Commission on Accreditation for Respiratory Care

1. Commission on Accreditation for Respiratory Care Dr. H. Fred Helmholz, Jr, MD Education Lecture Series

2. H. Fred Helmholz, Jr., MD1911-2012

3. Dr. H. Fred Helmholz MD Lecturers • H. Fred Helmholz Jr., MD • Shelley Mishoe, PhD, RRT • Jon Nilsestuen, PhD, RRT, Marilyn Childers, PhD, RRT, & Stephen Fracek, PhD • William Turner, PhD • Robert Wilkins, PhD, RRT • Garry Kauffman, MPA, RRT • Thomas Johnson, MS, RRT & Mike Nazarro, MPH, RRT • Sal Sanders, MS, RRT • Erna Boone, MEd, RRT & Bob DeLorme, MS, RRT • Viva Jo Siddall, MS, RRT • David Shelledy, PhD, RRT • Jeff Ward, MEd, RRT • Joseph Sorbello, MS, RRT • Mark Taylor, MSW, EdD • David Vines, MHS, RRT & Thomas Jones, MEd, RRT www.coarc.com

4. Commission on Accreditation for Respiratory Care Dr. H. Fred Helmholz, MD 16th Annual Education Lecture Bill Galvin, MSEd, RRT, CPFT, AE-C, FAARC “Excellence in Respiratory Care Education: Creating an Exemplary RC Program”

5. A Thank You to CoARC Board • David Bowton, MD, FCCP, FCCM , Immediate Past President • Stephen P. Mikles, EdS, RRT, FAARC, President • Robert DeLorme, EdS, RRT • Jolene K. Miller, MEd, RRT , Treasurer • Kathy Rye, EdD, RRT, FAARC,  President-Elect • Ronald C. Allison, MD • Charles E. Cowles, Jr., MD • Joseph P. Coyle, MD • Diane Flatland, MS, RRT-NPS, CPFT  • *Tom Smalling , PhD,RPFT, RPSGT, FAARC – Executive Director • Allen N. Gustin, Jr, MD, FCCP, Secretary • Thomas Hill, PhD, RRT, FAARC • Ralph L. Kendall, MD, FCCP • Diane J. Klepper, MD, FCCP • Bradley A. Leidich, MSEd, RRT, FAARC  • Kevin O’Neil, MD  • Pat Munzer, DHSc, RRT, FAARC • Monica Schibig, MA, RRT-NPS, CPFT • David Shelledy, PhD, RRT, FAARC • Gary C. White, MEd, RRT, RPFT

6. A Thank You to AARC Program Committee • Cheryl Hoerr, MBA, RRT, FAARC (Chair) • Ira Cheifetz, MD, FAARC • Patrick Dunne, RRT, MEd, FAARC • Dean Hess, PhD, RRT, FAARC   • Garry Kauffman, MPA, RRT, FAARC • Timothy Myers, MBA, RRT-NPS • Shawna Strickland, PhD, RRT-NPS, FAARC • Terry Volsko, MHS, RRT, FAARC • Staff Liaison: Doug Laher, RRT, MBA • *KCR

7. 0 American Association for Respiratory Care2012 Summer Forum – Santa Fe, NMJuly 15, 2012The Distinguished H.Fred Helmholz,MD Education LectureSponsored by Committee on Accreditation for Respiratory CareExcellence in Respiratory Care Education: Creating an Exemplary RC Program Presented by Bill Galvin, MSEd, RRT,CPFT, AE-C,FAARC Assistant Professor, School of Allied Health Professions Program Director, Respiratory Care Program Administrative/ Teaching Faculty, TIPS Program Gwynedd Mercy College

8. I have no real or perceived conflict of interest that relates to this presentation. I have however published books, chapters and articles related to this topic for W.B. Saunders, Elsevier, Delmar/Thompson Learning, and Jones and Bartlett Publishers. Any use of brand names is not in any way meant to be an endorsement of a specific product, but to merely illustrate a point of emphasis. Conflict of Interest Summer Meetings 2012

9. Objectives • List and explain the three key variables that shape/ impact program development, design and evaluation • Review the literature regarding successful educational programs • Recognize successful RC programs • Identify and discuss select variables from successful RC programs • Briefly list and explain elements of success • Identify the single key ingredient to program and professional success

10. an obvious starting point is … a “Systems Approach”to Education*Point: simply a conceptual way of viewing organizations, a management theory for administering and controlling education programs inputs outcomes processes *DeLapp GT. The Systems Approach for Administration of Respiratory Therapy Education Programs. Respiratory Care. June 1979; vol 24. No.6, 514-520.

11. A “Systems Approach” to Education Environment (Employers/ NBRC/ CoARC) Inputs (students) Processes (faculty/ RC lab/ clinical/curriculum/ library) Outcomes (RRT success rates/ Employment)

12. Inputs • The characteristics, traits, skills, talents, abilities, experiences and capabilities the students bring to the program • Student inputs are generally assessed during the admissions process where high school and/or previous college academic performance, and life experiences are evaluated in form of: • High school/ college transcripts • Overall GPA • Science GPA • SATs/ACTs • previous life/work experiences • family commitments • work requirements, etc.

13. Processes • Represent the sum total of all components that make up or support the teaching/ learning activities, to include: • Curriculum • Didactic/clinical faculty • RC Lab • Clinical affiliates • Library • Student services • Computer/ learning lab • Operating budget • Processes hold a central role or pivotal position in the system

14. Outcomes • The teaching/ learning activities represented by the curriculum, faculty, lab, clinical, etc (the process) transforms the student (input) into a caring, compassionate, and competent RT professional (outcome) • Outcomes can generally be measured by attainment of certain standards or desired results, such as: • professional credentialing exams • meaningful, discipline-specific employment • service • a well-rounded liberal arts education • civic responsibility • a contributing member of society

15. Key points to the “Systems Approach” Environment (Employers/ NBRC/ CoARC) • Components are interrelated • System is impacted by the external environment (receiving constant feedback) • It is dynamic (constantly subject to change) • It is considered a processor as it exists for transforming inputs into some altered form that leaves the system as outputs Processes (faculty/ RC lab/ clinical/curriculum Outcomes (RRT success rates/ employment, a “professional”) Inputs (students)

16. clinical sites? What makesan RT program successful ? students? • faculty? resources? curriculum? program design?

17. Selective Review of the LiteratureFrom the World of Physical Therapy • Bkgd & Purpose: examine effect of educational program characteristics on NPTE pass rates • Subjects: 132 accredited PT program surveyed – regression analysis performed on 21 independent variables and their role in predicting program’s pass rates • Results: 3 variables that best predicted pass rate on NPTE were: (1) accreditation status, (2) number of faculty with PhD &/or EdD, and (3) years of pre-professional and professional coursework combined • Source: Mohr TM et al. Educational Program Characteristics and • Pass rates on the National Physical Therapy Examination. Journal of • Physical Therapy Education. 2005;vol19,no 1, 60-66.

18. Selective Review of the LiteratureFrom the World of Physical Therapy • Bkgd & Purpose:purpose of study was to determine which factors are related to NPTE score. • Subjects: 92 alumni of professional Master of PT program surveyed – Pearson correlation analyses conducted for following variables: age at graduation, professional GPA (PGPA), comprehensive exam (CE) score, PT clinical performance instrument (CPI), and NPTE score • Results: CE and Professional GPA were most correlated with NPTE score • Source: Kosmahl E. Factors Related to Physical Therapist • License Examination Scores. Journal of Physical Therapy • Education. 2005;vol19,no 2, 52-56.

19. A Selective Review of the LiteratureFrom the World of Physical Therapy • Bkgd & Purpose: examine relationship between PTA education program characteristics and PTA graduate pass rates, and develop a model which includes student and programmatic characteristics to predict success • Subjects: Program Directors of 50 accredited PTA programs • Methods: responses were coded and matched with first time and ultimate pass rates – correlation and regression analysis performed between pass rates and survey variables • Results: pass rates of PTA graduates were positively correlated with newer, public programs, more clinical education credits, and less general education credits as a % of total credits required for program. Model best predicting ultimate pass rate success was program inception and whether institution was public or private • Source: Maring J and Costello, E. Education Program and Student Characteristics • Associated with Pass Rates on the National Physical Therapy Examination for • Physical Therapist Assistants. Journal of Physical Therapy Education. • 2009;vol23,no 1, 3-11.

20. Selective Review of the LiteratureFrom the World of Radiologic Technology • Bkgd & Purpose: to assess factors registered radiologist assistants & radiologist assistant students perceive to be the most significant for success in an RA educational program • Methods: An electronic survey sent to graduates & currently enrolled students in RA programs (N-99). Response was 60.6% and represented 8 RA programs. Factor analysis was used to examine relationships among variables. • Results:Four factors accounted for nearly 93% of the variance, 3 of the 4 related to role of radiologist preceptor. Although the quality of program seemed to be somewhat important, personal characteristics were perceived as contributing little to student success. • Conclusion: Study supports importance of developing strategies to engage radiologist preceptors in the RA education process. • Source: Ludwig R et al. Factors Influencing Success in RA Programs: A Survey. • Radiologic Technology. 2010;vol82,no 2, 113-123.

21. Selective Review of the LiteratureFrom the World of Nursing • Fishbone diagram was used as framework for identification of cause and effect • Eight causative factors were identified & thought to influence the achievement of its critical program outcomes (NCLEX-RC pass rates, graduation rates and graduate and employer satisfaction). • Eight factors were: environment, assessment and evaluation, standards/ criteria, faculty, students, resources, program of study, and policies, procedures and practices. • Brown JF and Marshall, BL. Continuous Quality Improvement: An Effective Strategy for Improvement of Program Outcomes in a Higher Education Setting. Nursing Education Perspectives. 2008, Vol 29, No. 4, 205-211

22. Hallmarks of Excellence in Nursing Education(characteristics in the pursuit of excellence) • Students • Faculty • Continuous quality improvement • Curriculum • Teaching/learning evaluations and strategies • Resources • Innovations • Educational resources • Environment • Leadership • Kalb K et al. The Hallmarks Survey: For Those Who Care to Teach the Very Best. Nursing Education Perspectives. 2008, Jan/Feb, vol 29, no 1, 34-37.

23. Excellence in Nursing Education Model-8 core elements- • 1. Clear program standards & hallmarks that raise expectations • 2. Evidence-based programs & teaching/evaluation methods • 3. Qualified students • 4. Quality & adequate resources • 5. recognition of expertise • 6. Student-centered, interactive, innovative programs & curricula • 7. Well-prepared educational administrators • 8. Well-prepared faculty • Source:Engelmann, L et al. Tapping Into Your Center of Excellence. Nursing • Education Perspectives, 2008 Nov/Dec, Vol29, no. 6, p383-385

24. Selective Review of the LiteratureFrom the Respiratory Care World Bkgrd & Objective: Study was designed to examine whether a variance in student and faculty credentials and fiscal expenditures were associated with program performance on the 1997 CRTT Exam Methods: 234 accredited college-based respiratory therapist programs surveyed, 100 (42.7%) returned usable questionnaires Results: revealed that grade point average of graduates; faculty credentials; and expenditures for travel, lab supplies, instructional aids, and electronic media were the strongest predictors to program effectiveness. Conclusion: Awareness of the degree and interrelatedness between program components (student, faculty, curriculum, and resource) and outcomes contributes to quality program effectiveness. Source: Johnson, PL. The extent to which factors relevant to program function influence effectiveness of respiratory care education. Respiratory Care Education Annual (RESPIR CARE EDUC ANNU), 2001 Spring; 10: 15-32 (41 ref)

25. Selective Review of the LiteratureFrom the Respiratory Care World Bkgrd & Objective: Study designed to examined the extent to which program resources predicted program performance on WRRT Exam Methods: analysis of BSRT Programs – 36 our of 57 surveyed Results: found significant relationship between program resources and program performance on WRRT Exam Conclusion: Programs with more financial and personnel resources consistently have better scores on the WRRTE. Therefore, RCE programs must assure their constituents that programs have the financial and personnel resources necessary to provide quality preparation for graduates Source: Ari A. A study of program effectiveness: the relationship between program resources and program performance on the Written Registry for Respiratory Care Examination. Respiratory Care Education Annual (RESPIR CARE EDUC ANNU), 2007 Fall; 16: 39-48 (15 ref)

26. A Review of the LiteratureForthcoming from the Respiratory Care World Forthcoming research: Karen Shaw, Program Director form College of Southern Nevada, will be undertaking an extensive research project for her doctoral degree attempting to identify different factors between successful and less successful RC program Objective: examined the extent to which program resources predicted program performance Methods: analysis of all RT Programs throughout the country and analyze data from 3 distinct groups or cohorts of programs (top 3rd, middle 3rd and lower 3rd) Point: I urge you to help her when requested to do so

27. Excellence* … • “Can be attained if you care more than others think is wise, risk more than others think is safe, dreammore than others think is practical, and expect more than others think is possible” • *Valiga,T & Grossman S. The New Leadership Challenge: Creating the Future of Nursing, 2000, FA Davis.

28. Successful RC Programs2011 CoARC Distinguished RRT Credentialing Success Awardees (32) • Borough of Manhattan Community College, New York, NY • Broward College, Coconut Creek, FL • Central Virginia Community College, Lynchburg, VA • Chattanooga State Community College, Chattanooga, TN • College of Southern Nevada, Las Vegas, NV • ConCorde Career College, Garden Grove, CA • ConCorde Career College, Memphis, TN • Dakota State University, Madison, SD • Foothill College, Los Altos Hills, CA • Georgia Health Sciences University, Augusta, GA • Gwinnett Technical College , Lawrenceville, GA

29. Successful RC Programs2011 CoARC Distinguished RRT Credentialing Success Awardees (32) • Harrisburg Area Community College - Harrisburg, PA • Henry Ford Community College - Dearborn, MI • Ivy Tech Community College -Wabash Valley, Terre Haute, IN • Kalamazoo Valley Community College - Kalamazoo, MI • Kapiolani Community College - Honolulu, HI • Long Island University - Brooklyn, NY • Louisiana State University Health Sciences - Shreveport, LA • Macomb Community College - Clinton Township, MI • Millersville University - Millersville, PA • Ohio State University - Columbus, OH • Ohlone College - Newark, CA

30. Successful RC Programs2011 CoARC Distinguished RRT Credentialing Success Awardees (32) • Ozarks Technical Community College - Springfield, MO • St Alexius Medical Center/University of Mary, - Bismarck, ND • Stony Brook University - Stony Brook, NY • Texas Southern University - Houston, TX • University of Arkansas for Medical Sciences - Little Rock, AR • University of Missouri-Columbia - Columbia, MO • University of Missouri at Mercy Hospital - St. Louis, MO • University of Texas Health Science - San Antonio, TX • University of Texas Medical Branch - Galveston, TX • Victoria College - Victoria, TX

31. Survey of 32 Programs with RRT Success • 1st – Congratulations! • 2nd – Thank You! • 3rd – Share results (descriptive not evaluative) • Suggestion – view data from perspective that this is what the 32 reported out and how does the data compare with my program • What nuggets can I garner from the • survey results to aid me in making • improvements in my own program?

32. Curriculum Laboratory Budget • Faculty Students Clinical Institutional Information Advisory Board Medical Direction

33. Successful RC Programs-Survey Results of Select Variables- • Institutional Data • Type of Degree • AS or BS • Institution Type • Community College/Junior College, Technical or Vocational School, Career or Technical College, 4-yr college/university, Academic HCS/Medical center, US Military • Institutional Control/ Funding • Public/ Not for Profit, Private/ Not for Profit, Private/ for Profit, Federal Government • Geographic Location • Program Inception Date

34. Successful RC ProgramsType of Degreen-32

35. Successful RC ProgramsInstitutional Typen-32

36. Successful RC ProgramsInstitutional Control/ Fundingn-32

37. Successful RC ProgramsGeographic Locationn=32

38. Successful RC ProgramsProgram Inception Daten-29

39. Successful RC Programs-survey results of select variables- • Student Demographics* • Number of applicants per year • Number acceptances per year • Number of graduates per year • Per cent attrition • * in a typical year

40. Successful RC ProgramsNumber of Applicantsn-30

41. Successful RC ProgramsNumber of Acceptancesn-30

42. Successful RC ProgramsNumber of Graduatesn-30

43. Successful RC ProgramsPercent Attritionn-30

44. Successful RC Programs-survey results of select variables- • Student Characteristics/Profile* • age at program entry • educational level at time of program entry • SAT/ACT Scores at entry • HS/ college/ science GPA • use of HOBET • Personal experiences with health care • * In a typical year for majority of students

45. Successful RC ProgramsAge at Program Entryn-30

46. Successful RC ProgramsEducational Level at Program Entryn-30

47. Successful RC ProgramsSAT/ ACT Scoresn-27

48. Successful RC ProgramsHS GPA -College GPA-Science GPAN=6 for HS, 20 for College GPA, 25 for Science GPS

49. Successful RC ProgramsUse of HOBETN=29

50. Successful RC ProgramsPersonal HC Experience Motivation to Enter RCN=29