational Technology
• Continuing Education
Management Curriculum
Competencies
•
•
•
•
•
•
•
•
Health Care Infrastructure and Economics
Leadership and Your Organization
Leadership and Teambuilding
Integrated Business Topics for Managers
Law and Ethics: Practice and Application
Managing Human Capital
Finance and Budgeting for Departments
Data Driven Performance Improvement
Research Curriculum Competencies
•
•
•
•
•
•
•
•
•
Ethics
The scientific method
Basic measurement theory
Identification of research topics
Review of the literature
Basic research designs
Steps in implementing a study
Basic statistical concepts
Publicizing study results
AARC Leadership Institute
Benefits of the Leadership Institute:
• Mentoring:
– Online classes that one completes at their own pace.
– Backed up by specific communities on AARC Connect with faculty
serving as mentors
• Contact with Module authors/subject experts
• Contact with peers interested in the same topic
• Participants can ask questions, engage in discussions, debate
important topics in an online discussion board
• Build networks for future
Institute Faculty
• Institute Chairman:
Toni Rodriguez, EdD, RRT, FAARC
• Track Chairs:
– Rob Chatburn, MHHS, RRT-NPS, FAARC (Research Chair)
– Rick Ford, BS, RRT, FAARC (Management Chair)
– Linda Van Scoder, EdD, RRT, FAARC (Education Chair)
Institute Faculty
– Management Faculty:
• Cheryl A Hoerr, MBA, RRT, FAARC
• Garry Kauffman MPA, RRT, FAARC
• John Sabo MS, RRT, RN, FAARC
• John Salyer MBA, RRT-NPS, FAARC
• Shawna L. Strickland, PhD, RRT-NPS, FAARC
– Education Faculty:
• Christine A. Hamilton DHSc, RRT, AE-C
• Diane R. Oldfather MHEd, RRT
• Toni Rodriguez, EdD, RRT, FAARC
• Shawna L. Strickland, PhD, RRT-NPS, FAARC
• Sarah M Varekojis PhD, RRT
– Research Faculty:
• Robert L. Chatburn, MHHS, RRT-NPS, FAARC
Benefits of the Leadership
Institute
• Format Presented as:
– Web-based course
– As PDF documents available for downloading
– ePub download for your electronic reader
– Complete at individual pace at time and location
best for you
– Course materials, supplemental readings,
activities, quizzes
Benefits of the Leadership
Institute
• End of course:
– CEUs
– Certificate of completion
Walking the
Walk of Change
Culture
The sum total of the learned behavior of a
group of people ..... and is transmitted from
generation to generation
The collective programming of the mind that
distinguishes the members of one group or
category of people from another.
Culture
Culture is never rigid or stagnant but
is constantly being shaped.
Culture
Key Question:
Should the culture of our profession be
shaped deliberately or accidentally by the
forces of the changing healthcare
environment?
ACTUAL
Practice
As we
are
today.
Continuing
education
REQUIRED
Practice
What we
need to be.
Continuing
education
Optimum
Practice
What we
could be.
Our commitment to continuous learning is essential
to the future health of our profession.
READY
Professional Evolution
RT Past:
• Swartz tube, oxygen tent, BLB O2 mask, iron
lung
• O2 technology
• Setup and operation of basic equipment
• Delivery of aerosol
• Provide IPPB
• Provide service/perform tasks
Professional Evolution
RT Present:
•
•
•
•
•
•
•
•
•
•
ICU vents
Non-invasive ventilation
ECMO
Transport of patients
Home care/Sub acute care
Aerosol delivery
Diagnostic studies
Disease management
Patient education
Consultants on patient care
Piedmont Technical College, Greenwood, SC
AARC Resources
•
•
•
•
•
•
•
•
Summer Forum
International Congress
Web Cast Central ( over 100 offerings)
AARC Through the Journal
Guides and CPG’s
Exam Prep Course
Asthma-Educator/COPD Educator
Ethics Course
Position respiratory therapists in all healthcare
settings:
Medical Respiratory Therapist Access Act: HR
2619
 Target Unmet Patient Needs
 Become Gate Keepers for Utilization
 Pt. Support Across Spectrum of Care
Academic Progression
• Accreditation organization, credentialing
bodies and licensing agencies validate
mechanisms of academic progression.
– Relevant accreditation standards for entry level to
advanced-level respiratory programs.
• Final draft of Proposed Accreditation Standards
• Accreditation Standards for Advanced Practice
Programs in Respiratory Care
• Accreditation Standards for Degree Advancement
Programs in Respiratory Care
Academic Progression
Advanced
Degrees:
Vocational
Training
Schools
OJT/Hospital
Based Training
Certificate of
Completion
Community
Colleges
2002 Associate
degree
Baccalaureate
Masters
Doctorate
Academic Progression
– Credentialing bodies evaluate professional
Competence:
• Credentialing Exams
• Continuing Competency Program
• Specialty Examinations
– Licensure Agencies
• Gate keepers for who can practice in a state
• Determine minimum CE to renew license
TAKE AIM
Conference 2
Spring 2009
“Competencies Needed by Graduate Respiratory
Therapists in 2015 and Beyond”,
RC May, 2010, Barnes, Gale
Kacmarek, Kageler, et al
“Competencies Needed….2015…”
• 67 competencies in 7 major areas:
– Diagnostics
– Disease Management
– Evidence-based medicine and respiratory care
protocols
– Patient assessment
– Leadership
– Emergency and Critical care
– Therapeutics
R C, May, 2010 Barnes, Kacmarek, et al
LET’S FIRE!
Doing Means Learning and Learning
Means Doing
Evidence Based Medicine
New modes of ventilation
Invasive Diagnostic Procedures
Protocols
Non-invasive ventilation
Aerosol device matching
Doing Means Learning and Learning
Means Doing
 Disease management opportunities:
Asthma
COPD
Obstructive Sleep Apnea
Smoking Cessation
 Opportunities to play an interdisciplinary role
 Make the most of teachable moments
 Only 1% of 140,000 RT’s design/conduct research
Keys to Continuing Professional
Evolution
• What keeps a health profession valuable to the
health care team and society in general assuring
longevity?
– Sound judgment grounded in ethical thinking.
– A common body of knowledge unique to their
profession.
– Ongoing research through critical inquiry and creative
synthesis.
– Commitment to maintaining competence through
continuing education.
– A commitment to patient advocacy.
We must keep our core ideologies tightly fixed
while displaying a powerful desire for progress
that enables us to change and adapt without
compromising what sets us apart as a
profession.
Don’t Think:
Because it is too hard we should not do it
Because there is opposition we should
stop
Of the cost to yourself but of the many
who will benefit
Rise to the Occasion
Only we can devalue ourselves as a
professionals. CARE
A true professional is a person who works
within their institution to achieve the goal of
excellence in patient care, and tailors their
tasks to realize that goal. KNOW
If we don't do that, we are in the business of
taking orders, which is a much less valuable
endeavor. DO
Accept the Challenge
It is easy to point fingers at those we feel have failed
to advance our profession in the right direction.
But how many people take advantage of their chance
to influence what is happening around them, instead
of just choosing to do what they were told?
Greatness lies ahead if we are true
to our calling as patient advocates
BUT
But if we forget, lose integrity,
are hampered by; fear
inconsistency, compromise and
incompetence we fail to fulfill our
purpose.
Lifelong Learning is an Individual
Responsibility
THE POWER OF ONE TO MAKE A
DIFFERENCE:
FOR BETTER OR WORSE
TAKE PERSONAL
ACTION!
ACT
I
ON
RODRIGUEZ@GATEWAYCC.EDU