By Rob DiBlasi, BSRT, RRT-NPS, FAARC
I first became involved in research when I assisted in a clinical research study as a staff therapist in 1999. Following that study, I participated in a number of bench studies with my mentor, John Salyer, MBA, RRT-NPS, FAARC. I realized that RT research was quickly becoming my penchant, but I never imagined that I could do it full-time.
A unique opportunity presented itself in 2004 when I was working as a nightshift RT supervisor. Seattle Children’s acquired a new CEO, Tom Hansen, MD, who wanted to advance basic and clinical research at our institution. Shortly after opening the new Seattle Children’s Hospital Research Institute, Tom hired a pulmonary physiologist, Peter Richardson, PhD, to do basic and clinical research.
Tom had a very successful pulmonary research career with Peter before becoming CEO and wanted to continue his legacy part-time. I was elated to hear that Tom and Peter wanted to hire me as an RT research coordinator. I am fortunate that John, Peter, and Tom were patient enough to mentor me on the research process. They encouraged me to begin asking my own research questions and supported me in developing hypotheses, conducting experiments, summarizing data, statistical analysis, and in writing manuscripts.
You don’t need a PhD
I found it extremely difficult to prepare for the new role as an RT researcher, since this is a highly specialized field and so few RTs are able to do this full-time. I relied on friends, like Rob Chatburn, MHS, RRT-NPS, FAARC, to bounce ideas off of and get valuable insight about designing certain experiments.
I also quickly realized that networking was vital to the success of building a research career, because it is important to solicit feedback from people who have been doing this for a while. I realized in time that confidence is a major driving factor, and that once I repeated the process of conducting experiments, I was amazed to learn that research wasn’t always rocket science.
I also realized that I didn’t need to have a PhD in order to do this work. In fact, nearly half of the papers I wrote were back when I had an associate’s in RT. I later went on to get a BSRT but feel strongly that if you have the right mentors, an advanced degree may not be altogether necessary for getting the job done.
I feel that many RTs today have it set in their mind that they are not entitled to do research if they don’t have an advanced degree. The take home message here is that anyone can do research, but only if they do the work!
Patience is key
I am extremely lucky to have the ability to get the funding and have the leadership and support to continue to ask research questions. A fun part about working as a research/QI manager is that I never have to leave the bedside. Many of our clinical research and quality improvement projects require us to be at the bedside making measurements.
It is my hope that the findings from my work will ultimately make a big difference and have some measureable impact out outcomes in children. It may take decades to see this work come to fruition, so patience is key when doing research.
I also love the diversity — one day I can be working in my animal lab and the next, I can be at the bedside making measurements in sick children. Between our multiple labs and the bedside, I never get bored!
A lab of our own
A unique feature of the Seattle Children’s Hospital (SCH) RT department is the Translational Research Laboratory, which is the only one of its kind on the west coast. RT staff work to advance neonatal and pediatric science by identifying bedside RT equipment performance issues and clinical management questions, bringing them back to the bench and exposing them to vigorous testing, with the goal of improving the equipment or process performance in this complex care environment.
This program was initiated by RT leadership over 10 years ago to test new equipment performance to ensure it was safe before using it in our pediatric patient populations.
The lab has grown through the implementation of improved safety standards, continuous process improvement, and clinical standard work. The RT leadership and staff review all new projects to assure close alignment with the SCH goal to improve the safety, delivery, quality, or cost of care for our patients.
High fidelity lung simulators and anatomically accurate nasal airway 3D models derived from CT scans were developed to conduct needed research in order to ascertain support provided by noninvasive techniques such as heated/humidified high flow nasal cannula.
There is also an RT Aerosol Research Lab and an Animal Physiology Lab located at the Seattle Children’s Research Institute to help answer some of the more complex research questions. Several RT-initiated clinical studies are underway in those labs now.
Pride in accomplishments
Our lab prides itself on its accomplishments because the majority of the research and QI projects are initiated, implemented, and completed by RT staff. Since the lab opened, the RT department has produced more than 50 poster presentations, 30 publications in peer-reviewed journals, and 10 textbook chapters.
The lab also collaborated with RN staff to help conduct research as part of the recently acquired Nursing Magnet Status Designation. The lab receives its funding from the Seattle Children’s Research Institute and several different industry sponsors.
Current projects include: CO2 elimination and pressure delivery with HFNC in children; breath-synchronized, aerosolized surfactant delivery with NCPAP in surfactant-deficient subjects; volume guarantee mode performance with and without ET tube leaks; and work of breathing between different subacute ventilators in patients with BPD.
We believe this work is important because it will help provide corroborative data to conduct future clinical studies, guide management, and improve the care we provide to our patients. There is so much that can be done because neonatal/pediatric RT practice is relatively new and we need to evaluate new technologies and current therapies to determine their place in the care of our patients.
More mentors needed
RTs add something to research that cannot be found anywhere else. Our advanced understanding of pulmonary physiology coupled with advanced ventilation knowledge make us an integral member of a research team.
Many of the folks who have spent most of their career in RT research have spent a lot of time mentoring medical students, fellows, and resident physicians. However, there needs to be more emphasis on mentoring/training RTs in research, so that we develop new leaders and continue to promote our wonderful profession.
It is difficult to learn all you need to know attending lectures on RT research. It needs to go beyond that, so that this is not a lost art.
Our RT lab has an “open door policy” and we feel that we may have a larger impact on pediatric outcomes by empowering RTs from other institutions through providing them with tools necessary to do their own research. In fact, many of the RTs we have mentored and collaborated with in the past have gone on to do research full-time at other centers.
Ideally, it would be nice to eventually have the necessary funding to provide an RT research fellowship, so that several RTs can come to our lab each year and conduct human, animal, aerosol, and bench research.
Research has changed my life. There is nothing I would rather do more than to be an RT researcher. The best part of my job is meeting with local and national RTs to find out what topics need to be addressed next so that we can improve upon our practice.
Another important aspect has been to work with industry leaders on developing/testing new devices and therapies. I would like to believe that everything we do may have some small impact on outcomes in our patients.
The sky is not the limit, and while it certainly helps, you do not need a PhD to do RT research.
Rob DiBlasi is a research/QI manager at Seattle Children’s Hospital in Seattle, WA.
Want to get more involved in respiratory research? Learn more about the research process through the Research Track in the AARC’s Leadership Institute. Join the Research Community to network with RT researchers and others interested in conducting research studies.