May 2002 / Volume 47 / Number 5 / Page 583
A Survey of Physicians to Identify Their Expectations of Respiratory Therapists in Patient Assessment
INTRODUCTION: The exact role of respiratory therapists (RTs) in patient assessment is not well defined. The purpose of this study was to identify local physician expectations of RTs for the application and interpretation of various assessment procedures. METHODS: A survey was developed that called for physicians to indicate on a scale of 1 to 5 (1 = never, 2 = rarely, 3 = occasionally, 4 = often, and 5 = always) how important they perceive it is for RTs to be able to interpret or perform 20 commonly used patient assessment tests or procedures. The survey was mailed to 25 physicians who care for patients in the medical and surgical intensive care units at Loma Linda University Medical Center and the Jerry L Pettis Veterans Administration Memorial Medical Center. RESULTS: Twenty (80%) of the surveys were returned. The assessment procedures rated highest were: to assess lung sounds (4.8), to interpret arterial blood gas values (4.5), to interpret pulmonary function tests (4.4), to assess and interpret vital signs (4.4), and to interview patient to clarify symptoms (4.3). The procedures consistently rated low were: to interpret echocardiography (2.5), to assess abdomen (2.3), to interpret sleep studies (2.2), and to interpret electroencephalogram (1.7). A total expectation score for each completed survey was determined by adding the scores from each of the 20 assessment procedures. The average ± SD total score was 66.8 ± 10.4 on a scale of 20 to 100. The total expectation score did not vary by years of experience in patient care or type of medical specialty. CONCLUSIONS: The results indicate that the physicians completing our survey generally have high expectations of RTs for the application of patient assessment techniques that involve direct evaluation of lung performance or condition.
Key words: patient assessment, physician expectations, survey, respiratory therapist.
[Respir Care 2002;47(5):583–585]
Respiratory care by protocol appears to be growing in popularity, which calls for respiratory therapists (RTs) to be skilled in patient assessment. The exact role of RTs in patient assessment, however, is not well defined and probably varies by location around the country. The expectations of physicians may be a key factor in determining the role of RTs in the assessment process, since RTs work under the direction of physicians. Educators of respiratory care students need to know physician expectations in order to provide students with the knowledge and skills they will need to be effective in patient care.
The purpose of this study was to identify local physicians' expectations of RTs in patient assessment. We attempted to answer 3 questions:
- What are local physicians' expectations of RTs regarding various patient assessment procedures and tests?
- Are there differences in expectations based on medical specialty (eg, pulmonologists vs physicians of other medical specialties)?
- Is there a relationship between a physician's years of experience and his or her expectations of RTs in patient assessment?
We hypothesized that pulmonologists would have different expectations than other physicians, because of their close relationship with RTs. In addition we expected that, because of their exposure to RTs in the clinical setting, physicians with many years of experience would have greater expectations than those with fewer years of experience.