IERS

Recognition Guidelines for Quality International Respiratory Care Education

These Guidelines were developed by International & American Educators and clinicians and approved by the INTERNATIONAL COUNCIL FOR RESPIRATORY CARE.

Levels Of Recognition

The three levels of recognition granted to educational experiences intended to improve the education provided to health care professionals who deliver respiratory/pulmonary care around the world are as follows:

Recognition of a Seminar

The applicant need only answer three essential questions in order for IERS reviewers and the Executive Committee of the IERS to award recognition at the seminar level. The three questions that need to be answered in the format provided are as follows:

  1. What do you intend to teach?
  2. How do you intend to teach it?
  3. How will you know you taught it?

Definition of SEMINAR LEVEL I:  For IERS recognition a seminar is an RC educational activity of any duration that does not purport to teach the same skill set each time the seminar is offered using similar content and instructors with the same instructional goals.  For example: one day, two day or three week educational experiences would fall in this category of recognition, especially if the theme/content/objectives were changed or significantly different each time it was offered. It would most likely have goals that are more general respiratory care knowledge as opposed to programs or schools that would have more specific/complex Respiratory care skills & competencies. 

IERS approval is granted to a resident sponsor of a seminar for the one country in which the RC education is delivered and from which the application is submitted.  It is not possible at this time to award IERS approval for multi-country applications.

  1. What do you intend to teach?

    1. Seminar Description: Describe the length and type of instructional unit for the onetime seminar, workshop or planned RC educational activity.  Give the number of days, and hours of RC instruction, lab and/or evaluation activities.  As an example, it may say:

      “A two day combination lecture and lab seminar, with 6 hours of lecture and lab per day for a total of 12 hours of educational activities.”

      1. Outline must include a list specifying date, day, topic, speaker, location, activity and length for each educational activity.
      2. Provide examples of test and evaluation strategy for participants as well as post-seminar evaluations.
    2. Seminar Goal: Describe the single most important, seminar goal, comprehensive competency, or general behavioral objective that best describes the overall   educational goal of the seminar.   It can be fairly specific,    e.g. Monitor hemodynamic devices, record results, and make recommendations, or  it can be more general, e.g. Increase the practitioners understanding of hemodynamic monitoring.
    3. In either of the above cases, you must then provide the following  outcome oriented and measurable information about your planned instruction:

    4. Supporting Instructional Objectives: Describe the specific objectives that you intend to achieve, matched to the overriding goal described above for each lecture, laboratory or other educational activity you have planned. These objectives must be written in criterion-referenced manner describing the level of outcome achievement expected.

      e.g. The attendees will be able to identify the basic parameters and their use in hemodynamic monitoring of a patient on mechanical ventilation with ARDS;

      e.g.  The attendees will be able to manage simulated patients with ARDS on mechanical ventilators by recording and making modifications using hemodynamic monitoring data with 95% accuracy on the post-seminar comprehensive 5 case computerized clinical simulations.

      The objectives, as you can see, may be general or specific, but in either case, they must be measurable outcome oriented instructional objectives.
  2. How do you intend to teach it?

    1. Instructors:  List the names and credentials of each instructor for each instructional unit as identified  in 1.a. above.  e.g. James Smith, BS, RRT, MD  Director of Pulmonary Medicine, Central Medical Center, City, Country,   Teaching:   “Hemodynamic monitoring equipment operation and trouble-shooting.”
    2. Strategies: Describe the teaching strategies you intend to use to teach the objectives described in 1.c. above. e.g. lecture, lab, clinical observation or practice, etc.
  3. Using the example in (2a.)  , above, the strategy might be described as:
    Teaching Strategy: ” 50 minutes of lecture, 2 hours of hands-on lab conducted by Dr. Smith and two assistants(BS,RRT, practitioners) to provide practice applying the information with simulated patient situations being monitored using operational equipment.”

  4. How will you know you taught it?

    1. Evaluation Strategy: Describe the evaluation strategy you intend to use to survey, test or certify participants’ attendance and/or knowledge and/or skills.

      Following the example in (2a), the strategy might be described as:         Evaluation Strategy: “To evaluate the participants a 50 question multiple choice test, a computerized hemodynamic monitoring simulation and a practical simulation using a manikin and operational hemodynamic equipment will be used.”

                                         Or

      Following the  example in (2a), the strategy might be described as:         Evaluation Strategy: “To evaluate the participants a ten question survey of attendees rating each of the topics, instruction and instructors on a 1 to 5 scale from poor to excellent will be employed.”

      Note: Presently post-seminar outcome data collected by the providers, sponsors and leaders of the seminar may be reported via email to IERS (Sinopoli@hotmail.com) within 60 days of completion of the seminar. It is expected that, in the next 2 years, with the input of providers; IERS will publish appropriate outcome data on the IERS site for informational purposes to those looking for quality respiratory care educational activities anywhere in the world.

    2. Evaluation Instruments:  Provide an example of each of the types of evaluation instruments you intend to use in your evaluation strategy.  It may be the written tests, computerized tests and simulations, observational, survey or attendance instruments.
    3. Attendance data should include at minimum the following fields of data: Participant name, profession (physician, Respiratory care practitioner, Physical Therapist, Nurse, etc.) credentials (MD, RRT, RN, PT, etc.), and AARC member number if applicable.

    4. Evaluation Strategy & post-seminar evaluation tools: Describe your evaluation strategy for participants as well as for evaluation of the seminar’s effectiveness. Include an example of your post-seminar evaluation tool.

      A post seminar survey of participants should be conducted to measure participant satisfaction with stated and achieved goals and objectives.
      Evaluation strategy should include a description of the how participant performance, opinion and attendance will be assessed before, during and /or after the seminar.

      1. Evaluation Instruments:  Provide an example of each of the types of evaluation instruments you intend to use in your participant evaluation strategy, if any.  It may be the written tests, computerized tests and simulations, observational tools, etc. 
        1. A post-seminar survey of participants should be conducted to measure participant satisfaction with stated and achieved goals and objectives.
        2. All data will be subject to posting on IERS website before and after the delivery of the seminar.

          Presently Post-seminar outcome data collected by the providers, sponsors and leaders of the seminar maybe reported via email to IERS (Sinopoli@hotmail.com) within 60 days of completion of the seminar.

          Note: It is expected that in the next 2 years with the input of providers, IERS will publish appropriate outcome data on the IERS site for informational purposes to those looking for quality respiratory care educational activities anywhere in the world.

        3. Post-seminar evaluation tools
        4. Provide an example of your topic, speaker, objectives, post-seminar evaluation instrument

          Post-seminar attendance data: Attendance data should be sent within 60 days of the seminar delivery. Include at minimum the following fields of data: Participant name, profession (physician, Respiratory care practitioner, Physical Therapist, Nurse, etc.) credentials (MD, RRT, RN, PT, etc.), and AARC member number if applicable.

 

Recognition of a Program

The applicant need only answer three essential questions in order for IERS reviewers and the Executive Committee of the IERS to award recognition at the program level. The three questions that need to be answered in the format provided are as follows:

  1. What do you intend to teach?
  2. How do you intend to teach it?
  3. How will you know you taught it?
  1. What Do You Intent to teach?

    1. Sponsoring Educational Entities
      A sponsor must be an individual organizational entity that is recognized by the appropriate office, agency or ministry from the applicant country.  The sponsor may be an individual entity or a consortium sponsor that consists of two or more entities that exists for the purpose of preparing individuals to provide respiratory care. The sponsor must assure that the program planners and faculty adhere to the guidelines in conducting their educational program.  The sponsor agrees to support program faculty and staff to fulfill their job responsibilities and promote the goals of the program.

    2. Non-Personnel
      Program resources must be sufficient to ensure the achievement of the program’s goals and objectives. Resources may include as appropriate: faculty, clerical/support staff, curriculum, finances, offices, classroom/laboratory facilities, ancillary student facilities, clinical affiliations, equipment/supplies, computer resources, and instructional reference materials.

    3. Personnel
      The sponsor must appoint sufficient faculty and staff with the necessary qualifications to perform the functions required to achieve the program’s stated goals and objectives.

      Provide a list of program personnel and their respective qualifications to perform in their roles in the boxes below:
      1. Faculty, Staff and administrative Personnel
        1. Administrative Personnel
          An individual must be designated as the primary administrator for the operations of the program.  This individual may be a member of the program faculty or staff.
        2. Faculty
          Individuals appointed to the faculty must have appropriate credentials and expert knowledge in the content area being taught. Faculty must also maintain high ethical standards and professional behavior at all times.
        3. Staff
          Program staff must be professionally qualified to fulfill their designated program responsibilities.
    4. Program Curriculum
      The program curriculum must be designed to achieve the stated goals and objectives. Educational strategy must be a sequence of instructional objects, didactive sessions and/or lab/clinical activities. Design of the program must be based on measurable learning goals, objectives, and competencies.

      The goals and objectives of the program must be made public prior to the delivery of the program. The program’s goals and learning objectives should be based on survey or other needs assessment data to show the program will meet a need in respiratory care education in the community for which it is planned.  Program personnel should design instruction to respond to the needs and/or expectations of the target community.

    5. Program Description
      Describe the length and type of instructional unit for the repeating program level workshop or planned RC educational activity.  Give the number of days, and hours of RC instruction, lab and/or evaluation activities.  As an example, it may say:

      “This is a  two week program, repeated annually, focusing on the latest techniques and ventilators used for prolonged artificial ventilation of the acute and long term patient in respiratory failure. The program will include 25 hours of lecture and 40 hours of hands on lab with mechanical ventilators operating using test lungs and lung simulators.”

                                         Or

       “The four year Bachelor’s Degree school will require  a combination of basic sciences, pre-clinical general courses totaling 60 academic units and 60 respiratory care academic units consisting of a combination of lecture, lab and clinical hours.  The lab and clinical hours total 800 hours of simulated and actual patient care in 2 acute care hospitals.”

      1. Program Goal: Describe the single most important, program goal, comprehensive competency,  or general behavioral objective  that best describes  the  overall   educational goal of the program. It can be fairly specific, e.g.:

        “Graduates will be able to monitor ventilators providing respiratory support to patients in respiratory failure and to suggest modifications in mode, PEEP levels, FIO2 and Minute Volume based on bedside and lab data.”

        The program goal may be more general, e.g. :
        “ The program/school will produce graduates possessing  cognitive and, psychomotor skills of a  competent,  professional respiratory care practitioner capable of performing all of the ICU level RC procedures  required in the country of application.”

        In either of the above cases, you must then provide the following  additional outcome and measurable information about your planned instruction.

      2. Supporting Instructional Objectives: Describe the specific objectives that you intend to achieve, matched  to the overriding goal described above  for each course, lab or other educational activities you have planned. These objectives must be  written in criterion-referenced manner describing the level of outcome achievement expected.

        e.g. The graduate will be able to:
        “Manage ventilators on patients in respiratory failure with 80% accuracy on all techniques, modifications in mode, and addition of PEEP, oxygen and other techniques to improve  ventilation and oxygenation.”

        “Provide assessment and RC plans for management of Asthma  competently for greater than 70% of the patient simulations and or actual patients encountered during the lab and clinical training.”

      3. Program Outline
        Describe the length and type of instructional unit for the onetime program, workshop or planned RC educational activity.  Give the number of days, and hours of RC instruction, lab and/or evaluation activities. 

        Outline should include a list specifying date, day, topic, speaker, location, evaluation tool, objective, activity, and length of time for each educational activity.

        Provide and outline of the program content and delivery if all educational activities being conducted as part of the program.

        1. Outline must include a list specifying date, day, topic, speaker, location, activity and length for each educational activity.
        2. Evaluation Instrument Descriptions

        Provide descriptions of test and evaluation strategy for participants as well as post-program evaluations.

      4. Special instructional tools.
        Provide decriptions of any special instructional tools being used, i.e. audience response systems, HPS, standardized patients, Ipads, computer simulations, etc.
    6. Publications and Disclosure
      1. Advertisements, brochures, announcements, catalogs, publications, and internet web pages must accurately reflect the program offered.  Name, statement, logo and any statements referenced to the AARC must have prior approval before they may be used.
      2. Participants should be informed in writing of the following: schedule of instruction dates, cost, criteria for successful completion, location, faculty and any policies and processes required of participants during or after the program.
    7. Lawful and Non-discriminatory Practices
      All activities associated with the program must comply with the applicant country’s rules and regulations.
    8. Safeguards
      The health and safety of patients, students, and faculty associated with the educational activities of the participants must be adequately safeguarded.
    9. Participant Records 
      Satisfactory records must be maintained for participant attendance, admission, advisement, counseling, and evaluation. Grades and/or continuing education credits for courses must be recorded and permanently maintained by the sponsor in a safe and accessible location.
    10. Substantive Change
      If the program is repeating each year with different content the sponsor must re-apply for recognition.  If the program is repeating the teaching of the same skills each year, the program level of recognition may be sought.  In either case, if during the year there is a significant change(s) in the program, the sponsor must notify the recognition agency before the changed program is offered again to retain its recognition status.
    11. Clinical Agreements
      If clinical experience is required as part of the program, documentation must be provided and maintained by the sponsor.
  2. How Do You Intend To Teach It?

    1. Instructional Strategies
      Use topic outline from above (I.A.1.) and describe the instructional strategy for each topic, i.e. lecture, lab, HPS, standardized patients, clinical experience, manikin simulation, etc.
      1. Strategies matched to topics & objectives: Describe the teaching strategies you intend to use to teach the objectives described in 1.c. above.  i.e. lecture, lab, HPS, standardized patients, clinical experience, manikin simulation, clinical observation and practice, etc.

        The strategy might be described as:
        Teaching Strategy: ” An 18 week course meeting every week for 50 minutes of lecture, 2 hours of hands-on lab and 12 hours of clinical practice,  conducted by Dr. Smith and two assistants(BS,RRT, practitioners) to provide experience applying the information on simulated and actual patients being supported and monitored using  contemporary ventilators.”

      2. Special instructional tools.
        Provide a description of special instructional tools you are using i.e. Ventilator test lung simulators, HPS model and manufacturer, IPADS, etc.

  3. How will you know you taught it?

    Evaluation of participants and or the program may be accomplished using various testing techniques matched to the instruction or by simply verifying attendance of participants. If evaluation techniques are used, faculty should demonstrate that the testing methods chosen are consistent with the objectives and competencies being tested.

    1. Evaluation Strategy: Describe the evaluation strategy you intend to use to survey, test or certify participants’ attendance and/or knowledge and/or skills.

      Following the above example, the strategy might be described as:
      Evaluation Strategy: “ Comprehensive written, computerized and performance based 1. observational testing instruments will be administered after each respiratory care course, lab and clinical rotation in the 4 year program.  In addition, a comprehensive day long summative evaluation will be performed at the end of the 4 year program and completion of all 800 clinical hours to certify competence on all skills required to practice as a respiratory therapist in the country of application.”

      Following the above example, the strategy might be described as:
      Evaluation Strategy: “A 100 question comprehensive written exam and 5 computerized clinical simulations will be administered to test the ability of the graduate to manage  and provide respiratory support for  patients on prolonged mechanical ventilation.”
    2. Evaluation Instruments: Provide an example of each of the types of evaluation instruments you intend to use in your evaluation strategy.  It may be the written tests, computerized tests and simulations, observational, survey or attendance instruments.  You must provide actual examples not just descriptions.  All tests etc., will be kept confidential and not shared or used for any other purpose by IERS reviewers except for the evaluation of the program.
      1. Evaluation Strategy & post-program evaluation tools: Describe your evaluation strategy for participants as well as for evaluation of the program’s effectiveness. Include an example of your post-program evaluation tool.

         A post program survey of participants should be conducted to measure participant satisfaction with stated and achieved goals and objectives.

        Evaluation strategy should include a description of the how participant performance, opinion and attendance will be assessed before, during and /or after the program.
    A post program survey of participants should be conducted to measure participant satisfaction with stated and achieved goals and objectives.

    All data will be subject to posting on IERS website before and after the delivery of the program.

    1. Student Attendance
      Provide a sample of the attendance form used to document attendance by individuals at all the program components and activities.  Attendance data should be sent within 60 days of the seminar delivery. Include at minimum the following fields of data: Participant name, profession (physician, Respiratory care practitioner, Physical Therapist, Nurse, etc.) credentials (MD, RRT, RN, PT, etc.), and AARC member number if applicable.

 

Recognition of a School

The applicant needs to answer three essential questions in order for IERS reviewers and the Executive Committee of the IERS to begin the process in order to award recognition at the school level. The three questions that need to be answered in the format provided are as follows:

  1. What do you intend to teach?
  2. How do you intend to teach it?
  3. How will you know you taught it?

Definition of School LEVEL III:  For IERS recognition of RC educational schools, a school is longer than one year in duration and designed to grant a degree in respiratory care at the bachelor’s degree level or higher from a recognized, university, in the host country. Granted to educational programs that meet level III school recognition guidelines. RC schools must set local evidence-based outcome measures for (graduate) outcome performance. Recognized Schools must meet or exceed the guidelines for a quality educational experience that produces graduate RC practitioners who will be providing RC at the bedside anywhere in the world, as set forth in the these guidelines.  For example:

“A four-year Bachelor’s Degree School with a combination of basic sciences, pre-clinical general courses totaling 60 academic units and 60 respiratory care academic units consisting of a combination of lecture, lab and clinical hours in respiratory care.  The lab and clinical hours total 800 hours of simulated and actual patient care in acute care hospitals.”

It would NOT likely have goals that focus on small set of very specific respiratory care skills(i.e. Program) but as such, Schools would have more MANY specific/complex Respiratory care skills & competencies as its School goals.

IERS approval is granted to a resident sponsor of a program for the one country in which the RC education is delivered and from which the application is submitted.  It is not possible at this time to award IERS approval for multi-country applications.

School Recognition(Level III)- Granted to educational institutions that meet level III requirements as specified in the school guidelines and application.  In addition, IERS RC schools must set local evidence-based outcome measures for (graduate) outcome performance.  Recognized Schools have met or exceeded the guidelines for a quality educational experience that graduates RC practitioners who will be providing RC at the bedside anywhere in the world, as set forth in the this Recognition System & Guidelines.  Graduation from these schools may then be approved by the country’s* credentialing and/or licensure system for RC practice in the hospital, ICUs, and other settings where patients receive respiratory care.

*Recognition is granted to the school for the one country it is delivering RC education in and applying from at the time of application.   If it is delivering RC education via online or hybrid courses, the school must obtain permissions** from the established respiratory care community of organizations, universities and/ or professional societies within each country and submit an application for each that follows the IERS guidelines.

To obtain school recognition the applicant school would need to complete the following steps:

Step1. Provide all information required in School Application.
Step 2. Submit Completed Application to IERS Evaluator.
Step 3. Provide plan for site visit if host school desires, this can occur during step 1 or after step 2 is completed.
Step 4. Provisional Approval
Step 5. Provide Bi-Annual outcome data as planned in step 2 & 3
Step 6. Provide evidence of stakeholder’s support or action plans, after review of data provided in step 5 and receive full Recognition as a school from IERS.

* Site visits are currently optional to the applying school.  Those schools that elect to have a site visit will receive SPECIAL RECOGNITION indicating that the school met the standards and scrutiny of the site visiting team.  The team will also assist the school in meaningful modification & techniques to implement and evaluate effective RC Coursework. Additionally, site visitors can help the school plan and implement stakeholder thresholds for meaningful evaluation of the school’s effectiveness.

You must meet or exceed the following guidelines to secure recognition of your RC school by IERS with support and sponsorship from the ICRC and AARC. If the applying school has just started and does not have sufficient outcome data and other resources fully operational, based on the information submitted may be granted PRELIMINARY RECOGNITION until sufficient outcome data is collected and interpreted by IERS.  FULL RECOGNITION is granted once outcome data has been collected for three years/cohorts and the school meets or exceeds all thresholds establishes by the stakeholders in the applying school's country.

  1. What do you intend to teach?
    1. School Description: Describe the length of the school & degree awarded.  Give the number & name of courses and hours of RC instruction in classroom lab and/or evaluation activities.  As an example, it may say:

      “The four-year Bachelor’s Degree School will require a combination of basic sciences, pre-clinical general courses totaling 60 academic units and 60 respiratory care academic units consisting of a combination of lecture, lab and clinical hours.  The lab and clinical hours total 800 hours of simulated and actual patient care in 2 acute care hospitals.”

                                         Or

      "The three-year Bachelor’s Degree school will require  a combination of online, hybrid & physical attendance courses in basic sciences, pre-clinical general courses totaling 60 academic units and 60 respiratory care academic units consisting of a combination of lecture, lab and clinical hours.  The lab and clinical hours total 1500 hours of simulated and actual patient care in 2 acute care hospitals.”
    2. School Goal: Describe the single most important, school goal, comprehensive competency, or general behavioral objective that best describes the overall   educational goal of the school.    It can be fairly specific, e.g.:

      “Graduates will be able to practice respiratory care at the advanced registered therapist level demonstrating the ability to collect information, interpret all respiratory information reaching the correct assessment and recommend/perform appropriate therapy.”

                                         Or

      The school goal may be more general, e.g.:
      “The school will produce graduates possessing cognitive and, psychomotor skills of a competent, professional respiratory care practitioner capable of performing all of the ICU level RC procedures required in the country of application.”
      In either of the above cases, you must then provide the following additional outcome and measurable information about your planned instruction.
    3. Supporting Instructional Objectives: Describe the specific objectives that you intend to achieve, matched to the overriding goal described above for each course, lab or other educational activities you have planned. These objectives must be written in criterion-referenced manner describing the level of outcome achievement expected.

      e.g. The graduate will be able to:
      “Manage ventilators on patients in respiratory failure with 80% accuracy on all techniques, modifications in mode, and addition of PEEP, oxygen and other techniques to improve ventilation and oxygenation.”

      “Provide assessment and RC plans for management of Asthma competently for greater than 70% of the patient simulations and or actual patients encountered during the lab and clinical training.”

    4. School Courses
      Describe the length and type of each course in the school.  Give the number of days, and hours of RC instruction, lab and/or evaluation activities.  As an example, it may list the following columns/fields:

       

      Course Title

      Units or Hours of Instruction

      Content or objectives

      Activity

      Evaluation
      Tool Description

      Instructor


    5. School Curriculum needs assessment
      The school curriculum must be planned to be likely to achieve the stated goals and learning objectives. Instruction must be an appropriate sequence of did active and/or clinical activities. Instruction must be based on clearly written learning goals, objectives, and competencies expected to be achieved by the completion of the school.  There must be a written statement of the school’s goals and learning objectives.  The school’s goals and learning objectives should be based on survey or other needs assessment data to show the school will meet a need in respiratory care education in the community for which it is planned.  School personnel should design instruction to respond to the needs and/or expectations of the target community.
    6. Sponsoring Educational Entities
      A sponsor must be an individual organizational entity that is recognized by the appropriate office, agency or ministry from the applicant country to grant college credit and a bachelor’s level degree.  The sponsor may be an individual entity or a consortium sponsor that consists of two or more entities that exists for the purpose of preparing individuals to provide respiratory care. The sponsor must assure that the curriculum planners and faculty adhere to the guidelines in conducting their educational school.  The sponsor agrees to support school faculty and staff to fulfill their job responsibilities and promote the goals of the school.
    7. Non-Personnel
      School resources must be sufficient to ensure the achievement of the school’s goals and objectives. Resources may include as appropriate: faculty, clerical/support staff, curriculum, finances, offices, classroom/laboratory facilities, ancillary student facilities, clinical affiliations, equipment/supplies, computer resources, and instructional reference materials.
    8. Personnel
      The sponsor must appoint sufficient faculty and staff with the necessary qualifications to perform the functions required to achieve the school’s stated goals and objectives.
    9. Faculty, Staff and administrative Personnel
      1. Administrative Personnel
        An individual must be designated as the primary administrator for the operations of the school. This individual may be a member of the school faculty or staff.
      2. Faculty
        Individuals appointed to the faculty must have appropriate credentials and expert knowledge in the content area being taught. Faculty must also maintain high ethical standards and professional behavior at all times.
      3. Staff
        School staff must be professionally qualified to fulfill their designated school responsibilities.
  2. How do you intend to teach it?

    1. Instructional Strategies: Describe the teaching strategies you intend to use to teach the objectives described in 1.c. above. e.g. lecture, lab, clinical observation and practice, etc.

      The strategy might be described as:
      Teaching Strategy:” An 18 week course meeting every week for 50 minutes of lecture, 2 hours of hands-on lab and 12 hours of clinical practice, conducted by Dr. Smith and two assistants (BS, RRT, practitioners) to provide experience applying the information on simulated and actual patients being supported and monitored using the contemporary ventilators.”

    2. Use a course outline table and describe the instructional strategy for each topic, i.e. lecture, lab, HPS, standardized patients, clinical experience, manikin simulation, etc.

    3. Strategies matched to topics & objectives: Describe the teaching strategies you intend to use to teach the objectives described in 1.c. above.  i.e. lecture, lab, HPS, standardized patients, clinical experience, manikin simulation, clinical observation and practice, etc.

      The strategy might be described as:
      Teaching Strategy: ” An 18 week course meeting every week for 50 minutes of lecture, 2 hours of hands-on lab and 12 hours of clinical practice,  conducted by Dr. Smith and two assistants(BS,RRT, practitioners) to provide experience applying the information on simulated and actual patients being supported and monitored using  contemporary ventilators.”

    4. Special instructional tools.
      Provide a description of special instructional tools you are using i.e. Ventilator test lung simulators, HPS model and manufacturer, IPADS, etc.  (The box will expand to accommodate all text.*):
    5. Publications and Disclosures
      1. Advertisements, brochures, announcements, catalogs, publications, and internet web pages must accurately reflect the school offered.  Name, statement, logo and any statements referenced to the AARC must have prior approval before they may be used.
      2. Participants should be informed in writing of the following: schedule of instruction dates, cost, criteria for successful completion, location, faculty and any policies and processes required of participants during or after the school.
    6. Lawful and Non-discriminatory Practices
      All activities associated with the school must comply with the applicant country’s rules and regulations.  In the box below paste your letters of recommendation from the universities, organizations and societies of RC in the applicant country that support the establishment of your school.
    7. Safeguards
      The health and safety of patients, students, and faculty associated with the educational activities of the participants must be adequately safeguarded.
    8. Participant Records
      Satisfactory records must be maintained for student attendance, admission, advisement, counseling, and evaluation. Grades and/or continuing education credits for courses must be recorded and permanently maintained by the sponsor in a safe and accessible location.
    9. Substantive Change
      If the school is changing curriculum each year, the sponsor must re-apply for recognition.  If any time during the bi-annual reporting period there is a substantive change(s) in the school the sponsor must report this to the recognition agency in order to retain its recognition status.
    10. Clinical Agreements
      All clinical experience required as part of the school, documentation must be provided and maintained by the sponsor.
  3. How will you know you taught it?

    Evaluation Strategy: Describe the evaluation strategy you intend to use to survey, test or certify students’ attendance and/or knowledge and/or skills.

    “Comprehensive written, computerized and performance based observational testing instruments will be administered after each respiratory care course, lab and clinical rotation in the 4 year school.  In addition, a comprehensive day long summative evaluation will be performed at the end of the 4 year school and completion of all 800 clinical hours to certify competence on all skills required to practice as a respiratory therapist in the country of application.”

    1. Provide an evaluation strategy for the school using the form below as an example of the fields you may report at least:

      Date school started,  1st Formative Test Date, 2nd Formative Test Date, 3d Formative Test Date, Summative Final Date, and Type of evaluation with examples for each.

      Formative Evaluation of students and or the school curriculum may be accomplished using various testing techniques matched to the instruction and designed to give specific course related feedback.  Summative evaluations should focus on comprehensive surveys of student’s cognitive ability in the course completed.  The school may also use meta comprehensive summative exams to judge progress from one year to another within the curriculum as well a graduation required comprehensive exam.

      If evaluation techniques are used, faculty should demonstrate that the testing methods chosen are consistent with the objectives and competencies being tested.
    2. Evaluation Instruments: Provide an example of each of the types of evaluation instruments you intend to use in your evaluation strategy.  It may be the written tests, computerized tests and simulations, observational, survey or attendance instruments.  You must provide actual examples not just descriptions.  All tests etc., will be kept confidential and not shared or used for any other purpose by IERS reviewers except for the evaluation of the school.
    3. Additional Tests, observational tools, surveys, etc.
      Provide examples of test questions, whole tests, surveys, observational tools and any other evaluation, testing or measurement instrument the school uses to evaluate its students and graduates.
    4. Student Attendance
      Provide a sample of the attendance forms used to document attendance by students at all the school components and activities. Post-seminar attendance data attendance data should be sent within 60 days of the seminar delivery. Include at minimum the following fields of data:

      Participant name, profession (physician, Respiratory care practitioner, Physical Therapist, Nurse, etc.) credentials (MD, RRT, RN, PT, etc.), and AARC member number if applicable.

    5. A post graduation survey of students/graduates and all stakeholders should be conducted bi-annually to measure satisfaction with stated and achieved goals and objectives.  Until adequate outcome data, the school will receive Preliminary Recognition, provided all other planning and resource data is submitted to IERS for review.

      All data will be subject to posting on IERS website before and after the delivery of the school data.

      Online & Hybrid Courses
      Online courses can only be used for cognitive certification of skills and competencies. Hybrid courses that have online and physical attendance/evaluations may be used like physical attendance only courses to teach to all three levels of blooms taxonomy, cognitive, psychomotor & attitude, for example:
      Course.     Physical attendance.   Online.      Hybrid.      Cog.  PM/Perf.   Attitude
      RC222.             Yes.                             No.             No.            X.           X.              X
      RC223.               No.                            Yes.           No.             X.         N/a.         N/a
      RC224.               Yes.                           Yes.           Yes.            X.           X.             X
      In the following table list/paste all courses in school and provide information in table for each course, add rows as needed:


      Course

      Physical attendance.  

      Online.

      Hybrid.

      Cognitive

      Psychomotor

      Attitude

      A post graduation survey of students/graduates and all stakeholders should be conducted bi-annually to measure satisfaction with stated and achieved goals and objectives.  Until adequate outcome data, the school will receive Preliminary Recognition, provided all other planning and resource data is submitted to IERS for review.

    6. All data will be subject to posting on IERS website before and after the delivery of the school data.

Appendix A: Approved School Recognition Process Continued

Optional Site visit & Report by site Visitors

The site visit has THREE primary objectives & is optional at this time:

  1. To evaluate the school of respiratory care & its clinical affiliates.
  2. To assist the school in establishing its stakeholders, outcomes and criterion for curriculum monitoring & improvement.
  3. To perform/complete inquiries regarding the quality and effectiveness of the resources available to the students and its faculty.

Evidence-based outcome measures Establishing Performance Criterion

The establishment of Criterion Evidence-based outcome measures is the responsibility of the applying school in partnership with IERS.  The procedure recommended to accomplish this is found in Appendix B.

Evidence Based Outcome Measurements
The school may have the following outcome goal expectation:

 “To prepare Respiratory Care providers competent in the delivery of safe, effective respiratory modalities to patients with acute and chronic pulmonary conditions”.

Schools may adopt educational goals that are modeled after entry-level, advanced or specialty level practice as defined in the United States or by the applicant’s own country’s stakeholders and/or national standards. The applicant must clearly identify the level of practice graduates will be expected to achieve upon graduation, This level of practice must correspond with evidence based outcome measurements collected to show that students have acquired the general knowledge base and can demonstrate the comprehensive competencies expected as a result of the instruction and evaluation provided by the school during the course of study.

Ultimately school graduates must demonstrate a level of preparation and practice adequate to insure the safe and effective provision of respiratory care as determined by the school’s stakeholders. A school’s educational outcomes must correspond to curriculum elements based on measurable goals, and general and specific behavioral objectives.  The evidence based outcome measurements should document the attainment of competencies corresponding with the appropriate cognitive, psychomotor, and affective learning domains.  The school’s curriculum, its goals, learning objectives and the periodic review and revision of the curriculum shall be based on the attainment of identified competencies.

  1. Evaluation of Evidence Based Outcome Measurements 

    The school is required to bi-annually evaluate and report to IERS its success in meeting or exceeding the expressed evidence based outcomes, goals, and learning objectives of the curriculum. Results of the school’s assessment of its outcome data shall form the basis for the review and potential revision of the instructional plan.  Changes in curriculum design and budget support to improve the school’s achievement of its educational outcomes must be included in the bi-annual report to IERS.

    Evaluation of Evidence Based Outcome Measurements will include at minimum:  pass rates on national/international credentialing examinations where applicable, meeting of standards set by the Minister of Health or other appropriate government entity, school admission, retention, graduation rates, level of support by the government, employers, and graduates; as well as job achievement in respiratory care, and other school summative measures in the cognitive, psychomotor, and affective learning domains deemed appropriate by the school’s  stakeholders.   The school is required to set and meet Criterion Levels for each of the outcome measurement evaluations.

    The School Evaluation of Evidenced Based Outcome Measurements should be a strategic planning process with a built in feed-back mechanism for curriculum improvement.  The evaluation process is formal and consultative and must involve the internal and external participants forming the school’s community of interest.

    Schools not meeting Criterion Levels set by their stakeholders will develop appropriate action plans to improve outcome success.

  2. Reporting of Evidence Based Outcome Measurements  

    The school is required to bi-annually report to IERS its success in meeting or exceeding the expressed evidence based outcomes, goals, and learning objectives of the curriculum. The report must also include an analysis of its evaluation instruments (including written and computerized examinations, clinical simulations and practicums, observational, survey or attendance instruments. The validity and reliability of the instruments must be statistically analyzed and included in the bi-annual report.   Results of the school’s assessment of its outcome data shall form the basis for the review and potential revision of the instructional plan.  Based on the evaluation, changes in curriculum design, addition of resources, and budget support to improve the school’s achievement of educational outcomes must be included in the bi-annual report to IERS.  Documentation of the effectiveness of changes in the school’s curriculum to improve outcomes must be monitored, evaluated and reported to IERS

    Once the school meets the required outcome data requirements for areas of assessment and Criterion evidence-based outcome measures it may submit data for review and FULL RECOGNITION.

    All of the schools outcome data will be published on the IERS website under the link for information about the school.

  3. Example Outcome data:

    e.g. 70% of graduates rate the school adequate to provide 4-year RC education.
    75% of graduates pass a comprehensive exam on all respiratory care skills required to practice respiratory care in the country of application.
    80% of graduates will be rated high on professionalism by their employers six months after graduation and obtaining employment as a full time respiratory care practitioner.
    90% of graduates employed six months after graduation will be rated as having highly developed, smooth respiratory care psychomotor skills when performing patient care.

    After using the procedures suggested in appendix B & by the site visit team, the sponsor will use the table below to list the outcomes selected to monitor and data collected thus far or dates planned for data collection.
  4. Outcomes

    Thresholds set
    by Faculty

    Thresholds set
    by advisory committee 

    Thresholds set
    by other stakeholders

    Achieved by all graduates and/or dates

    Percent +/- average thresholds

    Type or paste outcomes here:  

    Type or paste % of graduates:
     

    Type or paste % of graduates:
     

    Type or paste % of graduates:
     

    Type or paste % achieved by graduates:
     

    Type or paste % difference +/-  :   

    Some of the data required in section I, II, and III will be reviewed by the site visitors during their onsite visit, all data available before site visit should be put into the above boxes as requested and sent as part of the application/recognition process. Those schools not requesting

Selection Of Evidence Based Outcome Measurements 

At some point in planning the curriculum the school must establish a list of summative evidenced based outcome measurements to monitor as described above in the guidelines.  These are the terminal or summative outcomes and competencies expected to be displayed by graduates of the school.  In addition, the school in consultation with its stakeholders may wish to suggest examination performance, clinical evaluations from employers and other appropriate data sources.  The schools must monitor these outcomes on an annual basis (reporting bi-annually) and compare graduate performance to performance standards (referred to as criterion evidence-based outcome measures) set for each of the outcomes by the stakeholders.

Procedure for selecting the Evidence Based Outcome Measurements 

Develop a list of all the goals, objectives, competencies and other outcomes as indicated above for school graduates. Configure the list into a survey and request the stakeholders to rank order them by importance in order to establish the most important in each of the learning domains.  If needed, have faculty modify the list to make sure they are measurable and appropriate for school graduates.

Resend the final list to all the stakeholders and give them an opportunity to  modify,  with deletions or additions to the final list.  Do another round of ranking if needed to select the most important in each domain to monitor on a yearly basis.  Repeat the process until consensus is reached on the outcomes to measure.

Criterion Evidence-based outcome measures Setting 

After the above list is developed, the school must then determine the level of performance that will be required by graduates for each of the outcomes. It is this level of performance that the local stakeholders should establish to determine if the school is meeting community needs.  These criterion evidence-based outcome measures, once established, will be monitored and the data revealed to the IERS  Recognition Board, the stakeholders and the public.

Selection Of Evidence Based Outcome Measurement Performance Levels

The sponsor should take the final list of outcomes and criterion evidence-based outcome measures from above and resend to faculty, advisory committee members and others representing the stakeholders.  These stakeholders should vote on the level of performance that should be demanded of graduates of the school to retain continued community support.

This list can then be averaged and grouped by each community of interest and presented to all for final debate and voting on the performance criterion evidence-based outcome measures the school will be evaluated on annually.  Repeat the process until consensus is reached on the criterion evidence-based outcome measures to set for each outcome as a minimum standard for school and graduate performance.


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