1
Course Name: Advanced Clinical Practice
Course Number: RT-250
Cohort 8
RT-250 Start Date:
10/28/2013
Primary Instructor:
Ted Welker RRT
twelker@concorde.edu
Alternate Instructor:
503 964 3328
Office Location:
Instructor Prep Room 102
Class Location:
Lecture Room – See weekly
posted spreadsheet.
Room 105 – Computer Lab
Room 225 – Skills Lab
Semester Credit
Hours
10.0
Concorde: 503-281-4181
Office Hours:
Class Time: 5-8 hours
Lab: As assigned
Special Events: (ie:
ACLS, Gary Persing)
refer to class calendar
for class days and time
Clock hours:
See class calendar
Note: Class Time and
Class Day may be adjusted
to meet the special event
deadline or special
speaker’s availability
230
100
40
90
Total
Lecture
Lab
Clinical
COURSE DESCRIPTION
This course offers a comprehensive overview of the math used for respiratory therapy calculations and
provides and an opportunity of the student to learn advanced skills related to respiratory patient care.
The course offers a comprehensive study of current standardized pulmonary function modalities and the
interpretation of test data. It also includes a comprehensive review of critical thinking skills and therapist
driven protocols as applied to the successful completion of the certification examinations offered by the
National Board for Respiratory Care (NBRC). (Prerequisite: RT240)
COURSE OBJECTIVES





Perform calculations specific to respiratory therapy
Prepare for the NBRC exams
Practice and interpret pulmonary function tests
Apply critical thinking skills and therapist driven protocols
Execute advanced techniques of patient care
TEXTS
Gary C. White, Basic Clinical Lab Competencies for Respiratory Care: An Integrated Approach,
5th ed. ISBN-13: 978-1-4354-5365-4, Delmar, Cengage Learning, 2013
Gary C. White, Equipment Theory for Respiratory Care, 4th ed. ISBN: 1-4018-8454-7, Thomson Delmar
Learning, 2005
Robert M. Kacmarek, James K. Stoller, and Albert J. Heuer, Egan's Fundamentals of Respiratory Care,
10th ed. ISBN-13: 978-0-323-08203-7, Mosby, Elsevier, Inc., 2013
10/25/2013
2
Robert L. Wilkins, Richard L. Sheldon, and Susan Jones Krider, Clinical Assessment in Respiratory
Care, 6th ed. ISBN-13: Mosby, Elsevier, Inc., 2010
James R. Sills, The Comprehensive Respiratory Therapist Exam Review, 5th ed. ISBN-13: 978-0-32306701-0, Mosby, Elsevier, Inc., 2010
Dana Oakes, Clinical Practitioner’s Pocket Guide to Respiratory Care, 8th ed. ISBN-13: Health Educator
Publications, 2006
David W. Chang, Respiratory Care Calculations 3rd ed. ISBN-13: 978-1-1113-0734-9, Delmar, Cengage
Learning, 2012
STUDENT RESOURCES


Virtual Library: http://www.library.cengage.com [Contact instructor or the LRC coordinator for current
month’s password]
Northstar Learning www.northstarlearning.com
COMPUTER ACCESS
Some assignments in this course series require computer access. Students who do not have home access
to a computer should complete computer-based activities at a Concorde computer lab, resource center,
or public library. In addition there is tutorial software that can only be accessed in a Concorde computer
lab. When these tutorials are assigned, it is the students’ responsibility to schedule time to work in the
lab when class time is not allotted specifically for this purpose.
LEARNING RESOURCE CENTER
The school maintains at least one LRC for student use. Hours are posted and you are requested to sign a
log sheet each time you visit. Policies are posted in the LRC. You are expected to behave in accordance
with typical library etiquette and respect the needs of other students by not talking and sharing
materials/computers.
EVALUATION
Students will be evaluated on knowledge of textbook content, clinical skills, and competence on lab
activities. The minimum acceptable term grade is 75% for advancement. Refer to the Satisfactory
Academic Progress Policy in the catalog for grade point expectations. Term grades are calculated as
follows:
ACLS Course (counts as Exam I)
Clinical
Pass/Fail
Homework and Classwork
All Completed
LRC
Pass/Fail
Lab (class lab and scenarios)
Pass/Fail
Q&A Cards
All Completed
Four Unit Exams
12.5% each
Final
50 %
TERM GRADE
100%
10/25/2013
3
Point Values for the Course Assignments
90-100
80-89
75-79
=
=
=
A
B
C
70-74
69 or less
=
=
D
F
Partial points will not be rounded. Example: 79.4=79; however, 79.8=79 which leads to a grade of C.
A letter grade of D will be included in your CGPA but must be repeated in order to progress.
Make-up work
It is very important for students to be in class for tests and performance evaluations. The student must
initiate the request to reschedule on the first day the student returns to class. It is the student’s
responsibility to schedule time outside the student’s regularly scheduled class hours (with program
director and/or instructor) to complete any missed work. The PD will determine the method for making
up required course components like labs and competencies. Timelines are identified in the specific
sections below.
Tutoring
Tutoring will be scheduled at the discretion of the Program Director or Academic Dean. If you want
extra help, contact the instructor or program director immediately for available tutoring. If you do not
show or do not call for a session that you requested, the faculty is not obligated to reschedule or to
provide future assistance at your request.
The instructor and/or program director may require you attend a tutorial session if s/he believes that you
need assistance on any content, skill or clinical component. If you do not show or do not call for a
required session, you must meet with the Program Director before being allowed to attend class.
Weekly P&R sessions are scheduled for the benefit of all students and anyone may attend these sessions.
However, if you score 75% or below on a test you will be required to attend P&R sessions until you
reach competency. During any session that includes a test, you may be excused to the LRC and/or
assigned a paper or project to help your progress.
Homework & Classwork
A course schedule outlines the due dates for all assignments, lists reading assignments, and delineates
lab activities. Any homework not completed and received by the instructor prior to the applicable unit
test will receive an incomplete on the test. You have 5 business days (7 calendar days) to complete
missing working. Any outstanding assignments after this period must be turned in by the final course
day. Completion of all assigned work is required to pass the course.
Chart Exam papers, Physician Contact papers, and time cards are due on the first class following any
clinical experience. All papers must be completed to pass the course.
Calculators may NOT be used in this class. The NBRC does not allow calculators for their exam, so you
must be able to work all math equations without the aid of a calculator.
10/25/2013
4
Q&A Cards
Based on assigned readings you will create at least 10 questions written on 3x5 index cards with the
answer on the opposite side so you may use them as flash cards for exam preparation. You are
responsible for creating cards prior to each class session. They are due at the beginning of each class
session to be reviewed by the instructor. If no reading assignment has been designated for a class
session, then questions are to be created from the previous class reading assignment. When multiple
books are assigned, questions are to be created from each text in proportion to the amount of material
gleaned from each text. Cards will typically be returned to you prior to each unit exam so you may use
them for exam preparation. You are expected to carry any returned cards to class for group and class
reviews throughout the course. At times, especially later courses in the program, you will be expected to
bring all accumulated cards from previous program courses in preparation for the comprehensive exams.
Each card must have the book, page and paragraph number from which the question was generated. Any
cards deemed by the instructor to be incorrect or poorly written must be rewritten by the next class
session for the assignment to be considered complete.
Exams
Students must earn a 75% or higher on a test for a passing grade.
Due to the nature of an exam, students will be allowed up to 5 business days (7 calendar days) to take a
missed exam. However, the student must attend a Practice & Review (P&R) session, complete a P&R
assignment, and take an alternate version of the test. The P&R assignment is due prior to taking the test.
Not appearing for the P&R session or not completing the P&R assignment will result in an automatic
zero (0) on the unit exam. For any exam taken after the course’s original exam scheduled date, a 75%
will be recorded for any passing score.
Final Exams
On the last day of class (RT-250) you will take a NBRC RRT secure Self Assessment Exam.
Class will still be held for at least 3-hours on finals day to review and cover any remaining class items
with 3 hours allotted for the exam. Not attending class for 5 hours will be documented following the
attendance policy. The final exam must be made up within 5 business days as required by the incomplete
grade policy in the catalog. Not taking the final exam or meeting the other retake requirements will
result in failing the course.
Lab Grades
All labs and competencies are skills expected of professionals in the field, so a student will be required
to complete labs and competencies in order to pass the course. Not successfully completing all
competencies and labs/practicals will result in a failed course grade. Lab assignments may include tests,
activities and practicals. Students who do not obtain the minimum requirements stated in the
10/25/2013
5
performance evaluation must repeat the evaluation. Refer to each check list for scoring, but typically a
90% is required to pass.
Clinical Grades
Your clinical experience is a pass/fail grade. Students must demonstrate mastery and pass all clinical
objectives with a score of 2 or 90%, whichever is higher.
MAINTAINING SATISFACTORY ATTENDANCE STATUS
Attendance is mandatory. All absences are unexcused. It is also a reflection of a student’s commitment
to his or her own educational success. Review your school catalog for specifics of satisfactory
attendance, probation and terms of dismissal.
If you will be absent or late to a class, you must contact the program director by calling the school. If
you must leave a voice message, please leave a detailed message and a return phone number where you
can be reached. Notify your instructor if you plan to leave class before dismissal.
Clinical Attendance
For clinical absences, you must contact the clinical site and the Director of Clinical Education (DCE). If
the DCE is not available, you must request s/he be paged and leave a number for you to be reached. In
addition you must contact the department supervisor, or designated contact at the clinical site, at least
one hour before your scheduled shift. A voice mail message is not considered appropriate and would be
a last resort measure.
A no show-no call is unprofessional behavior and is grounds for dismissal. A second offense is an
automatic withdraw from the program. If a site requests removal, refer to the catalog for policy.
STUDENT RESPONSIBILITIES
Mastery of the theory and lab skills in this course is essential to your success in clinical. Also you will
be preparing for the NBRC advanced level exam. In preparation, you are expected to spend
approximately 22 hours per week on assignments and activities to help you achieve the course
objectives. At least half of your outside class time should be spent reading the textbook materials,
developing outlines and notes for exam preparation, memorizing theory, and practicing application of
theory. For the remaining time complete the end of chapter activities in the textbook, investigate the web
resources associated with the text, research, draft, and write papers or presentations, finish study guide
or workbook activities as available, and perform any other practice as assigned by the instructor. It is
recommended that you spend time on a daily basis reviewing past material to prepare you for the NBRC
exam. Details of weekly activities will be in your course schedule.
The syllabus is a guideline for instruction. The instructor, Program Director and/or Academic Dean reserve
the right to change, modify, or delete any item as necessary.
RT-250 Class Schedule
RT-250 Start:
10/28/2013
10/25/2013
6
Note:
Use of the RT skills lab and computer lab varies depending on topic and day’s activity. Class times also may vary
depending on special speaker’s availability or the special event’s design. Any changes are noted on the schedule
below.
10/28
Monday
Clinical – 12 hours
10/29
Tuesday
Clinical – 12 hours
10/31
Thursday
Class – 5 hours
Intro to RT 250
Test taking Strategies
NBRC-CRT/RRT/CSE – Test Matrix – SAE eval
Sills Practice Exam
11/4
Monday
Clinical – 12 hours
11/5
Tuesday
Clinical – 12 hours
11/7
Thursday
Class – 5 hours
Assessment review
Hx, cc, past hx, social/family/occupation hx, tobacco hx
Physical, sputum, lab values, I&O assessments
Friday
Lab – 5 hours
Practice calculation exam questions computer lab
Calculations; O2 cylinders, O2/air mix entrainment. LOX, suction
Catheters, O2 transport, O2 content
Sills pg 1-57
Egan pg 329-355
11/8
Sills pg 276, 277, 397, 401, 211, 388, 434-435
Egan pg 208, 220, 716, 733, 924-925
Chang pg 60-76, 121-123, 161-163, 175-187, 301-303
Cards due
11/11
Monday
Clinical – 12 hours
11/12
Tuesday
Clinical – 12 hours
11/14
Thursday
Class – 5 hours
FBI fingerprinting
NBRC exam sign up
11/15
Friday
Lab – 5 hours
Review pharmacology & calculations
Pharmacology Review Quizzes: CRT & RRT questions com lab
Sills pg 263-277, Ch 9
Egan Ch 32
Chang pg 55-66
Cards due
11/18
Monday
Clinical – 12 hours
10/25/2013
7
11/19
Tuesday
Clinical – 12 hours
11/21
Thursday
Class – 8 hours
ACLS (Core program) Day 1 of 2 – 8:00AM – 5:00PM
11/22
Friday
11/25
Monday
Class – 6 hours
ACLS (Mega code & exam) Day 2 of 2 – 8:00AM – 3:00PM
Exam I
Class & Computer Lab - 8 hours
HIV/AIDS Curriculum
“And the Band Played On”
Exam II
11/26
Tuesday
11/28
Thursday
Thanksgiving Day aka Tofurky Day
11/29
Friday
Thanksgiving Holiday
12/2
Monday
Class – 5 hours
Resumes, Cover Letters, Mock Interview questions, EVF’s, Clinical
Sign off forms
12/3
Tuesday
Class – 5 hours
Respiratory calculations; FEV1/FVC%, Cstat, Vd, IBW, RR/Vt, I:E
NBRC mechanical ventilation computer exam questions
-
Lab 6 hours
Neonate/pediatric considerations; ET/trach tube sizes, meds, CPT,
ventilation
Neonate/pediatric com sim exam questions
Mid-term advising due
Sills pg 28, 47-50, 94-98, 106, 107, 157, 197, 224, 258, 273, 283, 313, 314, 354-370, 382, 397-400, 498517
Egan pg 389-391, Ch 31, 48
Cards due
Sills pg 110-114, 156, 444-446
Egan Ch 42, 44, 46, 47
Chang pg 9, 35-51, 77-87, 125-129, 229-231, 239-241
12/4
Wednesday
Class – 5 hours
Xray assessment – Dr Markin
Cards due
12/9
Monday
Class – 5 hours
Advanced patient care
10/25/2013
8
Hypoxia assessment
Sills pg 73-102, 545
Egan Ch 16, 18
12/10
Tuesday
Class – 5 hours
Vent review; calculations, flow patterns, Vt (flow/time)
Va, RSBI, etc
Sills pg 112-114
Egan Ch 42, 44, 47
Chang pg 9, 35-51,77-87, 125-129, 199-200, 229-231, 239-244, 246-263
12/11
Wednesday
Cards due
Lab – 5 hours
Interview & Resume Prep day
Resume and Interview PowerPoint and in class practices
Practice clin sim case
12/13
Friday
8am – 5pm
Class – 8 hours
Gary Persing’s review course – Day 1 of 2
12/14
Saturday
8am – 3pm
Class – 7 hours
Gary Persing’s review course – Day 2 of 2
12/17
Tuesday
Class – 4 hours
Résumé Review & preparations (workshop)
12/18
Wednesday
Lab – 5 hours
Special procedures; bronchs, thorecentesis, chest tubes, lung
IPPB/lung recruitment, CPAP, BiPAP, AVAPS
Exam III
Break
1/2
Thursday
Class – 5 hours
Mock Interviews with Concorde Campus Staff
Come to class in Business attire; jeans/khakis not acceptable
Men: suit or slacks with dress shirt & tie
Women: business dress
1/3
Friday
Class – 5 hours
Hemodynamics
Hemodynamics computer sim exam questions
Cards due
12/19 - 1/1
Sills pg 149-191
Egan Ch 17, 26
Chang pg 11-15, 18-22, 29-32, 83, 144-145, 214-222
Cards due
1/6
Monday
Class – 5 hours
Oral exams
10/25/2013
9
1/7
Tuesday
Class – 5 hours
Oral exams
1/8
Wednesday
Lab – 5 hours
Pulmonary function
Practice pulmonary function computer sim NBRC questions
Sills Ch 4, 119-143
EganCh 19, 24
Chang pg 93-102
Cards due
1/13
Monday
Class – 5 hours
Exam IV & exam review
1/14
Tuesday
Class - 5 hours
Final Exam Part 1 of 2 = WRRT-Computer Lab
1/17
Friday
Class – 5 hours
Final Exam Part 2 of 2 = RRT Clin Sims-Com Lab
Final Advising
Now go out there & conquer something.
10/25/2013