Abstract
BACKGROUND: New graduate respiratory therapists (RTs), regardless of the degree program, receive limited preparation in neonatal/pediatric diseases and management. Experienced RTs typically have adult knowledge but limited exposure to pediatrics. We developed a program that included competence-based simulation to improve orientation success.
METHODS: A 9-week orientation program curriculum with simulation-based competence assessment was developed to ensure all new hires gained knowledge and skills to perform pediatric clinical tasks. Each new hire individually completed the same simulation scenarios during the first week and last week of orientation. Curriculum changes were made over time based on performance in simulations and on-the-job knowledge and skills during and after orientation. Paired and unpaired t tests were used with P < .05 as significant.
RESULTS: From January 2017–February 2020, the program had 3 updates. Noninvasive ventilation and decompensating patient scenarios were completed for all periods. Ninety-two new staff were oriented in period 1 = 29 (new graduate RTs 20, experienced RTs 9); period 2 = 17 (new graduate RTs 10, experienced RTs 7); period 3 = 24 (new graduate RTs 21, experienced RTs 3), and period 4 = 22 (new graduate RTs = 22). Remediation during orientation occurred in 15% of the staff. Seventy-one percent successfully advanced to ICU orientation after completion of the program. All staff improved scores between pre- versus post-simulations in all periods: mean difference ± SD period 1: new graduate RTs 32.0 ± 17.0, P < .001; experienced RTs 28.0 ± 18.9, P < .001; period 2: new graduate RTs 23.0 ± 15.2, P < .001; experienced RTs 29.0 ± 12.1, P < .001; period 3: new graduate RTs 26.0 ± 15.8, P < .001; experienced RTs 27.0 ± 15.1, P = .007; and period 4: new graduate RTs 19.0 ± 14.5, P < .001, paired t test. The scores between new graduate RTs and experienced RTs during post-simulation were not significantly different for period 1 (P = .35) but were significantly different for periods 2–4 (P = .040, unpaired t test).
CONCLUSIONS: The use of a competence-based orientation program showed educational advancements and helped determine successful orientation completion.
- orientation
- outcomes
- simulation
- assessment
- competence
- respiratory therapists
Footnotes
- Correspondence: Honey Pezzimenti MEd RRT RRT-NPS AE-C, Children’s Hospital of Philadelphia, Respiratory Care Department, 3401 Civic Center Boulevard, Philadelphia, PA 19104. E-mail: PezzimentH{at}chop.edu
Ms Napolitano discloses relationships with Dräger Medical, Vero-Biotech, Smiths Medical, Philips Respironics, and Actuated Medical. The remaining authors have disclosed no conflicts of interest.
A version of the study was presented by Ms Pezzimenti as an Editors’ Choice abstract at AARC Congress 2021 LIVE!, held virtually December 1, 2021.
Supplementary material related to this paper is available at http://www.rcjournal.com.
- Copyright © by 2022 Daedalus Enterprises
Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$30.00
Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.
