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:
- Seminar Recognition (Level I)
- Granted to educational non-repeating (content) RC seminars of any length. Recognized RC Seminars have met or exceeded the guidelines for quality seminars that teach different content each time they are offered, as set forth in these Recognition System Guidelines.
- Program Recognition (Level II)
- Granted to educational repeating(content/skills) RC programs that are designed to teach the same content/skill set each time the program is delivered. Recognized RC programs have met or exceeded the guidelines for quality programs that teach similar RC skills each time they are offered, as set forth in the Recognition System Guidelines.
- School Recognition (Level III)
- Granted to educational programs that meet level II (Recognized Program) recognition guidelines and also meet these level III additional requirements. In addition to level II recognition, 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 these 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.
Disclaimer: Recognition by the AARC does not imply that: CRCE credits will be awarded, courses will transfer to US colleges, or that participants/graduates will be eligible for USA NBRC examinations.
Application Process and Guidelines
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:
- What do you intend to teach?
- How do you intend to teach it?
- How will you know you taught it?
To answer these questions the applicant needs to provide the following:
- What do you intend to teach?
- 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.”
- 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.
In either of the above cases, you must then provide the following outcome oriented and measurable information about your planned instruction.
- 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.
- 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:
- How do you intend to teach it?
- 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.”
- 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.
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.”
- How will you know you taught it?
- 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.”
- 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.
- Evaluation Strategy: Describe the evaluation strategy you intend to use to survey, test or certify participants’ attendance and/or knowledge and/or skills.
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:
- What do you intend to teach?
- How do you intend to teach it?
- How will you know you taught it?
To answer these questions the applicant needs to provide the following:
- What do you intend to teach?
- Program Description: Describe the length of the repeating skill RC program, workshop or planned RC educational activities. Give the number of days, and hours of RC instruction, lab and/or evaluation activities. As an example, it may say:
“The four year Bachelors Degree program 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
“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.”
- 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. :
Or, the program goal may be more general, 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.”
In either of the above cases, you must then provide the following additional outcome and measurable information about your planned instruction.“The program 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.”
- 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.”
Or
“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.”
- Program Description: Describe the length of the repeating skill RC program, workshop or planned RC educational activities. Give the number of days, and hours of RC instruction, lab and/or evaluation activities. As an example, it may say:
- How do you intend to teach it?
- Instructors: List the names and credentials of each instructor for the lectures, labs, etc., listed in 1.a. above. e.g. James Smith,BS,RRT, Program Director and Professor of RC, Central University and Medical Center, City, Country, Teaching a 12 unit course: “Mechanical ventilation equipment operation and trouble-shooting during prolonged artificial ventilation of patients in respiratory failure.”
- 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.”
- How will you know you taught it?
- 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 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.”
Or“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.”
- 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.
- 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:
Approved School Recognition Process
- School Recognition
School recognition can be obtained by any program which already has met Program Recognition guidelines outlined above, and in addition, which agrees to meet the following outcome guidelines.
Program and School Recognition may be applied for at the same time or separately with Program Recognition required before School recognition can be granted.
- Evidence-based outcome measures Establishing Performance Criterion
The establishment of Criterion Evidence-based outcome measures is the responsibility of the applying school. The procedure recommended 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 communities of interest 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 program 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 communities of interest. 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 program of study, its goals, learning objectives and the periodic review and revision of the curriculum shall be based on the attainment of identified competencies.
- 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 communities of interest. 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 communities of interest will develop appropriate action plans to improve outcome success.
- 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 recognition.
All of the schools outcome data will be published on the IERS website under the link for information about the school.
- Example Outcome data:
e.g. 70% of graduates rate the program 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.
