RT Journal Article
SR Electronic
T1 Utilizing Competence-Based Simulation to Improve Orientation Outcomes
JF Respiratory Care
FD American Association for Respiratory Care
SP 1527
OP 1533
DO 10.4187/respcare.09870
VO 67
IS 12
A1 Honey L Pezzimenti
A1 Patricia A Achuff
A1 Roberta L Hales
A1 Maureen E Ginda
A1 Cheryl L Dominick
A1 Akira Nishisaki
A1 Natalie Napolitano
YR 2022
UL http://rc.rcjournal.com/content/67/12/1527.abstract
AB 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 &lt; .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 &lt; .001; experienced RTs 28.0 ± 18.9, P &lt; .001; period 2: new graduate RTs 23.0 ± 15.2, P &lt; .001; experienced RTs 29.0 ± 12.1, P &lt; .001; period 3: new graduate RTs 26.0 ± 15.8, P &lt; .001; experienced RTs 27.0 ± 15.1, P = .007; and period 4: new graduate RTs 19.0 ± 14.5, P &lt; .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.