Adequacy of the Provider Workforce for Persons With Cardiopulmonary Disease.

BACKGROUND: Access and quality of health care for cardiopulmonary disease in the United States ranks poorly compared with economically similar nations. No recent comprehensive assessment of the cardiopulmonary workforce is available. This systematic review was conducted to evaluate current published evidence about the workforce caring for persons with cardiopulmonary disease. METHODS: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Structured searches of medical databases were conducted to find studies published from 2006 through 2016. Because of the paucity of quantitative data retrieved, a qualitative synthesis was conducted. Thematic analyses were performed on 15 identified articles through a process of open and axial coding. RESULTS: There is published evidence of current and projected workforce shortages in all clinical settings where care of persons with cardiopulmonary disease occurs. Advanced practice providers complete much of their cardiopulmonary training on the job. The aging population and the advent of new medical interventions are projected to increase growth in health-care demand. Some physicians limit hiring of advanced practice providers because of a deficiency in formal cardiopulmonary training. CONCLUSIONS: There is a gap in care between the needs of persons with cardiopulmonary disease and cardiopulmonary providers. Strategies resolving this problem may include one or more approaches that reduce the administrative burden associated with current care and assure the availability of suitably trained providers.

Becoming Lifelong Learners: A Study in Self-Regulated Learning.

While health professions educators espouse the need to develop lifelong learning skills in students, little is written about such attempts. The purpose of this study was to assess the effectiveness of educational and awareness interventions designed to promote self-regulated learning processes as a means to improve lifelong learning skills. First-year students in respiratory care and radiologic imaging sciences took the Learning and Study Skills Inventory (LASSI) in fall and spring semesters. They made the decision to use or not use educational resources in an online course focused on self-regulated learning skills. All students maintained a journal and responded to prompts about changes in their study skills. Final grades, reported in percentages, from selected required courses for fall and spring semesters were recorded. There were no substantive effects of the intervention (LASSI and online resources) as measured by the LASSI and course averages. Qualitative analysis indicated that students valued the LASSI and the online resources and that they altered their study skills as they perceived the need. Suggestions for future work include continued use of the LASSI, integration of self-regulated learning strategies into courses with role-modeling by faculty, and the use of microanalytic protocols.

Respiratory care year in review 2011: long-term oxygen therapy, pulmonary rehabilitation, airway management, acute lung injury, education, and management.

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

Respiratory care clinical education: a needs assessment for preceptor training.

BACKGROUND: There has been a growing interest in the use of volunteer clinical preceptors to provide clinical instruction to respiratory therapy (RT) students. However, many RT preceptors have had little or no training in preceptorship. We sought to identify the preceptor training needs of programs that lead to the Registered Respiratory Therapist or Certified Respiratory Therapist credential (RT programs). METHODS: Via e-mail we asked the directors of accredited RT programs to respond to a Web-based survey. RESULTS: Seventy-four RT program directors, from programs across the United States, responded. Eighty-two percent of the respondents' programs offer an associate's degree and 16% offer a baccalaureate degree. The majority of the respondents' programs use unpaid clinical preceptors. Thirty-two percent of the respondents indicated that the preceptors had received no preceptor training. Among the preceptors who did receive training, the duration of training ranged from 1 hour to 6 weeks. The training was typically delivered by the director of clinical education or program faculty. Eighty-one percent of the respondents believed there is a need for a standardized preceptor-training program. The respondents' understanding of, curriculum for, and implementation of preceptor training differed considerably, and there were substantial differences in the content and duration of the existing preceptor-training programs. Seventy-two percent of the respondents had experienced barriers to preceptor training. CONCLUSIONS: A standardized preceptor-training program is needed to improve the quality of preceptorship and assure that RT programs prepare graduates for 21st-century RT practice.

Perceived benefits of the use of learning contracts to guide clinical education in respiratory care students.

BACKGROUND: The benefits of contract learning have been identified in the literature as increased individualization to meet the student's individual needs, promotion of learner independence, and development of lifelong learning behaviors among students. METHODS: I used an "action research" approach to implement the contract-learning method into a clinical course. Clinical learning contracts were designed to provide students with the opportunity to focus on any identified areas of unsatisfactory or desired practice. The learning contract specified how the learner would acquire the knowledge and attitudes relevant to their selected learning experience. The learning contract was used as a learning tool and as evidence of the student's development in the clinical experience. Twenty-four senior respiratory therapy students in the College of Health Related Professions, University of Arkansas for Medical Sciences, prepared and used learning contracts during their Clinical Practicum IV. After they had completed the clinical practicum and received their grades, I surveyed the students about their experience with the learning-contract method. The surveys were administered anonymously. RESULTS: Twenty-one students (88%) returned the surveys. The respondents were overall quite optimistic regarding learning contracts. They generally agreed that they could use the learning contract with confidence and that there is an increase in student autonomy and motivation in scholarship with a learning contract. The median agree/disagree ratings on the survey ranged from 1 (strongly agree) to 2 (agree). CONCLUSIONS: Contract learning is favorable to students' knowledge and skill acquisition and can be incorporated into clinical education of respiratory care students.

Distance education in respiratory care.

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