The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF A COMPUTERIZED CLINICAL COMPETENCY PROGRAM IN AN UNDERGRADUATE ALLIED HEALTH SCIENCE PROGRAM.

Hall CR, MS RRT-NPS RPFT, Reyes JJ, BS RRT-NPS, Taft AA, PhD RRT, Dennison FH, M.ED RRT RPFT, Hernlen KM, MBA RRT, Baker RR, PhD RRT RPCT. Medical College of Georgia, Augusta, Georgia.

Background: Educational programs in allied health science require effective methods for evaluating and documenting clinical competencies. Many programs continue to use standardized paper-based forms and written manuals for this process. These methods are frequently cumbersome and inefficient for collecting and analyzing point-of-care competency data from the clinical setting. Advances in portable computer technology may now offer a viable option to increase efficiency and effectiveness when documenting and evaluating clinical competencies.

Methods:
A clinical competency program for baccalaureate undergraduate respiratory therapy students (n=26) was developed using personal data assistants (PDAs) and access to WebCT™. HanDbase™ and Document To Go™ software was used as the platform to develop the clinical data base and supporting reference documents, respectively. Clinical competency areas included patient assessment, oxygen delivery, hyperinflation therapy, bronchial hygiene therapy and critical care areas in the neonatal, pediatric and adult populations. The software was loaded onto faculty and students’ PDAs and a centrally located desktop computer for data base maintenance by the Director of Clinical Education (DCE). Two report formats, Microsoft Excel™ and web page, were used to provide competency updates to faculty and students.. Students and faculty were trained to use the PDAs during clinical rotations. Students were required to enter the procedures and tasks they observed or performed at the point-of-care into their PDAs. Faculty or preceptors verified competencies by electronic signature and students were required to sync their PDAs to the desktop computer following clinical rotations. Data analysis was routinely performed by the DCE to verify student and faculty compliance with the program and to identify deficiencies in the students’ clinical experiences. In addition, clinical resource software including drug references and clinical practice guidelines were also installed
onto the PDAs.

Results:
PDAs and associated software were incorporated successfully into the clinical setting and allowed faculty and preceptors to document clinical competencies in a timely manner. The developed PDA database program, which includes menus with imbedded submenus, lends itself to the use of many combinations of tasks or procedures without the large number of pages required to detail the same information on paper. The PDA allowed unlimited numbers of competency verification signatures as compared to only 3 on a previous paper-based manual. Also, students were able to easily document clinical observations and practices of required tasks and procedures in the PDA. Electronic physician interaction forms were also successfully incorporated and utilized. Evaluations demonstrate that 100% of the students preferred the PDA format versus a paper-based format to include the valued use of clinical practice guidelines (AARC), drug references (Epocrates™) and medical mathematical software (MedCalc™). The DCE was able perform data analysis of clinical procedures performed on an ongoing basis. Problems encountered were minimal and included PDA memory deficiencies, syncing difficulties, and battery power failures, which were alleviated through initiation of battery charging mechanisms. No permanent data loss was recorded due to routine software backup integrated into the syncing process.

Conclusion:
Our experience demonstrated that using computer technology, to include versatile PDA devices, relevant software, and web-based access offered a viable option for recording and managing clinical competency data obtained at the point-of care. Efficiency was increased by allowing the DCE to review and manipulate the database on an ongoing basis with minimal effort. This allowed for any deficiencies in the program to be identified and adjustments to be made immediately to the clinical rotations to provide for continued quality improvement of the students’ clinical experience.

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