1996 OPEN FORUM Abstracts
THE EXTENT OF MULTI-SKILLING EDUCATION IN RESPIRATORY CARE EDUCATIONAL PROGRAMS
by Philip D. Hoberty, Ed D. R.R.T. The Ohio State University, Columbus, Ohio.
Background: Prestigious national study commissions and professional associations, including the AARC, have indicated that the future allied health practitioner will be the multi-competent health care professional who is trained and proficient in skills not limited to a single allied health profession. Hospital restructuring and elimination of central Respiratory Care (RC) departments have added to the pressure to create the multi-skilled practitioner. The purpose of this study was to determine the extent of multi-skilling education (MSE) in the curricula of the RC programs approved by the Commission for the Accreditation of Allied Health Education Programs (CAAHEP). Method: Sixteen-item questionnaires were mailed to the program directors at 378 institutions listed in the June 1995 JRCRTE directory. Program directors were asked to report on the amount of instruction in 10 curricular skill areas which, although not traditionally included in respiratory care, have been identified in the literature as ripe for cross-training or "multi-skilling" of RC personal including: non-invasive and invasive cardiology, sleep disorders studies, neurodiagnostics, extra-corporeal membrane oxygenation, assisting with bronchoscopy, intravenous infusion, performing simple radiographic and medical laboratory procedures and performing basic patient care skills. The directors also identified the settings for instruction (classroom, laboratory or clinic), the type of faculty (program, clinical or other) and type of students for each of the 10 areas. The directors were also asked to speculate whether they foresaw more MSE in the next 12 months in basic or advanced skills. Results: Usable questionnaires were returned by 62% of the institutions offering accredited RC educational programs at the technician or therapist level. The returns reported on 233 accredited programs. The degree of curricular commitment ranged from a high of 88 % of programs offering some instruction in assisting with bronchoscopy, to a low of 6% of programs offering some instruction in performing simple radiographic procedures such as taking chest radiographs and processing films. In other areas of MSE, from more to less common, 79% offered instruction in sleep disorders studies, 74% in invasive cardiology, 66% in non-invasive cardiology, 40% in basic patient care skills, 38% in ECMO, 30% in simple medical laboratory procedures, 18% in infusion therapy, and 13% in neurodiagnostics. The vast majority of this instruction consisted of from 1 to several class hours of a course. The percentage of programs offering instruction in the form of 1 or more courses of at least 1 quarter hour credit ranged from a high of 7 % of programs in invasive cardiology, to a low of 0% in performing simple radiographic procedures. Only 14% of MSE is conducted through the fully trinity of classroom, laboratory and clinical instruction. Only 38% of MSE reported is conducted so that program and clinical, or program and outside faculty offer instruction. Ninety-nine percent of MSE instruction is offered to RC students, graduates or practitioners. Directors in 51% of the programs indicated that within the next 12 months they intend to offer more MSE, with 36% of that being at basic level skills only, 21% at advanced level skills only and 43% at both levels. Conclusion : Although MSE has broad support in the literature, it has made a minor impact on the current curricula of approved RC programs. A relatively small portion of that instruction is offered through the full range of instructional settings and faculty. Almost all MSE is directed toward those in or entering RC. About half of the directors reported plans to offer more MSE in the next year in a mix of basic and advanced level skills.