Shaw Robert, Vines David, Benavente Jennifer, Keene Shane
National Board for Respiratory Care, Overland Park, KS.
National Board for Respiratory Care and Clinical Integration and Interdisciplinary Initiatives at Rush University, Chicago, IL.
Chest. 2025 Jan;167(1):202-210. doi: 10.1016/j.chest.2024.09.026. Epub 2024 Oct 3.
There are physician shortages in the United States including in the cardiopulmonary specialty. Nonphysician advanced practice providers, including nurse practitioners or physician assistants, have been proposed to meet some more routine patient care needs. A supplementary provider called an advanced practice respiratory therapist (APRT) has been proposed. Such personnel start as respiratory therapists followed by training in a graduate degree program. The Commission on Accreditation for Respiratory Care has published a set of standards for such an education program, and one program has begun to train APRTs. The Commission on Accreditation for Respiratory Care requires each accredited program to publish its outcomes. The respiratory therapy credentialing board, the National Board for Respiratory Care, has undertaken stewardship of assessing APRT education program outcomes. The research question asks whether there is national support to develop a standardized assessment of graduates' performances near the end of an APRT education program. This paper describes methods used during this study of the nascent APRT role, which informed decisions of an advisory committee as they considered what content to assess and how to design the measurement instrument. The study exposed a set of survey-derived metrics about potential content signaling whether there was endorsement among physicians, nonphysician advanced practice providers, and APRT graduates. Metrics are described from these and other subgroups plus the committee's decisions are explained about what content to assess and how. Most of the surveyed content was endorsed for being part of the APRT role; therefore, the committee proceeded to make design decisions about the outcome assessment.
美国存在医生短缺的情况,包括心肺专科领域。有人提议由非医生高级执业提供者,如执业护士或医师助理,来满足一些较为常规的患者护理需求。还提议设立一种名为高级执业呼吸治疗师(APRT)的补充性医疗人员。这类人员最初是呼吸治疗师,之后接受研究生学位项目的培训。呼吸治疗认证委员会已发布了此类教育项目的一套标准,并且一个项目已开始培训APRT。呼吸治疗认证委员会要求每个获得认证的项目公布其成果。呼吸治疗资格认证委员会,即国家呼吸治疗委员会,已承担起评估APRT教育项目成果的职责。该研究问题是,在APRT教育项目接近尾声时,是否有全国性的支持来开展对毕业生表现的标准化评估。本文描述了在这项关于新兴APRT角色的研究中所使用的方法,这些方法为一个咨询委员会在考虑评估内容以及如何设计测量工具时提供了决策依据。该研究揭示了一组从调查中得出的指标,这些指标涉及潜在内容,表明医生、非医生高级执业提供者以及APRT毕业生是否认可。文中描述了来自这些及其他亚组的指标,并解释了委员会关于评估内容及方式的决策。大多数被调查的内容都被认可为APRT角色的一部分;因此,委员会着手就成果评估做出设计决策。