Preceptorship is the ideal method for teaching students in the healthcare environment. Due to a shortage of staffing, respiratory care students are not often assigned with preceptors, rather they are assigned with respiratory care staff that has minimal to no formal training in education. Therefore, students may not receive appropriate role involvement, decision-making and patient skills experience. PURPOSE: The purpose of this study was to examine the current methods of preceptor training and evaluate the need for a preceptor-training program according to the education coordinators and respiratory care directors/managers. METHODS Data were acquired through a descriptive survey. The survey was formulated and sent using the online survey generator Zoomerang. The survey was submitted to a convenience sample of department directors, department education coordinators, and staff at clinical affiliates associated with Georgia State University. RESULTS: Thirty-six participants were surveyed with a response rate of 67%. Forty-eight percent were a respiratory director/manager, 35% education coordinator and 9% supervisor. Eighty-six percent of participants work in not-for-profit hospitals. Seventy-nine percent of participants believe there is a need for a standardized preceptor-training program, however, only 64% reported that preceptors receive training prior to receiving students. CONCLUSION: There is a need for a standardized preceptor-training program for respiratory therapists to improve the quality of clinical education provided to respiratory therapy students.

According to the report of the Bureau of National Healthcare Insurance (NHI) in 1997, the total expenses on ventilator-dependent patients was about 7,100 million yuan in hospital, account for 3% of the cost of one year of health insurance of the whole people. To efficiently control their admission so as to decrease unsuitable utilization of mechanical ventilation, and to achieve the rational growth of medical expenditure, the NHI has developed the perspective payment system for the ventilator-dependent integrated delivery system (IDS) respiratory care program since July 1, 2000. Ventilator-dependent patients, difficult to wean, rely on the mechanical ventilation, using for at least 21 days in succession. The patients are dependent upon long-term mechanical respiratory care. Integrating the different level of respiratory care, IDS program is including ¡§ICU , intensive care unit¡¨, ¡¨RCC, respiratory care center¡¨, ¡¨ RCW , respiratory care ward¡¨ and ¡§home care¡¨ and pay in accordance with the level. The purpose of IDS program is to promote the quality of respiratory care and effectively to utilize the limited medical resources. The data for this research was retrieved from the 2002-2004 ¡§NHI database¡¨ that includes charge and discharge information for 115 hospitals. Of the 115 hospitals analyzed using data envelopment analysis (DEA) technique, to explore the whole efficiency and purely technological efficiency.

Because of the potential age-related mass departure of seasoned educators in respiratory care programs, higher education institutions should develop strategies for attracting practitioners who hold or are pursuing graduate degrees to transition to academia. The purpose of this study was to identify current mentoring practices of new faculty members in Commission on Accreditation for Respiratory Care (CoARC) accredited respiratory care programs in the U.S. and to identify the perceptions of program directors regarding the observed impact of program mentoring practices. The methodology for the study was quantitative nonexperimental survey research. The survey instrument was an electronic questionnaire. The survey consisted of 25 items that were divided into 3 dimensions: mentoring practices, mentor/mentee relationship, and perceptions of mentoring program impact. Of the 410 possible participants, 126 (30%) responded to the survey. Data from the survey were used to analyze 12 research questions and 12 null hypotheses. Six research questions were analyzed using an independent-samples t test and 6 research questions were analyzed using a one-way analysis of variance. Testing of the null hypotheses associated with the 12 research questions resulted in 3 significant findings and 9 findings that were not significant. Significant findings included female program directors reported greater opportunities for mentoring within their programs and greater levels of expectations in regard to mentoring. Associate degree programs also reported a higher level of expectation in regard to mentoring. There was overwhelming agreement concerning the potential impact and benefit of new faculty mentoring on job performance, turnover, job satisfaction, and organizational commitment. The results of this study may benefit administrators and educators in the field of respiratory care in efforts to support new faculty in higher education who may feel underprepared or overwhelmed in the new role. Because other allied health fields of study are similar in nature to respiratory care, the findings of the study could have potential implications across a range of health related professions.

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Interprofessional education has the potential to prepare health career students to be practice-ready and enter the workforce with a collaborative mindset. Respiratory care educators must adequately prepare students to work in this capacity. This emphasis on a team approach to patient-centered care has the ability to impact and improve health outcomes. Throughout the last decade, sleep medicine has experienced fluctuations. Sustainability of sleep labs who only perform diagnostic testing may prove challenging. The role of interprofessional practice in sleep medicine would be to overcome traditional roles (silos) so that multiple skilled practitioners could help identify and treat complex patient conditions. A review of the literature demonstrated how various providers can serve as active members of interprofessional health care teams. The opportunity to expand services and partner with other providers to detect, educate, and treat sleep disordered breathing could help laboratories endure and even thrive in the current health care system.

Background¡G Ventilator-dependent patients have a great and far-reaching impact on families. Their primary caregivers, who are usually the ventilator-dependent patients¡¦ families, have played important roles during the caring process. Those caregivers are burdened with a lot of responsibility and pressure. It is crucial to find out how to assist the caregivers within selected methods of caring and to provide them with suitable needs in order to reduce their psychological burden. Therefore, the purpose of this study is to explore the related factors and to compare the burden and the needs of the primary caregivers in respiratory care ward and home care on long-term ventilator-dependent patients. Design¡G The survey adopts cross-sectional and purposive sampling by using a structured questionnaire to collect information. Both Burden and Needs Questionnaire¡¦s reliability is respectively 0.923 and 0.943; their KMO is 0.828 and 0.829 ; their Expert Validity (CVI) is 0.88 and 0.91. The questionnaire has reached the ideal value of reliability and validity. The sampling subjects are from respiratory care ward and home care centers in southern Taiwan. Total 260 out of 280 questionnaires are returned (the response rate has reached 92.9%) and there are 241 valid samples. The questionnaires are used for data collection and are divided into four sections; ¡§patient basic information¡¨ , ¡§family basic information¡¨, ¡§caregiver burden scale¡¨, and ¡§caregiver need scale ¡¨. The collected data is analyzed with descriptive statistics-test, one-way ANOVA, Pearson¡¦s correlation and multiple regressions by using SPSS Windows version 12.0. Result¡G (1) Patients from Home-care centre are normally younger in comparison with the patients from respiratory care wards; their average usage of mechanical ventilator is 30.98 month longer; they tend to have more conscious and tracheotomy patients. According to the demography, these two groups of the patients have a significant difference. (2) The average age of primary home care and respiratory care ward caregivers is 50¡ã52; most of them are female; most of the care givers are the patients¡¦ children. (3) "Physiological burdens" and "physiological needs" of home care centers caregivers are greater than the caregivers in respiratory care ward. They have reached a significant difference in statistic. (4) The primary caregivers have a declining health, and their workload and demands are increasing. (5) There is a significant positive correlation between the primary caregivers¡¦ burden and needs. (6) Base on the numbers of admitting to the ICU, the hospital and the current health status of the primary caregivers; the workload is predictable. Conclusion¡G Hopefully the result of this study can provide the Government to formulate a long-term-care insurance. Focus on providing the services to different needs for the caregivers; reduce the caregivers¡¦ burden on caring the mechanical ventilator patients. Also, to provide health care workers and respiratory therapists to implement on transferring patients to respiratory care ward and to offer further health education for the primary caregivers of home care centers.

Respiratory therapy graduate students are going to face a clinical environment that commands greater responsibility and culpability than in years past. Therefore, respiratory therapy educators must prepare graduates for the multidimensional demands of the workplace. PURPOSE: The purpose of this study was to explore the perception of the undergraduate respiratory therapy (BSRT) and integrated graduate respiratory therapy (MSRT) students in the implementation of simulation in the educational laboratory setting. METHODS: Data were collected through a descriptive survey. The survey was distributed to a convenience sample of first year BSRT and MSRT students attending an accredited respiratory therapy program at an urban public research university in the southeast United States. The survey consisted of 10 questions presented in a four-point Likert-type scale to obtain students’ perceptions regarding their simulation experience. The collected data were analyzed using descriptive statistics. RESULTS: Thirty-two students were surveyed, more than two-thirds of the participants were female. Approximately seventy-one percent of respondents were BSRT, females accounted for 87% and males 13%. Graduate MSRT were 28.1% of the total sample with 44.4% females and 55.6% males. More than two-thirds of MSRT students reported previous clinical experience while BSRT students reported less than one-quarter. Additionally, only two students from BSRT indicated that they have previous simulation experience, whereas more than half of MSRT students reported previous simulation experience. The study findings indicate BSRT and MSRT students’ overall perceptions are similar, however, both perceive the experience of nervousness differently. BSRT students indicated high agreement with the statement that they experienced nervousness during the simulation with mean = 3.52 (SD ± .51). MSRT students indicated high agreement with the statement that simulation was a valuable learning experience with mean = 3.33 (SD ± .70). Both of BSRT & MSRT students agreed that simulation should continue to be an integral part of the respiratory therapy program. MSRT students demonstrated higher agreement with mean = 3.55 (SD ± .72). Finally, the majority of responses to a debriefing session after simulation experience supported their understanding and reasoning were positive from both BSRT & MSRT students with means respectively = 3.39 (SD ± .65), and 3.55, (SD ± .52). CONCLUSION: Respiratory therapy educators continue to strive to enhance respiratory therapy students’ clinical reasoning, transference of theory to clinical practice, skills acquisition, and critical thinking. Use of simulation is essential to achieve these objectives. The results of this study support the implementation of simulation course in the curriculum as a mandatory requirement prior to clinical practice as evidenced by positive responses from students. Although students felt positively that simulation should be continued in the curriculum, they did not feel it should totally substitute for all clinical experiences.

Clinical Instructors’ Perceptions of Effective Student Behavioral Characteristics Among Respiratory Therapy Students in the State of Georgia By Yousef Aldabayan (Under the Direction of Dr. Lynda T. Goodfellow) ABSTRACT Background: Student behavioral characteristics are perceived to be crucial factors in developing and nurturing desirable qualities of future professionals. Similar to how respiratory therapy (RT) clinical instructors (CIs) are expected to possess great teaching skills, it is significant to determine the effective student behavioral characteristics among RT students in order to identify what motivates them and what qualities influence their clinical success in relation to the perceptions of RT CIs. PURPOSE: The aim of this study was to identify and acknowledge the effective behavioral characteristics of RT students based on what the RT CIs in the State of Georgia perceive to be most and least important. METHODS: A descriptive survey was used to collect data. The survey was modified and later emailed to all RT CIs and registered proactive members of the American Association for Respiratory Care (AARC), according to their website. The descriptive survey was composed of four main domains, including professional competence, relationship with the CI, personal attributes, and the perceptions of CIs and its role in their motivation to teach. Forty-one behavioral characteristics were revealed on a five-point Likert scale based on importance. RESULTS: One hundred eighty-four responses were received out of the eight hundred surveys emailed to the CIs, with a response rate of 23%. Most of the respondents specified a bachelor degree as their highest degree. From the list of student behavioral characteristics, “Show genuine interest in patients and their care” in clinical was perceived as the most important student behavioral characteristic (M 4.67, S.D ± .57). However, the RT students’ need to “be honest and direct to the CIs” was determined to be the most important behavioral characteristic (M 4.40, S.D ±0.70). In addition, to “demonstrate effective communications skills” was determined as the most important characteristic in the personal attributes domain (M 4.5, S.D ±0.56). Lastly, the “CIs stay motivated to teach and assist students when faced with acceptable student behaviors” was the most important domain of CIs’ perceptions of student behavioral characteristic that motivates them to teach, (M 4.38, S.D ±0.67). CONCLUSION: RT CIs from the list of active AARC members agreed that showing genuine interest in patients and their care was the most effective student behavioral characteristic among RT students in the State of Georgia. According to these findings, it is highly suggested that RT clinical students should work hard in improving their behaviors and attitudes toward their CIs to increase their motivation in achieving their goals in clinical learning.

Bakrund: Fast track-kirurgi är ett alltmer vanligt förekommande arbetssätt inom hjärtkirurgi. Tidigare studier har påvisat att en tidig extubation har medfört en vinst i patientens rehabili-teringsprocess samt bidragit till kortare vårdtider och sänkta sjukvårdskostnader. Syfte: Syftet med studien är att kartlägga och redovisa graden av smärta och konfusion efter extubation hos patienter som genomgått hjärtkirurgi. Metod: Material inhämtades genom en fortlöpande journalgranskning. Pilotstudien granskade patientjournaler samt övervakningsjournaler i realtid. Detta utfördes i kombination med ett observationsformulär som utformats till studien innehållande mätinstrumenten VAS [Visuell Analog Skala, för smärtskattning] och RASS [The Richmond Agitation-Sedation Scale, för konfusionsbedömning]. Resultat: Patienterna upplevde smärta både efter tidig och sen extubering vid hjärtkirurgi. Efter tidig extubation dokumenterades fyra av tio patienter vara lugna och alerta samt sex av tio som slöa. Efter sen extubation dokumenterades en patient vara lätt sederad, åtta patienter slöa, en patient alert och lugn samt en patient var rastlös. Konklusion: Datamaterialet är anpassat till en pilotstudie. Således är det inte möjligt att dra några vetenskapliga slutsatser gällande korrelationen mellan extubationstid, smärta och konfusion. För att kunna uppnå en vetenskaplig signifikans krävs en studie av större kvantitet. / Background: Fast-track surgery is an increasingly common work procedure in cardiac surgery. Previous studies have shown that an early extubation has a positive effect on the patients’ reha-bilitation process and contributes to a shorter hospitalization and lowered medical costs. Purpose: The purpose of this study is to identify and recognize the degree of pain and confusion after extubation in patients’ undergone cardiac surgery. Method: Material was collected through an ongoing record review. The pilot study examined the medical records and monitoring records in real time. This was carried out in combination with an observation form designed for the study containing the instruments VAS [Visual Analogue Scale for pain measurement] and RASS [The Richmond Agitation-Sedation Scale, for the assessment of the degree of confusion]. Results: Patients experienced pain after both early and late extubation in heart surgery. After early extubation four of ten patients were documented as calm and alert, and six of ten as dull. After late extubation one patient was documented/revised to be slightly sedated, eight patients as lethargic, one patient as alert and calm, and one patient as restless. Conclusion: The data set is appropriate for a pilot study. Thus, it is not possible to draw any scientific conclusions concerning the correlation between the time of extubation, pain and confusion. In order to achieve a scientific significance, a study of greater amplitude is required.

Introduction: The purpose of this study was to identify mentoring practices of new faculty members in Commission on Accreditation for Respiratory Care (CoARC) accredited respiratory care programs in the U.S. and to identify the perceptions of program directors regarding the observed impact of program mentoring practices. Methods: The method for the study was quantitative non-experimental survey research. The survey instrument was an electronic questionnaire titled Respiratory Care Faculty (RCF) Mentoring Survey. The 25-item survey was divided into three dimensions: mentoring practices, mentor/mentee relationship, and perceptions of the impact of new faculty mentoring. Of the 410 possible program director participants, 126 (30%) responded to the survey. Data from the survey were used to analyze three primary research questions on four independent variables (12 total research questions). Results: Testing of the null hypotheses associated with the 12 research questions resulted in three significant findings and 9 findings that were not significant. Significant findings included female program directors reported greater opportunities for mentoring within their programs and greater levels of expectation concerning mentoring as compared to male program directors. Program directors from associate degree programs also reported a higher level of expectation concerning mentoring than program directors in bachelor’s degree programs. There was overwhelming agreement regarding the potential impact and benefit of mentoring new faculty to improve job performance, reduce turnover, improve job satisfaction, and organizational commitment. Conclusion: The results of this study may benefit administrators and educators in respiratory care in efforts to support new faculty who possibly feel underprepared or overwhelmed in the new role. Because other allied health fields of study are similar in nature to respiratory care, the findings of the study could have potential implications across a range of health-related professions.