2002 OPEN FORUM Abstracts
CURRENT MEDICAL STUDENT EDUCATION REGARDING RESPIRATORY THERAPY.
Leslie Patzwahl, BS, RRT, Lucy Kester, RRT, MBA, FAARC, James K. Stoller, MD, MS, FAARC. The Cleveland Clinic Foundation, Cleveland Ohio.
Introduction: In the context that protocol-directed care implemented by respiratory therapists has been shown to offer more appropriate respiratory care than usual physician-directed care, we wished to examine the caliber and quantity of respiratory care training offered to medical students. The hypothesis is that sparse initial exposure to respiratory therapy may contribute to later inattention and lack of respiratory therapy expertise among physicians. To assess the amount of attention given to instructing medical students regarding respiratory care, we assessed the respiratory care content of textbooks assigned in medical school curricula of three Ohio medical schools.
Methods: Textbooks were identified by contacting the coordinator/director of curriculum development at three Ohio medical schools. Books were those used in conjunction with first and second year medical student instruction regarding pulmonary physiology and pathophysiology. The textbooks that were identified by the curriculum coordinators were:
1. Pulmonary Physiology, Michael A. Grippi, M.D. with eleven additional contributors, J. B. Lippincott Company, Philadelphia, 308 pages, 1995.
2. Respiratory Physiology: The Essentials, John B. West, M.D., Lippincott, Williams and Wilkins, Philadelphia, 142 pages (6th edition, 2000).
3. Pulmonary Pathophysiology: The Essentials, John B. West, M.D., Williams and Wilkins, Baltimore, 166 pages. (5th edition, 1995).
Specific respiratory therapy topics regarded diagnostic issues (including use of pulmonary function testing [i.e., their performance and significance]), pulse oximetry, arterial blood gases, respiratory failure, and therapeutic issues (including use of supplemental oxygen, mechanical ventilation, and bronchodilators).
Results: Table 1 presents the amount of space (rounded to the nearest page) allocated to discussing respiratory therapy issues in these textbooks. Our survey suggested that inhaled medication devices, hyperinflation techniques, secretion clearance techniques, and use of artificial airways were not discussed in these textbooks.
|Table 1. Review of Textbooks|
|School||Respiratory Physiology||Respiratory Pathology||Pulmonary Function||Arterial Blood Gases||Oxygen||Ventilators||
|1||5 pages||2 pages||14 pages||6 pages||2 pages||5 pages||1 page|
|2||10 chapters||1 page||12 pages||2 pages||4 pages|
|3||5 pages||1 page||2 pages||4 pages|
Conclusions: Recognizing the limited sample of textbooks examined, our data suggest relative inattention to respiratory therapy issues in first and second-year medical school curricula. While the current survey did not address respiratory therapy education during medical students? later clinical rotations, the sparse formal textbook coverage suggests that physicians receive respiratory therapy education in an ?on the job? context. The opportunities to enhance respiratory therapy education among physicians warrants re-examination of how and when to best educate physicians-in-training regarding respiratory therapy.