Benchmark Analysis of Student Performance in Respiratory Therapy Programs, Exams of Physiotherapy

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Five Year Program Review

Respiratory Therapy, A

Prepared by

Angela Pruitt

March 25, 2020

Program: Respiratory Therapy

Prepared by: Angela Pruitt, Program Director

Date: March 25, 2020

A. Program Purpose

In support of the mission of Rockingham Community College, the purpose of the Respiratory Therapy curriculum is to prepare individuals to function as respiratory therapists through competence in cognitive, psychomotor, and affective learning domains of respiratory care practice. Graduates are eligible to complete the credentialing process through the National Board for Respiratory Care, which will qualify them for a license to practice in a variety of healthcare settings with responsibilities for assessment, treatment, management, and education of patients with cardiopulmonary diseases.

B. Program Student Learning Outcomes

1. Provide the current and past year Program Student Learning Outcomes and the results.

2018 - 2019

Outcome #1: The student will develop an educational plan for respiratory disease management.

Benchmark: A) 80% of students will score 3 or higher for all criteria on a 4-point rubric in RCP 123 (Special Practice Lab). B) 80% of students will score 80% or higher on embedded quiz/exam questions in RCP 123.

RESULTS:  Benchmark met: A) 100% of students scored 3 or higher on all criteria on a 4- point rubric in RCP 123. B) 100% of students scored 80% or higher on embedded quiz/exam questions in RCP 123.

Outcome #2: The student will correctly interpret Arterial Blood Gases (ABG). Benchmark: A) 80% of students will score 90% or higher on ABG worksheet in RCP 114 (Cardiopulmonary Anatomy and Physiology). B) 80% of students will score 80% or higher on embedded quiz/exam questions in RCP 114.

RESULTS:  Benchmark not met: A) 76.9% (10 of 13) of students scored 90% or higher on ABG worksheet in RCP 114. B) 62% (6 of 13) of students scored 80% or higher on embedded quiz/exam questions in RCP 114.

 Benchmark not met: B) 33% (3 of 9) of students scored 80% or higher on embedded quiz/exam questions.

2. Provide a summary of your findings and how the faculty within this program used the results for improvement.

2018 - 2019 Outcome #1: Benchmark met. Faculty decided to revise this assignment to emphasize information gathering and decision making. Information gathering and decision making were identified as areas of weakness by subset domain scores on the clinical simulation exam. Faculty will focus on these areas in RCP 223-Special Practice Lab during the last semester in the program. Faculty will include disease specific case studies, to include information gathering and decision making. Faculty will also include modules related to these topics.

2018 - 2019 Outcome #2: Benchmark not met. Program faculty discussed the need for more resources related to arterial blood gas (ABG) interpretation in RCP 114- (Cardiopulmonary Anatomy and Physiology). Program faculty consulted Anatomy and Physiology faculty at RCC, as well as Respiratory Therapy program faculty from across the state concerning lower scores with this concept to discuss other methods of instruction in RCP 114. Program faculty completed a survey sent by RCC Anatomy and Physiology faculty assessing former A & P students at the end of their first semester in the RT program. Program faculty found through the survey that added emphasis needed to be placed on cardiopulmonary anatomical structures and location as well as acid-base balance issues while students are enrolled in A & P. These recommendations were made to A & P faculty.

2018 - 2019 Outcome #3: This course was redesigned to develop curriculum specific to the Therapist Multiple Choice (TMC) exam matrix for students in their last semester of the program. Emphasis placed on activities related to patient data, evaluation and recommendations, troubleshooting and quality control of equipment, and infection control. The student will also concentrate on initiation and modification of respiratory interventions. PSLO3 will be updated for 2019-2020 academic year. Program faculty discussed the redesign of RCP 223-Special Practice Lab, taken during last semester of program, in order to enhance completion of the threshold (sub scores above the 85% national mean) providing documentation toward demonstrating compliance with the Commission on Accreditation for Respiratory Care (CoARC) Standards 3.05 and 4.03. The results of course update will be trended annually with the programs CoARC annual reporting tool. Upon evaluating exam scores by content are for graduating class of 2019, it was noted that there were improvements in several areas. Program faculty will further redesign RCP 223 to address any area that is below the threshold of 85% of the national mean. 2019 - 2020 Outcome #1: PENDING FINAL GRADES FROM RCP 215 (LAST GRADE SHOULD BE ENTERED 4/ 30 /2020)

2019 - 2020 Outcome #2: PENDING FINAL GRADES FROM RCP 215 (LAST GRADE SHOULD BE ENTERED 4/ 30 /2020) 2019 - 2020 Outcome #3: Program faculty discussed the need for more resources related to ABG interpretation in RCP 114 as well as other methods of instruction in RCP 114. RCP 114 currently has no text specific to this course. Program faculty is considering adding Cengage instructional materials to RCP 114. Program faculty has also had lengthy conversations with fellow Respiratory Therapy program faculty from across the state to develop optimal curriculum.

C. Program Resources

1. Staffing a. Provide a table indicating credit evaluation summary on file and courses credentialed to teach. The Respiratory Therapy program has a full-time Program Director, a full-time Director of Clinical Education, and adjunct faculty as needed.

NAME CES ON FILE COURSES CREDENTIALED TO TEACH Vickie Chitwood Yes Respiratory Therapy Angela G. Pruitt Yes Respiratory Therapy Ruth W. Underwood Yes Respiratory Therapy

b. Provide a table providing 2 years of FTE and CHP earnings.

FTE FTE % CHP CHP %

FT Total 12.02 53% 305 100% Chitwood, Vickie 12.02 (^) 53% 305 100% Frazier, Tina 0 0% 0 0% PT Total 10.47 47% 191 63% Underwood, Ruth 10.47 47% 191 63% Grand Total 22.49 100% 496 163%

FTE and CHP Earnings 2017-

for all equipment. The dedicated lab has a capacity of 14 students. The building also houses eight high-fidelity simulation rooms, four low-fidelity simulation rooms, and a faculty recording room. There is also a cooperative learning classroom for faculty and students to review simulation scenarios. The second floor of the Owens Building contains four classrooms, three of which can seat approximately 24 students, while the fourth classroom can seat approximately 30 students. There are additional classrooms on the lower level of the Owens building with varying capacities, from approximately 20 to 30 students. With increasing class sizes, there will be a need for additional lab and classroom space. Although having seven classrooms in the building, the RT program is required to share classroom space with other Health Science programs due to the large number of students.

b. Provide a narrative regarding the adequacy of your equipment as well as needs. The RT program has a dedicated lab which contains three mechanical ventilators in excellent working condition, including a Servo i, Avea, and a Puritan Bennett

980. These ventilators are seen frequently by RT students at clinical sites, making them a valuable asset for our program. The lab also holds a V60 Bipap, the most commonly used non-invasive ventilator used in our clinical facilities. While the program does own a SiPAP for use with neonates, there are limited supplies for use with this machine. There is a definite need for supplies, such as, circuits for ventilators, SiPAP masks/prongs and circuits, and oxygen therapy supplies. The program would also benefit from purchasing a MetaNeb system. This is a newer form of Intrapulmonary Percussive Ventilation which is included in the updated TMC matrix.

Classrooms in the Owens Health Sciences building are well equipped with computers, projectors, and white boards. The building also has a laptop cart available for use by faculty when the computer lab is unavailable.

3. Budget a. Provide the program budget for the previous and current year.

b. Provide a narrative regarding future budgetary needs. Future budgetary needs will include supplies for SiPAP, ventilator circuits, and oxygen therapy supplies as well as 3 new airway manikins, and a MetaNeb system.

4. Program Specific Professional Development a. Provide a narrative regarding professional development. The Program Director and Director of Clinical Education attend the annual meeting of the North Carolina Association of Respiratory Educators (NCARE). This meeting provides Respiratory educators an opportunity to discuss important information concerning all RT programs within the state as well as any updates from the North Carolina Respiratory Care Board (NBRCB).

In addition, the Program Director and Director of Clinical Education are required to maintain the North Carolina Respiratory Care License. In order to satisfy this requirement, an individual must complete a minimum of 12 continuing education credits, with at least 6 of those credits from live seminars, every 12 months. These credits can be achieved by attending conferences, online webinars, or online courses with related exam. These credits are solely related to respiratory care.

The Program Director and Director of Clinical Education must maintain Basic Life Support (BLS) credential, renewed every 2 years. The Program Director and Director of Clinical Education are also certified BLS instructors, which required an additional course from the American Heart

3. Student Demographics

• NUMBER OF GRADUATES FA15 FA16 FA17 FA18 FA
• Associate In Applied Science A45720
• Total Respiratory Graduates
• AGE FA15 FA16 FA17 FA18 FA
• <18
• 18-19
• 20-22
• 23-29
• 30-39
• 40-49
• 50+
• Total
• GENDER FA15 FA16 FA17 FA18 FA
• Female
• Male
• CREDIT HOURS FA14 FA15 FA16 FA17 FA Percent Female 74.3% 87.0% 82.5% 79.1% 83.7%
• Full-time
• Part-time
• HOME COUNTY FA14 FA15 FA16 FA17 FA Percent Full-time 28.6% 60.9% 60.0% 39.5% 34.9%
• Rockingham
• Other

E. Curriculum

1. Refer to the Annual Program of Study Review to provide a narrative describing any changes or revisions that have been made since the last review. In Spring 2017, program faculty implemented an online simulated testing course, RT Board Review, for use in RCP-215, Career Preparation. This course allows the student to gain experience with an online review of concepts and practice computerized test- taking skills.

In Fall 2018, program faculty changed the second English requirement from COM-120, Introduction to Interpersonal Communication, or ENG-114, Professional Research and Reporting, to ENG-112, Writing and Research in the Discipline. This change was necessary because the profession is transitioning to requiring a Bachelor’s degree and faculty would like to ease the transfer process for our graduates. ENG-112 concentrates on writing in APA format, placing more emphasis on practicing proper citation. ENG- 112 is a Universal General Education Transfer Component (UGETC) course, which is transferable, ENG-114 and COM-120 are not transferable.

In Fall 2019, program faculty increased the required GPA for admission from 2.5 to 2.8. This increase was necessary due to the implementation of Reinforced Instruction for Student Excellence (RISE) at RCC. RISE required certain courses to have a corequisite if the student’s GPA was below 2.8 and program faculty believed it would be very difficult to schedule program classes around additional corequisite courses. The GPA is calculated using only prerequisites and Respiratory Therapy general education courses. Program Faculty also felt this change would improve the quality of student applicants.

Program faculty also made prerequisite changes in the fall of 2019. Program Faculty required BIO-168, Anatomy and Physiology I, BIO-169, Anatomy and Physiology II, and CHM-131/131A, Introduction to Chemistry as prerequisites for entry into the program. Students must earn a “C” or higher in each of these prerequisites. Program faculty felt this would allow the student to concentrate on respiratory therapy classes and they would be better prepared, having already taken both Anatomy and Physiology courses, as well as Chemistry.

ETHNICITY FA14 FA15 FA16 FA17 FA

White, Non-Hispanic 24 16 29 32 28

Black, Non-Hispanic 8 5 5 6 7

Hispanic 1 1 3 1 2

Other/Unknown/Multiple 2 1 3 4 6

Rockingham Community College Respiratory Therapy Program Advisory Committee Meeting October 19, 2018 12:00 p.m. Owens Health Sciences Building, Room 122

Attending: Vickie Chitwood, RCP Program Director; Dr. Mark Kinlaw, President; Ms. Sheila Regan, Vice President for Academic Affairs; Laura Jennings, Assistant Director of Enrollment; Angie Pruett, Director of Clinical Education; Ruth Underwood, Adjunct Instructor; Ally Feder, graduate student representative; Don Hendrix, 2nd year student representative; Shyenne Ore, 1st year student representative; Lisa Cutshaw, Novant Health - Forsyth Medical Center; Phillip Christmas, Kindred Hospital; Heather Kalill, Sovah Health - Danville; James Parramore, Sovah Health - Martinsville; Julia Tatum, Rockingham Early College High School; Teri Hicks, Cone Health

Recorder: Katherine Leebrick, Health and Public Services Administrative Assistant

Prior to the official meeting, lunch was provided.

1. Call to Order Vickie Chitwood welcomed everyone and officially opened the meeting.
2. Introductions Introductions were made and Vickie announced her promotion to Dean of Health Sciences and Public Service Technologies. She will continue to be the Program Director for Respiratory Therapy and reassured members she will remain involved with the program.
3. Purpose Vickie read the advisory board purpose statement which comes from CoARC.
4. Minutes Minutes of the previous meeting were reviewed and approved.
5. Old Business Vickie asked if there was any old business or concerns; none was noted.
6. Program Effectiveness Outcomes Data on the program effectiveness outcomes of the Respiratory Therapy Program was given in a handout and discussed. These are based on CoARC standards as well as RCC’s

standards. Vickie thanked the members for their help in getting the graduate surveys back. Employers return them soon, but they are very difficult to get them from students. We are held accountable for a 50% return rate; however, we received 100% of the surveys this year. CRT and RRT exams have been combined to form the Therapist Multiple Choice exam. CoARC is collecting data from TMC testing to establish appropriate thresholds. CoARC standards hold our program to three-year average results, not first time pass rates.

CoARC is developing new software and Vickie will send the members information from CoARC after receiving it form CoARC.

RCC will be hosting Kettering on April 29, 30 and May 1 in the Advanced Technologies Building. We have 13 students, but have openings for 35. The more people who take the test, the less expensive it will be. RCC students get a $100 discount for having it on our campus.

7. Program Curriculum A handout of the curriculum for fall 2019 was distributed. The program is now requiring credit for BIO 168, BIO 169 and CHM 131/CHEM 131A with a “C” or higher as program prerequisites. Candidates must have a 2.8 GPA or higher from all pre- requisites and respiratory therapy general education courses. Also, the applicants are asked if they have been in a previous health related program and if it was completed. If not, they are asked why it was not completed.
8. Status of Graduates Eleven students graduated in May and all are registered respiratory therapists and are employed.
9. Status of Current Students We enrolled 14 first year students this year and lost one this week. There are 13 students in the second-year class.
10. Program Enrollment and Demographics The Respiratory Therapy Report on fall 2018 enrollment data was reviewed. Sheila noted there are a lot more students from out of Rockingham County. Vickie said the second- year class has a higher maturity level and has several young students.
11. Program Resources

The college is redoing the web pages. Vickie is hoping to have a link on the Respiratory Therapy page to the IRR Moodle Shell.

Vickie asked for feedback concerning the best time of the year to meet. She may send out a Survey Monkey for feedback. Vickie was asked what the school is doing for recruitment. Vickie responded that faculty and students are participating in tours and showing the simulation hospital to perspective students. They are also participating in health fairs. The Respiratory therapy program has less students and therapists are retiring. Sheila says enrollment across the state is down.

Vickie thanked everyone for coming and supporting our program and students.

The meeting adjourned at 1:40 p.m.

Rockingham Community College Respiratory Therapy Program Advisory Committee Meeting October 11, 2019 12:00 p.m. Owens Health Sciences Building, Room 122

Attending: Vickie Chitwood, RCP Program Director; Ms. Sheila Regan, Vice President for Academic Affairs; Laura Jennings, Assistant Director of Enrollment; Angie Pruitt, Director of Clinical Education; Ruth Underwood, Adjunct Instructor; Kristen Samples, High Point Regional Hospital; Shonda Pulliam, graduate student representative; Macy Walker, 2nd year student representative; Katelyn Washington, 1st^ year student representative; Lisa Cutshaw, Novant Health - Forsyth Medical Center; Phillip Christmas, Kindred Hospital; Heather Kalil, Sovah Health - Danville; James Parramore, Sovah Health - Martinsville; Teri Hicks, Cone Health; Tina Lovings, Wake Health

Recorder: Katherine Leebrick, Health and Public Services Administrative Assistant

Prior to the official meeting, lunch was provided.

1. Call to Order Vickie Chitwood welcomed everyone and Kristen Samples officially opened the meeting.

2. Introductions Introductions were made.
3. Purpose Everyone was given the opportunity to read the advisory board purpose statement from the Commission on Accreditation for Respiratory Care.
4. Minutes Minutes of the previous meeting were reviewed and approved.
5. Old Business Vickie asked if there was any old business or concerns; none was noted.
6. Program Effectiveness Outcomes . The program faculty stated we have struggled with graduates passing the TMC at the high cut score the first time as well as the CSE. We have adjusted in the curriculum to address these issues such as devoting a special practice lab, information gathering and decision-making exercises, changing the Career Prep class to a 1 6 - week course and changing admission requirements for GPA to 2.8. Kettering will be offered in the spring as it has been in the past.

a. The first-year group is our first cohort with the 2.8 GPA requirement. b. CoARC is still collecting data for the threshold low/high cut scores for their accreditation purposes. c. The class of 2019 was a different type of student – they were happy just getting by no matter how we stressed the importance of time-management, study skills, and retaining the information. d. We are still teaching without calculators, but NBRC will allow students to use calculators in 2020. This could help our pass scores since students struggle with math. A calculator will pop up on the computer when answering math problems. Students, of course, still need to understand concepts and formulas. The students attending commented that being able to use calculators will help with anxiety. We have recently ordered basic calculators which students can use in class.

7. Program Curriculum a. We have implemented a special lab to help students with decision making, discussion and practice for the exam. b. There will be a 16-week Respiratory Therapy Board review online in the spring. We have changed this from 8-13 to 16 weeks for better preparation. This will consist of data analysis so that students will be told what they need to work on.

11. Program Resources Vickie thanked the clinical sites for donating lab supplies. We have purchased a PB 980 and V60 BIPAP and additional lab supplies as we need them. She informed members there are a number of resources for students which include tutoring on campus and in the learning management system (Moodle) Faculty are available one on one. Next year the first-year students will have a lab kit. Vickie tells students to look at the hospital equipment room and become familiar with the different types of equipment. Heather said they participated in a Trade Expo in Virginia with 7th^ and 10th^ grade students. The students had hands-on experiences. It was not just health fields represented. RCC will sponsor a Career Fair similar to that on April 2. Students will have 15 minutes at four stations.
12. Student Reflections Katelyn Washington, first-year representative, said faculty is available for students to talk with and are supportive. She likes the teamwork. Macy Walker, second-year student representative, has had a good experience. She is confident in clinical because of going over so much in lab. She suggested Todd come back the second year to go over the PFTs. Shonda Pulliam, graduate representative, is working with Cone. She enjoyed the program and said it feels rewarding to be a respiratory therapist.
13. Medical Director CoARC requires a medical director and we need a co-director. It is very important the director attend the advisory meetings. Our director is unable to attend the meetings; therefore, we take the minutes to him, review them with him and he signs them. He also lectures and has rounds with students when doing patient assessments. We need your assistance in acquiring a co-medical director. If you have any suggestions, please give us a name and contact information.
14. Objectives Ruth Underwood said the first-year students are working on oxygen therapy. They work well together and are working in groups and studying together. Angie Pruitt works with the second-year students and they have been going over ventilator graphics, clinical concepts and given scenarios to work together in groups during lab and also given neonatal scenarios. Vickie said pharmacology is online and she has had no complaints of it being online. Videos help and Pharmacology is incorporated in the labs.
15. Clinical Affiliates

Angie is trying to visit each clinical site. She would like to know if students are having trouble. We have great preceptors. Some would like to be paid. It can be overwhelming and she tries to remind students of that. Preceptors can receive 1 CEU per 12 hours of student contact, up to 3 CEU’s for 36 hours of student contact.

16. Inter-rater Reliability Inter-rater reliability standardizes the way students are evaluated during clinical rotations. In order for us to be compliant with COARC, we must have a student clinical experience handbook. We have completed that and have our public Moodle shell available to all clinical affiliates.
17. Other Business/Questions Kristen thanked us for keeping the lines of communication open and said everything is going well. Sheila asked for feedback concerning the four-day orientation. Katelyn thinks the idea is great.
18. Closing Remarks Vickie stated the program has met every standard. Also, she would like to have surveys returned with comments. We take suggestions seriously. Vickie thanked everyone for coming and supporting our program and students.

The meeting adjourned at 1:35 p.m.

3. What recommendations has the Advisory Committee made? a. A member of the program advisory committee (PAC) suggested that every applicant to the program should be interviewed prior to admission. This suggestion was made in an effort to avoid students that would most likely not be successful in the program, due to personality traits or interpersonal skills by assessing soft skills. b. There was also a suggestion to require job shadowing to allow potential students to experience the field of RT. c. It was also suggested that program faculty request an essay from each applicant detailing why they chose to study respiratory therapy; this would be included with their application. 4. Have the Advisory Committee recommendations been implemented? a. Program Faculty now requires each applicant to schedule a meeting with the Program Director. During this meeting, Program Director will inform the applicant of the expectations placed upon them during the program, related to professional