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The Coalition Chronicle

Coalition for Baccalaureate and Graduate Respiratory Therapy Education July 31, 2015 Volume 4 (7)

Spotlight Article

DEPARTMENT OF CARDIORESPIRATORY CARE UNIVERSITY OF SOUTH ALABAMA

MOBILE, ALABAMA

Introduction

The Department of Cardiorespiratory Care (CRC) at the University of South Alabama is located

in Mobile, Alabama with clinical sites reaching into Florida and Mississippi. USA is a state

supported comprehensive university that offers a wide range of health professional degrees

including medicine, allied health, and nursing. The CRC program offers a 5-semester

undergraduate curriculum leading to a Bachelor of Science degree. In conjunction with the

College of Education, CRC also offers a Master of Science degree in Instructional Design and

Development for BS/RRTs interested in a career option in education. The undergraduate

curriculum uses a combination of different teaching and learning strategies: problem-based

learning, team-based learning, human simulation lab, and online testing. During the senior year,

a 3-semester research sequence provides students an opportunity to conduct scientific inquires.

In 2015, nine research abstracts were accepted for poster discussion or presentation at the AARC

International Congress.

Curriculum

The Cardiorespiratory Care (CRC) curriculum at the University of South Alabama provides the didactic,

laboratory, and clinical education needed to graduate with a Bachelor of Science degree in

Cardiorespiratory Sciences. The pre-professional component consists of 59 semester hours in the

freshman and sophomore years of college; the professional component calls for 62 semester hours which

are taken over the course of 5 consecutive semesters beginning in the junior year.

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CRC Professional component:

Semester 1 (fall)

CRC 330 Assessment skills

CRC 331 Respiratory Anatomy and Physiology

CRC 334 Pharmacology

CRC 342 Intermittent Cardiorespiratory Care Practicum

Total semester hours: 14

Semester 2 (spring)

CRC 332 Intermittent and Diagnostic Cardiorespiratory Care

CRC 335 Intensive Cardiorespiratory Care

CRC 345 Intensive Cardiorespiratory Care Practicum

Total semester hours: 14

Semester 3 (summer)

CRC 415 Research Methodology

CRC 430 Neonatal/Pediatric Cardiorespiratory Care

CRC 431 Special Procedures

Total semester hours: 8

Semester 4 (fall)

CRC 435 Critical Care Concepts

CRC 440 Advanced Clinical I

CRC 447 Cardiorespiratory Care Management

CRC 450 Clinical Research I

Total semester hours: 13

Semester 5 (spring)

CRC 441 Advanced Clinical II

CRC 446 Cardiorespiratory Care Education

CRC 451 Clinical Research II

CRC 460 Advanced-Level Exam Review

Total semester hours: 13

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Problem-based learning (PBL) is included in several courses of the CRC curriculum, and encourages

development of student knowledge and skills by working for an extended time to investigate and respond

to patient cases. The progressive disclosure of the case in a small-group setting is facilitated by the faculty

and the process engages students in critical thinking, while fostering patient assessment and decision-

making skills. The PBL courses incorporate small group discussions, enrichment lectures, and

laboratories.

Senior students in the CRC program complete research projects to gain insight and understanding of the

basics of the research process. A course in education provides learning in the foundational principles of

education, as well as practical application of teaching as students present lectures and workshops. The

course in critical care concepts is

designed to prepare the student to

work in the intensive care arena and

to succeed in obtaining the Adult

Critical Care Specialty Credential.

The management course provides a

broad view of the healthcare

environment while also drilling

down into challenges that the

respiratory care department

leadership face day-by-day. The

special procedures course provides

a close-up look at sub-acute care,

hyperbaric oxygen therapy, sleep,

open-heart surgery, and cardiac bypass with the perfusionist, bronchoscopy, non-invasive and invasive

cardiac diagnostic and therapeutic procedures (such as cardiac catheterization, echocardiography, nuclear

cardiology, and ambulatory monitoring), and hemodynamic monitoring.

Every semester in the CRC program includes a clinical component. Students obtain clinical experience in,

at least, four or five hospitals during their junior and senior years. The program has clinical affiliation

with 13 hospitals across the Gulf coast region in Alabama, the Florida panhandle, and Mississippi.

Students gain valuable clinical experience in neonatal and pediatric care during rotations in two children’s

hospitals in the area that house level III NICUs. In addition, working with the faculty in the outpatient

environment at a local pulmonary clinic for uninsured adults has enhanced student skill and experience in

performing patient assessment, gathering diagnostic evidence, and case management while giving back to

the community in a service-learning environment.

Use of simulations has become an excellent learning environment. The CRC program regularly works

with the state-of-the-art simulation lab that is shared with various health professions in the Patsy Capps

Covey College of Allied Health Professions and the College of Nursing. Along with simulations that are

designed for the CRC students, the department participates in several inter-professional education events

and simulations to increase the student exposure and experience working with a team of professionals.

Health Sciences building, housing the Pat Capps Covey College

of Allied Health and the College of Nursing

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Registered respiratory therapists with baccalaureate degrees in respiratory care or other disciplines who

have completed specific prerequisite courses can enroll in graduate school through the College of

Education and earn the Master of Science degree in Instructional Design & Development.

Faculty

William V. Wojciechowski MS, RRT, Associate Professor and program

Chair received his BS from the University of Dayton and his Master’s in

Education from the University of Illinois. Bill teaches our pulmonary

physiology and special procedures. He has been the program Chair since its

founding in 1979.

William Pruitt MBA, RRT, CPFT, AE-C, FAARC received his BA from

Georgia College, and his MBA from Brenau College. Bill serves as the

director of clinical education. He is responsible for our pulmonary function

preparation and his management background prepared him for his course in

management. He has been with the program since 1999.

Timothy Op’t Holt, EdD, RRT, AE-C, FAARC received his BS from

Michigan State University, a Master’s in Health Professions Education from

University of Illinois, and an EdD from Auburn University. Tim introduced

and integrated problem-based learning in the curriculum in 1999. He has been

with the program for 31 years.

David Chang, EdD, RRT received his BS from the University of Northern

Iowa, MEd. from Columbus State University Columbus Ga, and an EdD, from

Nova Southeastern University. David came to the program from Athens

Technical College in Athens, Ga, where he was the director of clinical

education. He has been instrumental in introducing team-based learning in our

curriculum, and helps prepare our students for the registry examinations. He has

been with the program since 2007.

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Coincidentally, these four faculty members are graduates of the respiratory therapy program at

the University of Chicago. In 2014, the faculty worked in Dammam, Saudi Arabia to assist the

University of Dammam with teaching duties and in faculty preparation for problem-based

learning. The program director at the University of Dammam is an alumnus of the

Cardiorespiratory Care (CRC) program. He recognized the utility of PBL and wanted to

incorporate the technique in his program. Also, a program in Riyadh uses the CRC curriculum.

Jennifer McDaniel, BSRT, is an alumnus of our program and is our neonatal/pediatric

instructor, Jennifer serves as a full-time therapist in the neonatal intensive care at USA

Children’s and Women’s Hospital in Mobile, AL.

Our Students

Most of our students are from the southeast region of the United States, but we have hosted

students from Saudi Arabia, Hong Kong, India, Iran, Somalia, South Korea, Russia, and Kenya.

Summary

The Cardiorespiratory Care Program at the University of South Alabama was established in 1979

and has had over 300 graduates who are practicing all over the U.S. and world-wide. Our

baccalaureate curriculum incorporates traditional teaching as well as team-based and problem-

based learning, simulation, and hospital and clinic-based clinical experiences. All students

complete a research project and courses in education and management. Presently, the University

of South Alabama is the only baccalaureate respiratory therapy program in Alabama.

Action Required

As an AARC member you recently received an important message from AARC President, Frank

R. Salvatore, RRT, MBA, FAARC, urging you to send a message to your members of Congress

asking for their support for HR 2948 the Medicare Telehealth Parity Act. CoBGRTE

leadership encourages all respiratory therapy educators and students to respond to the AARC call

for action. AARC has made it easy by use of their Capitol Connection

http://capwiz.com/aarc/issues/?style=d. Read the bill using the AARC provided link:

https://www.govtrack.us/congress/bills/114/hr2948. Take action today – it is important!

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Transfer Credits – A Holistic View

Robert Joyner, PhD, RRT, RRT-ACCS, FAARC

Associate Dean, Henson School of Science and Technology

Director, Respiratory Therapy Program

Salisbury University Salisbury, MD

rljoyner@salisbury.edu

Recently Dr. Ellen Becker (Rush University – Respiratory Care),

solicited opinions in the AARC Education Section listserv regarding

an article published in Inside Higher Ed discussing the challenges for

students transferring from a two-year community college to a four

year university.1 Essentially the article Dr. Becker referenced

summarizes the opinion of a Connecticut based Legislative Program

Review and Investigations Committee (PRI) who analyzed data

originating from the University of Connecticut on credit/course

transfers from a two-year community college to a four-year

university. The original analysis can be found here:

http://gatewayct.edu/Offices-Departments/Public-Affairs/Faculty-Staff-News/faculty-staff-

news/ost-transfer-credits-at-UConn-costs-Community-Coll. The Inside Higher Ed article was not

specifically written with Respiratory Care education in mind, but it certainly resonates with the

current initiative of the profession of Respiratory Care to move toward more baccalaureate

degree prepared respiratory care providers.

I applaud Dr. Becker for bringing transfer status as an issue to the educators of our profession.

The data analysis presented in the article only presents a limited understanding for those who

read it, and could be misleading to students who are looking to fast-track their degree

completion. I propose that the issue of transfer credits has at least two perspectives. The article

alludes to the idea that there should be a direct relationship between the two years spent in an

associate degree designed program and a four year baccalaureate program (I say this generically,

not Respiratory Care specifically). This idea can be very attractive to students, community

colleges and legislators who are looking for the fastest way to degree completion (i.e., think

reduction in costs) possible.

Another perspective would be that the institution being transferred into has autonomy over the

general education and program pre-requisites required to complete a degree from said institution.

In defense of this issue, university general education and major curricula are designed by the

faculty to provide a student with what they believe is the best education that their institution can

offer.

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It is an unrealistic expectation of a student to move directly from one institution to the other

without the need for additional course work. Institutions have different ideologies regarding what

they believe is best for their students/graduates.

In regard to credit being transferred in to a four year institution, there are usually limits (in the

University System of Maryland that limit is approximately 74 credits), but as long as the number

of credits don't exceed those limits then the credits usually transfer (assuming a passing grade

from the transferring course). Students in Maryland community colleges have access to the

systems online articulation system: http://artsys.usmd.edu/ (All states should have something

similar, but likely do not.)

What can happen is that some of those credits don't have a direct course equivalence in the

institution accepting transfer credit. As a silly example -- If a student takes a 3 credit "Basic

Klingon" at a two year institution and the four year institution does not have an equivalent

course, the credits may transfer, but the course itself does not fulfill a required course at the four

year institution. The credit count would go toward the number of credits needed to graduate from

the four year institution, but would not fulfill a specific course requirement.

When potential transfer students ask questions about our program they generally have a desire to

graduate with a baccalaureate degree in Respiratory Care in the shortest time possible. We can

help with that, but they also need to buy into the idea that they are graduating with a degree from

Salisbury University (SU). SU is not unique from other educational institutions in that it has

certain expectations of all of their graduates (i.e., general education and degree requirements).

For our program curriculum issues for potential transfer/post-associate degree students arise

almost every time we discuss needs. Very commonly and because of SU's general education

requirements incoming students need an additional English, History, and Physical Education, but

more importantly they usually need a General Chemistry course or two, and a statistics course.

They complain and ask "what does that have to do with Respiratory Care" and I explain not only

are you seeking a degree in Respiratory Care, but you are seeking a degree from Salisbury

University and these are the general education and basic science courses every graduate from the

University and our program are required to take. It is at that point that they either embrace the

idea of getting a baccalaureate degree from SU or lose interest. What is usually not understood is

that it is these general education and basic sciences courses that are an important part of what

makes a SU grad desirable to employers. In no way am I saying that we have a perfect system,

we don’t; we just have our system.

I don't think we should move into the direction of creating two plus two programs unless they are

specifically designed and advertised that way. While I may be a relic among new growth, I

believe there is a “Je ne sais quoi” in seeking out the knowledge that can be provided by a

university education for its knowledge sake, and for continuing that quest for knowledge for a

life time.

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While I am in no way disrespectful of the degree seeking student that is out for the degree solely

for the opportunities it may bring, I am in awe of the student whose desire is to advance their

knowledge because they believe it will result in improved care for their patients.

We should teach students to understand the difference in these two strategies and find resources

to support both.

Another Perspective on Transfer Credit

Ellen Becker, PhD, RRT-NPS, RPFT, AE-C, FAARC

Professor, Respiratory Care

Rush University, Chicago, IL

Ellen_Becker@rush.edu

Here is another perspective on the article1 and a challenge for advocacy

in our educational leadership roles. Dr. Joyner accurately described how

transfer credits work in our current educational system and why the

number of credits that transfer into various baccalaureate degree bridge

programs may differ. Within the current structure, it is important for

prospective respiratory care students to have realistic expectations when

transferring with an associate degree into a baccalaureate degree

program.

I would like to see a more effective process for transferring credits

within systems acknowledging the path will not be easy, nor quick. As

respiratory care leaders, we are positioned to advocate for change. First the landscape, federal

and state governments are putting less money into education systems and more costs are being

shifted to students. Today’s student graduates with more college debt than in the past. High debt

loads may deter individuals who would normally be willing to pursue advanced degrees, but who

simply cannot take on more debt. I am especially concerned about bright, driven individuals

from underprivileged backgrounds. They have to be concerned not only about debt, but also with

the amount of time they spend in school and away from wage-earning and caregiving

responsibilities. In order to have a diverse respiratory therapist workforce at all levels, education

needs to be accessible to all – or at least have unnecessary roadblocks removed.

Is it possible for systems to streamline the transfer process while maintaining their individual

missions? Partly yes, however this process will take effort from both the associate degree and

baccalaureate degree programs. For example, almost a decade ago the Wisconsin Technical

College System forced all of its associate degree respiratory care programs to have the same

curriculum to facilitate transfer credit if a resident needed to relocate within the state. As Dr.

Joyner noted above for the Maryland system, students can access an online resource to evaluate

in advance the credits that will transfer. If a student is aware that statistics and chemistry are

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required for an advanced degree, the student may choose some of these courses as electives or

consider substituting higher-level courses in the present curriculum that will have a greater

likelihood of transferring toward an upper level degree. Thus, assuring that students who are

entering the profession are informed about their current entry-level program requirements and

the implications for transfer to advanced degree programs is essential.

To facilitate the AARC’s goal of having 80% of respiratory therapists holding or in the process

of earning a baccalaureate degree by 2020, faculty from associate, baccalaureate, and graduate

degree programs have to work together to help students maximize opportunities for credit

transfer. This responsibility will take a partnership across all levels of respiratory care.

REFERENCE

1. Smith AA. Two-year transfers are finding not all of their credits go with them. Inside Higher Ed.

2015, June 8 https://www.insidehighered.com/news/2015/06/08/two-year-transfers-are-finding-not-

all-their-credits-go-them Accessed 07/23/2015.

Role Model for Professionalism

Tom Barnes, EdD, RRT, FAARC

Professor Emeritus of Cardiopulmonary Sciences

Northeastern University, Boston

t.barnes@neu.edu

Respiratory therapy faculty members have a responsibility to serve as a

role model for professionalism. It starts by assuring that all faculty

members, full-time, part-time, adjuncts, clinical instructors and clinical

preceptors are active members of their professional associations: AARC,

CoBGRTE and NBRC. It was recently reported in the 2014 AARC

Human Resources Study that 172,921 RTs have been given a license by

state agencies to deliver respiratory care (150 were estimated by a

representative of the Alaska Society for Respiratory), and the NBRC

reported that they had in July of 2014, 136,807 credentialed therapists in their database.1 Given

the large workforce there should be over 100,000 respiratory therapists that are active members

of their professional associations. Member support is needed to support the AARC’s legislative

effort to include RTs in the Medicare Telehealth Parity Act under consideration in Congress, and

to support important educational activities and programs. The NBRC needs more active

members to support their continuing competency program. CoBGRTE needs membership

support to help establish baccalaureate and graduate RT education as a standard for entry into the

profession. Faculty members can educate their students and colleagues on the importance of

becoming a member of their professional associations by example and by taking the time to

explain why it is important to the profession and to the individual’s career. When faculty

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members are active regionally and nationally in professional associations it sends a clear

message to their students and colleagues on the importance of leadership and support to help

respiratory therapists assume a wider scope of practice, more recognition and higher wages.

Respiratory department managers/directors have a responsibility to only hire applicants that are

AARC and NBRC active members since this is a fundamental sign of professionalism. If

applicants support baccalaureate and graduate respiratory therapy education during employment

interviews they should be asked about their active CoBGRTE membership. I challenge you to

aim for 100% AARC, 100% NBRC and 100% CoBGRTE active or student membership among

your colleagues, new hires and students in your BSRT or graduate RT program. Settle for

nothing less than 100% and insist that everyone is on board with their professional association

memberships. No one should be allowed to instruct your students or work in your respiratory

department unless they serve as a model for professionalism by being a member and active with

three key professional associations: AARC, NBRC and CoBGRTE. Ask your students, new hires

and colleagues to prepare three, five and 10 year goals for professional service and help them to

understand where they can help advance respiratory care. The bottom line are the patients that

will benefit from a more professional and educated workforce.

REFERENCE

1. Shaw R, Benavente J. 2014 AARC Human Resource Survey of Respiratory Therapists.

AARC, 2014, Irving, Texas.

Report on Round Table Discussion Dinner in Phoenix

The following discussion leaders have provided a summary of the discussion at their tables at the Yard

House Restaurant in Phoenix on July 14. Save the date for the next round table discussion dinner that will

be held in Tampa at the historic Columbia Restaurant on Monday November 9, 7:00 to 9:30 PM.

Advanced Practice Respiratory Therapists – José D Rojas, PhD, RRT

This discussion group included individuals from education and clinical practice. We had lively

discussions about the role of respiratory therapists in the ever-evolving health care system. Given

the Association of American Medical Colleges' predicted shortage of primary and specialty care

physicians in the United States by 2025, and the void for access to health care for patients with

chronic respiratory conditions that this will create, the group agreed that this projected void

could be filled by respiratory therapists trained in advanced practice. Several in the group knew

of respiratory therapists serving in advanced practice roles in physician's practices. We

acknowledged that the use of physician extenders to provide better access to health care is not a

new concept. Nurse practitioners and physician assistants scope of practice has been in primary

care and specialty care areas and these clinicians provide services in multiple settings including

physician practices and hospitals. The educational programs for both of these physician extender

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roles are two-year master’s degree programs that include didactic and clinical training. The

group agreed that one limitation to respiratory therapists providing advanced practice was that of

reimbursement; however, we are optimistic for the future of our profession and the possibility of

advanced practice with

reintroduction of H.R.

2948-The Medicare

Health Parity Act. The

group would encourage

our profession to

advocate for this

legislation as a crucial

step in providing for

the reimbursement of

chronic care

management services.

As we continued in our

discussion, the group

was asked for

suggestions on how to identify both the number and scope of practice of therapists currently

providing advanced practice in either physician's offices or hospital settings. The rationale being

that this data is essential for guiding the development of specific areas of advanced practice. This

information will be essential in preparing a specimen curriculum for advanced practice graduate

programs in respiratory therapy. Several at the table commented that the AARC's advancement

of the Pulmonary Disease Educator Course was also useful in defining roles in advanced

practice. As we closed the evening, the group was reminded of the CoBGRTE APRT committee

and its goal to prepare a specimen curriculum for advanced practice graduate programs in

respiratory therapy. They were encouraged to contact committee chair José Rojas, PhD, RRT

<jdrojas@utmb.edu> if they were interested in participating or if they could provide contact

information for therapists currently providing advanced practice.

New BSRT Programs – Gregg Marshall, PhD, RRT, RPSGT

Our table was filled with lively discussion as we enjoyed meeting each other from all across the US and

learning our commonalities and connections from the various universities and institutions.

The question posed to the group was this: “What are the barriers to beginning new BSRT Programs

throughout the country in order to raise the number of BSRT graduates each year?” A summary of the

comments follows:

1) Lack of university funding: everyone agreed that higher education is being stretched financially and

university administrators are seeking those degree opportunities that will yield a large, successful

graduating cohort.

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2) Lack of recognition of the value of the BS degree by industry: the group felt that industry must lead

the way in valuing the BS degree by offering either pay differences for terminal degrees or providing

career ladders to provide incentive for continued education. Also, the group felt that industry must

“make a place for the BSRT” in the function of the department through clear job description/degree-

related positions.

3) Lack of

recognition of

BS for

insurance

reimbursement:

there was lively

discussion

regarding the

role of

insurance

reimbursement

that recognized

a profession

with a BS

degree.

Comments

were made

about current

legislation before Congress (ie: H.R. 2948 expanding opportunities for Medicare beneficiaries who

suffer from pulmonary disease by 1) covering respiratory services when furnished via an interactive

telecommunications system, 2) including an individual’s home as a telehealth site, and 3) naming

respiratory therapists as qualified telehealth professionals.)

4) Proprietary competition with the proliferation of programs in one city with poor pass rates and

poor representatives of the profession to industry: discussion by two dinner guests from

California was quite intense as they painted the picture of the poor quality of graduates from

proprietary programs and frustration with CoARC for granting program status to so many

programs within the same geographic region. This glut of programs dilutes the applicant pool

to a stronger, more demanding BSRT program possibility.

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AARC – CoBGRTE Goal Alignment – Jennifer Anderson, EdD, RRT

Jamy Chulak, Lynda Goodfellow, Tim Op’t Holt, Marc Mays, Warren Guiste, Lisa Trujillo, and

Jennifer Anderson attended the AARC Roundtable discussion table. The CoBGRTE members at

the roundtable

were a mix of

educators, a

manager, and a

student. Many

members at the

table currently

serve on the

AARC board of

directors or in

the House of

Delegates. The

table had a

wonderful

discussion about

the two

organizations.

Below you will find a few topics that were discussed:

The role of CoBGRTE is unique to that of other partners within the “tripartite”

Why can’t CoBGRTE be better partners and have a seat at the table?

CoBGRTE and AARC goals are aligned more than ever, how can our focus and work

compliment the work to advance the profession?

In summary, CoBGRTE membership includes some of the most talented educators in respiratory

therapy education who are also AARC members. CoBGRTE members are committed to assisting

the AARC in moving the profession forward to Bachelor’s entry education and RRT entry for

licensure. The AARC and CoBGRTE have many commonalities and therefore it is important for

the AARC and CoBGRTE to work together.

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CAAHEP – ARC-RT – Tom Barnes, EdD, RRT, FAARC, David Shelledy, PhD, RRT,

FAARC

At the Round Table Discussion Dinner our table discussed the proposed Accreditation Review

Committee for Respiratory Therapy (ARC-RT), a new committee on accreditation (CoA) to be

developed under the

auspices of the

Commission on

Accreditation of

Allied Health

Education Programs

(CAAHEP) and

CoBGRTE. The

rationale for ARC-

RT is to improve the

quality of

respiratory therapist

educational

programs by

developing and

implementing a

collegial and collaborative, peer-review accreditation system and associated standards with a

focus on outcomes evaluation. Features of this new accreditation system should include: 1)

programs must award the BS or MS degree in respiratory care (or equivalent degree title); 2) use

of RRT examination performance as a primary outcome measure (instead of CRT pass rate); 3)

emphasis on the AARC approved competencies developed from the second AARC 2015 and

Beyond Conference; 4) strong representation of BSRT and MSRT entry to practice programs and

faculty as members of the ARC-RT; 5) a philosophy of consultation and support of accredited

programs; 6) direct communication with the program leadership at the college level; 7) use of

100% digital records during self-studies and site visits; 8) site visits limited to one day; 8)

support for direct entry (i.e. first professional) master’s degree programs and the development of

advanced practice respiratory therapist (APRT) master’s and doctoral degree (professional)

programs; 9) advance respiratory care education in a manner consistent with current and future

needs of the profession; and 10) decrease the number of hours required by faculty members to

maintain accreditation standards. The timelines for CAAHEP approval of the ARC-RT and the

development of standards, guidelines, policies, and methods for feedback of the community of

interest were discussed.

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Direct-Entry Master’s Programs – DeDe Gardner, MHSP, RRT-NPS, FAARC

The Direct-Entry Master’s Program group answered a few questions:

1. Define Direct-Entry Master’s Program

2. Identify the skills, expectations of a prospective student

3. Identify the barriers associated with a Direct-Entry Master’s Program

4. Describe the benefits of a Direct-Entry Master’s program workforce.

The Direct-Entry Master’s Program group defined this type of program as one for students who have a

bachelor’s degree in any subject and interest in pursuing a degree in health care. The Direct-Entry

Master’s Programs are direct path to care for patients. The program provides the competencies to be an

advanced level

respiratory therapist at

the Registered

Respiratory Therapist

level with added skills

such as clinical

education, leadership

and research.

The Direct-Entry

Master’s Program

prospective students

should have critical

thinking skills and the

ability to

communicate well for

engaging in team care.

These prospective

students should have a high Science and Math GPA (greater than a 3.0); Letters of recommendation from

the math and science teachers that speak to the student’s abilities to critically think and communicate;

possibly have a high GRE score; and an understanding of respiratory therapy as a profession.

The group identified barriers to the Direct-Entry Master’s Program include the entry level to practice in

most states is the associate degree with a certified respiratory therapist (CRT) credential. The current

workforce does not recognize the importance of a Direct-Entry Master’s program and therefore the pay

scales are usually based on a credential unless a career ladder is in place which would allow for the

education level to come into play.

The benefits of Direct-Entry Master’s Program graduates would provide a unique workforce that would

be ready to move into the department leadership as team leaders; assist with quality improvement plans

and other types of clinical research and provide preceptors/clinical educators for students in the hospital

setting. This unique workforce overtime would be able to step in to a junior faculty position or research

and development positions. The career ladder could be wide open for these graduates.

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Virtual Ventilator: the advantages of immersive simulation, the

convenience of a web-based computer application

Craig D. Smallwood, BS, RRT

Research Associate

Boston Children's Hospital

Harvard Medical School

Boston, MA

The virtual ventilator is a cutting edge training tool offering state of the art digital simulation

training for respiratory clinicians. The ventilator offers a comprehensive representation of a

mechanical ventilation bedside experience including patient appearance, physiologic monitor,

pulmonary mechanics and more. “Blurring the lines between computer simulation and bedside

experience”

Unlike many other online

training tools, the virtual

ventilator requires users to

use patient assessment

skills including

auscultation, blood gas

interpretation, chest X-ray

interpretation, waveform

analysis (including

capnography) and more.

Treating the patient is

very close to the dynamic

bedside experience; you’ll

not only have to choose

appropriate ventilator

settings but also administer aerosolized medication and perform other physical interventions

such as needle decompression.

The application is structured in three areas to offer fundamental information to those new to

mechanical ventilation through use of the knowledge guide, identification and treatment of

specific isolated conditions and the tactics required to treat them (hypocarbia, hypoxia, airway

obstruction, pneumothorax) and lastly, a complete case simulation using patient data and

following the time course of a patients response to mechanical ventilation.

The knowledge guide offers users fundamental information about mechanical ventilation

through the use of written content, display of important graphics on the ventilator and

explanations of important ventilation concepts. A total of 11 tactics that require identification of

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the condition and appropriate treatment allow the user to hone their skills. At the completion of

each tactic users are given general feedback about the tactics as well as specific automated

feedback about the specific intervention they made on the ventilator. Feedback includes

adequacy of settings to achieve target gas exchange, lung protection if applicable and whether or

not drug or other physical

interventions were

appropriately applied. It

all comes together in the

last and most

comprehensive portion of

the virtual ventilator, the

cases. Each case requires

the user to take care of

patient for their entire

simulated duration of

ventilation; from initiation

(even running a pre-use

check) to extubation.

Cases range from simple

post-operative patients to obstructive airway disease to acute respiratory distress syndrome.

Throughout the case, users are graded at discrete points and are presented with a summary of

their performance (gas exchange, ventilator settings, alarms and interventions) both during and at

the completion of the case.

Future development

Although the system is still young, we are always looking for ways to make it more powerful and

realistic. By the end of August, additional content (including new tactics, three neonatal and three

adult cases) will be live. Important additions will include administration of nitric oxide, PEEP

titration, recognition of severe obstruction during chronic obstructive pulmonary disorder and

more.

If you’re interested in deploying the virtual ventilator at your school or hospital; we are looking

for a select number institutions to partner with us as test sites.

Currently, the virtual ventilator is offered through openpediatrics.org and navigating to the

application through the library OR by going to virtualventilator.org, which takes you directly to

the ventilator after the log-in screen. Students and clinicians can sign up for free and use the

system.

If you have any questions, would like to set up a time to demo the software or you’d like more

information please contact me via email at craig.smallwood@childrens.harvard.edu.

18

Congratulations Class of 2015

The University of Arkansas for Medical Sciences BS Degree Class of 2015

Long Island University BS Degree Class of 2015

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Long Island University Scholars

The Long Island University Respiratory Care program has had its

second consecutive NBRC/AMP scholar with Ms. Christina Rocks

(class of 2015) winning both the 2014 William W. Burgin Jr. MD

and the Robert M. Lawrence MD Education Recognition Award

for her paper on The Peri-operative Respiratory Care of the LVAD

Patient. Christina has just heard that her paper has been accepted for

publication through the Journal of Lung, Pulmonary & Respiratory

Research: http://medcraveonline.com/JLPRR/. She presented this

paper to the New Jersey Society for Respiratory Care's Shore

Conference in October 2014. In 2013, Ms. Katherine Meza (Class

of 2014) won the Robert M. Lawrence Education Recognition

Award at the AARC 2013 International Congress. The Long Island

University Respiratory Care Program received another consecutive award for “Distinguished

Credentialing Success” at the 2015 AARC Summer Forum in Phoenix.

CHI Health Midland University Baccalaureate Class of 2015

L to R, Andrea Hall, Essam Al-Yami, Jannae Takemoto

20

CoBGRTE Board Meets in Phoenix

The Board of Directors met in Phoenix following the AARC Summer Forum. Dr. Ellen Becker,

Chair of the AARC Education Section, visited the meeting to report on activities on current and

future activities. She mentioned the importance of introducing students to AARC membership

and encouraged

faculty

members to

help them

become

members while

in school and

when they

graduate. Dr.

Becker

emphasized the

importance of

becoming a

member of the AARC Education Section thereby helping to assure that the Section qualifies for a

seat on the AARC Board of Directors. She encouraged everyone to submit nominations for the

AARC Education Section “Practitioner of the Year Award.” She shared information on the

AARC’s Strategic Plan that includes a goal of 80% of respiratory therapists in the workforce

either holding or working on a baccalaureate degree by 2020.

The Executive Committee members reported to the Board on a

meeting of the CoBGRTE and AARC Executive Committees and

AARC professional staff members that was held immediately prior

to the CoBGRTE Board meeting. The joint session provided a

forum to report activities occurring in both associations.

Opportunities to move forward together to develop both

baccalaureate and graduate education while “grandfathering” the

associate degree programs to assure an adequate workforce were

discussed. The leadership of AARC President, Frank Salvatore, in

arranging the joint meeting was greatly appreciated by all in

attendance. President Salvatore stated that the AARC was

supporting baccalaureate education and that it was an important

part of their Strategic Plan. Tom Kallstrom, AARC Executive

Director offered to provide information for The Coalition

Chronicle on the Strategic Plan and President Salvatore’s goals. Tom Barnes, CoBGRTE

President offered to work with BSRT and MSRT program directors to assist with, AARC

21

membership (see article on pages 9-10). All in attendance of the combined Executive

Committees meeting agreed that the meeting led to positive communication.

Also, joining the Board of Directors meeting was Grace Richards, Marketing Manager, for Jones

and Bartlett Publishers. The Board thanked Ms. Richards for the support that J&B has provided

as a CoBGRTE sponsor since 2013. Plans were discussed for a J&B sponsored program in

Tampa, preceding the 2015 AARC Congress on how to use software that accompanies J&B

textbooks to enhance the learning experience.

CoBGRTE President, Dr. Tom Barnes, reported a healthy

growth of membership including a 25% increase in

institutional members that now total 61 and represent most

universities offering baccalaureate and graduate degrees to

RT students. In 2015, the Membership Committee has

encouraged academic health science centers, major

clinical affiliates, and respiratory care state societies

interested in supporting baccalaureate and graduate RT

education to become institutional members of CoBGRTE.

Dr. Barnes reviewed continued work on the

recommendations of the CoBGRTE Accreditation Task

Force White Paper on Accreditation published in 2014. He

reported that on July 1, 2015 CoBGRTE became an

Associate Organizational Member of the Commission for

Accreditation of Allied Health Education Programs

(CAAHEP). Dr. Barnes reviewed a major revision of the

CoBGRTE Bylaws prepared by the Executive Committee.

Changes include an addition of a Medical Advisor to the Board of Directors, three new members

on the Executive Committee, President-Elect, Past President, and separation of the

Secretary/Treasurer into two positions of Treasurer and Secretary. The revised Bylaws also

establish an Institutional Member Council with the Chair of the Council serving on the Board of

Directors. Active members of CoBGRTE will vote on the revised Bylaws in September as part of

the Election of three new directors to the Board. The remainder of the Board meeting was

dedicated to a review and action on minutes from past Board and Executive Committee

meetings, and other committee reports.

22

Why I’m a CoBGRTE Member

Paul G. Eberle, PhD, RRT

Professor & Department Chair / Respiratory Therapy

Dr. Ezekiel R. Dumke College of Health Professions

Weber State University

Ogden, Utah

Three reasons why I’m a CoBGRTE member:

“As we transition into increasing professional responsibilities as life-

support experts, we find ourselves creatively learning how to help our

patients as advocates, educators, collaborators, and disease consultants to

pathologies that affect their health. In these roles, it is important to

develop knowledgeable, competent, and capable practitioners with

competencies that advance our expertise as a health provider. I am a

member of CoBGRTE because the association advocates for advancing

educational pathways for professional growth, is actively engaged in

supporting programs with resources and mentors to improve outcomes, and has prepared a

vision for future development.”

Professional positions posted at http://www.cobgrte.org/professionalpositions.html

Bellarmine University

University of Texas Health Science Center at San Antonio

Nova Southeastern University

Indiana University Health

Georgia State University

Highline College

Northern Kentucky University

Salisbury University

University of Texas Medical Branch Galveston

Cincinnati Children’s Hospital

University of Dammam

University of North Carolina at Charlotte

Wexner Medical Center

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24

CoBGRTE Institutional Members

Indiana Respiratory Therapy Consortium

Georgia State University

Weber State University

Boise State University

Bellarmine University

Rush University

Salisbury University

University of Toledo

The Ohio State University

State University of New York Upstate Medical University

Northeastern University

University of Texas Medical Branch - Galveston

Wheeling Jesuit University

Texas State University

University of South Alabama

Long Island University

University of North Carolina – Charlotte

Louisiana State University Health Science Center – New Orleans

Midwestern State University

Jefferson College of Health Sciences

Youngstown State University

Rutgers University - North

Nova Southeastern University

Loma Linda University

University of Arkansas for Medical Sciences

State University of New York at Stony Brook

University of Texas Health Science Center – San Antonio

University of Hartford

University of Cincinnati

25

CoBGRTE Institutional Members – Continued

University of Kansas Medical Center

College of Southern Nevada

Highline College

University of Akron

Oregon Institute of Technology

Georgia Regents University

St. Alexius Medical Center-University of Mary

Valencia College

Kettering College of Medical Arts

Shenandoah University

Middle Georgia State College

York College of Pennsylvania

University of Alabama at Birmingham

Respiratory Care Board of California

Texas Southern University

St. Catherine University

Armstrong State University

Cincinnati Children’s Hospital Medical Center

East Tennessee State University

University of Virginia Medical Center

University of Dammam

Seattle Central College

Florida Southwestern State College

Utah Society for Respiratory Care

Intermountain Healthcare

Southern Connecticut State University

Washington Adventist University

Rutgers University - South

Northern Kentucky University

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CoBGRTE Institutional Members – Continued

Boston Children’s Hospital

California Society for Respiratory Care

Respiratory Care Society of Washington

If you haven’t already decided to become a CoBGRTE member after visiting www.cobgrte.org, the following are 10 reasons why you should join the coalition.

Ten Reasons Why You Should Become a CoBGRTE Member

1. Award scholarships to baccalaureate and graduate respiratory therapy students.

2. Assist in the development of ASRT to BSRT Bridge Programs.

3. Collectively work towards the day when all respiratory therapists enter the profession with a

baccalaureate or graduate degree in respiratory care.

4. Support a national association, representing the 55 colleges/universities awarding baccalaureate

and graduate degrees in respiratory care, to move forward the recommendations of the third 2015

conference.

5. Help start new baccalaureate and graduate RT programs thus leading to a higher quality of

respiratory therapist entering the workforce.

6. Work to change the image of the RT profession from technical-vocational-associate degree

education to professional education at the baccalaureate and graduate degree level.

7. Join colleagues to collectively develop standards for baccalaureate and graduate respiratory

therapist education.

8. Develop public relations programs to make potential students aware of baccalaureate and graduate

respiratory therapist programs.

9. Help to publicize, among department directors/managers, the differences between respiratory

therapists with associate, baccalaureate and graduate degrees.

10. Help to support maintaining a roster and web site for all baccalaureate and graduate respiratory

therapist programs.

Become a CoBGRTE member by completing the application on the Membership

Page: http://www.cobgrte.org/membership.html

Reminder: CoBGRTE Institutional Members receive free postings for open faculty member positions or hospital RT department staff and leadership positions at: http://www.cobgrte.org/professionalpositions.html

27

Editorial Board

Tom Barnes, EdD, RRT, FAARC - Editor in Chief Northeastern University

Boston, Massachusetts

Will Beachey, PhD, RRT, FAARC CHI St. Alexius Health/University of Mary

Bismarck, North Dakota

Paul Eberle, PhD, RRT, FAARC Weber State University

Ogden Utah

Christy Kane, PhD, RRT-NPS Bellarmine University

Louisville, Kentucky

Gregg Marshall, PhD, RRT, RPSGT, RST Texas State University

San Marcos, Texas

Jon Nilsestuen, PhD, RRT, FAARC University of Texas Medical Branch

Galveston, Texas

Timothy Op’t Holt, EdD, RRT, AE-C, FAARC University of South Alabama

Mobile, Alabama

“Dedicated to Improving Respiratory Therapy Education”

www.cobgrte.org

©Copyright 2015 Coalition for Baccalaureate and Graduate Respiratory Therapy Education

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