NBRC horizons 3rdqtr14 web

HORIZONS Third Quarter 2014

V. 40 / N. 3

CREDENTIALING FOR THE RESPIRATORY CARE PROFESSION

Q: A:

1–Jun 30, Jan 1–Jun 30, 2014 2013

2015 PFT Examination Changes FAQs 4

Scholarships Available!

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AARC Congress 2014 to be Held in Las Vegas, Nevada 6

Student Survivor Hour to be Held at the AARC Congress 2014 7

Annual Renewal Reminder

THE 2014 JIMMY A. YOUNG MEMORIAL LECTURE: THE CLINICAL SIMULATION EXAMINATION

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he NBRC has presented the Jimmy A. Young lecture each year since 1978 to honor the memory of a remarkable contributor to the respiratory care profession. Within the span of fifteen years, Jimmy went from being an on-the-job trainee to achieving the RRT credential (#263). He directed an education program in Boston, directed a department in one of Boston’s leading hospitals, became the 22nd President of the AARC, and was a trustee of the NBRC at the time of his unexpected death. Robert C. Shaw, Jr., PhD, RRT, FAARC, Assistant Executive Director and Psychometrician presented the 2014 Jimmy A. Young Memorial Lecture in Marco Island, FL on July 17th.

Dr. Shaw began the lecture by describing changes to the RRT credentialing system that relate to the table below. Dr. Shaw pointed out that most of the CRT program elements will remain the same.

NUMBER RRT Program Elements

Current

January 2015

Hours of testing time

9

7

Examinations

3

2

Testing sessions for a candidate who passes on first attempts

3

2

Sets of test scores

4

2

Passing points

7

4

3

Multiple-choice items to assess competencies broadly

240

140

Patient management problems to assess competencies deeply

10

20

10 (8-12)

5 (4-6)

Typical number of sections in a patient management problem

Examination Statistics for the First Half of 2014 8

Dr. Shaw continued his presentation by comparing the value of information that has been provided by results from the Clinical Simulation Examination to other elements of the RRT credentialing system. He did so by discussing two research hypotheses.

The first research hypothesis was that scores from the Clinical Simulation Examination

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70.0%

14.7%

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CLINICAL SIMULATION… º CONTINUED FROM PAGE 1 added information beyond the information from multiple-choice examination scores when predicting membership in three groups for candidates who sought the RRT credential. Dr. Shaw provided the following table to explain how the three groups (certification, certification+1, and registration) were formed.

Credential Status

Label for Group

EXAMINATION OUTCOME CRT

certification CRT RRT

certification +1

pass

registration

Written Registry

Clinical Simulation

fail

fail

pass

fail

fail

pass

pass

pass

Four sets of test scores from the population of about 9,000 candidates over a recent two and one-half year period were studied. The four test scores were associated with the following examinations: CRT, Written RRT, Clinical Simulation Information Gathering, and Clinical Simulation Decision Making. Dr. Shaw explained that the two clinical simulation examination subscores could be treated separately since each had its own passing score.

Discriminant analysis was applied to the data set, first with all four sets of scores and second with only the scores from the multiple-choice examinations. Dr. Shaw was interested in (1) the order in which variables were automatically entered into the model during the first run and (2) whether the results from the first run were more accurate than the second run.

The Decision Making subscores from the Clinical Simulation Examination were the strongest predictor of RRT outcomes followed by the scores from the Written RRT Examination. Coefficients associated with production of a discriminant score for each person indicated that both the Decision Making score and the Written RRT score were vital to the RRT credentialing system. After observing that the accuracy in predicting RRT outcomes was reduced by 7% when scores from the Clinical Simulation Examination were left out of the model, Dr. Shaw stated that this would yield between 500 and 600 inaccurate determinations of the RRT credential each year. Hence, removing the Clinical Simulation Examination from the system would be associated with increased patient risk.

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Published Quarterly by the NATIONAL BOARD FOR RESPIRATORY CARE, INC. 18000 W. 105th St. Olathe, Kansas 66061-7543 (913) 895-4900 Fax: (913) 895-4650 Email: nbrc-info@nbrc.org Website: www.nbrc.org NBRC Horizons is published quarterly to communicate information about the admission policies and procedures, the day-to-day activities, and the short-term and long-range plans of the National Board for Respiratory Care, the national certifying board for the respiratory care profession. The NBRC is sponsored by the American Association for Respiratory Care, the American Society of Anesthesiologists, the American Thoracic Society and the American College of Chest Physicians. Subscriptions to NBRC Horizons are free for active credentialed practitioners and $24 for inactive practitioners and others. Subscription forms can be obtained by contacting the NBRC Executive Office.

MEMBERS OF THE BOARD Doreen J. Addrizzo-Harris, MD, FCCP (ATS) Sherry L. Barnhart, RRT, RRT-NPS, FAARC (AARC) Todd G. Bocklage, MPA, RRT (AARC) Suzanne Bollig, RRT, RRT-SDS, RPSGT, R. EEG T., FAARC (AARC) William W. Burgin, Jr., MD, FCCP (ATS) Brian W. Carlin, MD, FCCP, FAARC (ACCP) Robin J. Elwood, MD, FAAP (ASA) Katherine L. Fedor, RRT, RRT-NPS, CPFT (AARC) Hyacinth M. Johnson, RN, BSN, MPA, RRT (AARC) David A. Kaminsky, MD, FCCP (ACCP) Carl A. Kaplan, MD, FCCP (ACCP) David C. Levin, MD, FCCP (ATS) Robert A. May, MD, FCCP (ACCP) Omid G. Moayed, MD, MBA (ASA) Carl D. Mottram, BA, RRT, RPFT, FAARC (AARC) Theodora K. Nicholau, MD, PhD (ASA) Donald S. Prough, MD, FCCP (ASA) Gregg L. Ruppel, MEd, RRT, RPFT, FAARC (AARC) Robert A. Sinkin, MD, MPH, FAAP (ATS) Mark S. Siobal, BS, RRT, FAARC (AARC) David L. Vines, MHS, RRT, FAARC (AARC) Teresa A. Volsko, MHHS, RRT, FAARC (AARC)

Copyright © 2014. The National Board for Respiratory Care, Inc. Permission must be secured in writing to reprint any portion of this issue. State societies for respiratory care, respiratory care education programs and state licensure agencies may reprint any portion of this publication in their newsletter provided they mention the source.

EXECUTIVE COMMITTEE Carl F. Haas, MLS, RRT, RRT-ACCS, CPFT, FAARC (AARC), President Alan L. Plummer, MD, FCCP, FAARC (ATS), Vice President Linda A. Napoli, MBA, RRT, RRT-NPS, RPFT (AARC), Secretary Robert A. Balk, MD, FCCP (ACCP), Treasurer Kerry E. George, MEd, RRT, RRT-ACCS, FAARC (AARC), Past President PUBLIC ADVISOR John R. Garrison, MPA MEMBERS-AT-LARGE Susan B. Blonshine, BS, RRT, RPFT, AE-C, FAARC (AARC) Robert L. Joyner, Jr., PhD, RRT, RRT-ACCS, FAARC (AARC) Stephen A. Stayer, MD (ASA)

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TRUSTEE EMERITUS H. F. Helmholz Jr., MD, FAARC Robert M. Lawrence, MD Theodore Oslick, MD, FCCP, FAARC CHAIRMAN OF NBRC PUBLIC RELATIONS AND PUBLICATIONS COMMITTEE Carl Mottram, BA, RRT, RPFT, FAARC (AARC) STAFF Gary A. Smith, RRT (Hon), FAARC, Chief Executive Officer and Executive Director Lori M. Tinkler, MBA, Chief Operating Officer and Associate Executive Director Chelsea Earhart, MBA, Assistant Executive Director Robert C. Shaw Jr., PhD, RRT, FAARC, Assistant Executive Director Homer Rodriguez, RRT, Director, International Affairs Ami Lucky, Administrative Support Specialist Scott M. Hermansen, CPA, Chief Financial Officer Glenda Hocker, Executive Assistant Nancy Sachen, Administrative Assistant

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CLINICAL SIMULATION… º CONTINUED FROM PAGE 2 Dr. Shaw transitioned to a second line of research that investigated whether the four sets of examination scores loaded onto only one principal component. Only one component emerged from the analysis, which confirmed the hypothesis that all of the current examinations associated with the RRT credential are assessments of the ability to provide respiratory care. While that may seem like an obvious conclusion, using multiple examinations brings a risk that the simulation examination scores could have coalesced on a different component than the one on which multiple-choice examination scores loaded. Alternatively, RRT examination scores could have hung together while CRT examination scores loaded onto a different component.

Considering results from the two studies together, the NBRC can be confident that the RRT credentialing system was strengthened by collecting information about candidates’ abilities from multiple examinations while avoiding the risks that could be linked to using more than one examination.

In the final portion of the presentation, Dr. Shaw described features of the new 20-probem Clinical Simulation Examination for which candidates should be prepared by January 2015. Dr. Shaw explained that keeping the examination content current after a decade had become an increasing challenge. The NBRC chose to solve this challenge by halving the number of sections in problems and doubling the number of problems in the examination while maintaining the four-hour assessment experience.

Additional changes will occur at Dr. Shaw’s urging. First, the specifications for assembling each test form will permit less variability. At present, 70% of the problem types are mandated; going forward 100% will be mandated. Second, points associated with responses in information gathering and decision making sections will be accumulated together into a grand score rather than separately calculated and compared to two passing points. Dr. Shaw explained that a test with more items and more points than its predecessors will yield more accurate scores as indicators of candidates’ abilities, and thus pass and fail decisions become more accurate.

The total number of information gathering and decision making sections that candidates experience across the whole examination will remain as they have been. However, candidates may experience some patient problems on the new examination that include no information gathering sections. Dr. Shaw urged audience members to help get the word out about this change. Otherwise, some candidates might wrongly assume that a technical flaw had occurred while they were taking the examination, which could disrupt their test-taking experience.

Lastly, Dr. Shaw described the implications that will be associated with a change to the policy that is associated with the determination of a passing level. The range for decision making passing levels remains unchanged at 60% to 70%. However, instead of passing levels falling between 60% and 70% for information gathering sections as in the past, they will fall between 77% and 81%. Dr. Shaw illustrated how the scoring system for one information gathering section will be affected by the policy change. He also illustrated the fact that information gathering responses will likely influence success on the Clinical Simulation Examination starting in January of 2015. In contrast, information gathering responses have rarely affected success prior to 2015. Dr. Shaw expressed hope that this will be another change for which candidates will be prepared.

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PULMONARY FUNCTION TECHNOLOGIST EXAMINATION FAQ’S Q: What changes are being made to the CPFT and RPFT

All NBRC multiple-choice examinations contain questions that are being pretested for use in future versions of the examination.

Examination programs in 2015?

A:

The CPFT and RPFT credentialing programs will transition to a single examination, with two-cut scores in June 2015. The new examination for pulmonary function technologists will contain 115 multiple-choice (100 scored, 15 pretest), four-option items, which candidates will take within a two-hour time limit.

Q: How long is the new examination?

A: The testing time for the PFT Examination is two hours.

Q: What do the cut scores mean?

A: There will be two established cut scores for the PFT

Q: What is the rationale for changes to CPFT and RPFT

Examination. If a candidate achieves the lower cut score, they will earn the CPFT credential. If a candidate achieves the higher cut score, they will earn the RPFT credential.

Examinations?

A:

A recent assessment of overlapping content between examinations for the CPFT and RPFT programs revealed a similar result as had been observed when the same kind of assessment was made for CRT and RRT programs three years ago. Among tasks that the 2006 CPFT and RPFT job analyses had found were critical to assess in examinations, more than 95% of tasks were critical for both the CPFT and RPFT programs. In other words, the vast majority of content that was critical to the assessment of RPFT competencies also were critical to assessments of CPFT competencies.

NBRC trustees interpreted this result as evidence of sufficient convergence between what had been more strongly distinct roles for persons holding the CPFT and RPFT credentials in the past.

Q: When is the last opportunity to apply to take the current CPFT and RPFT Examinations?

A: The last date applications will be accepted for the current

examination is February 28, 2014. These applicants must schedule testing appointments before June 2015. Applications received on or after March 1, 2015 will be processed with an eligibility start date of June 15, 2015.

Q: What are the admission requirements for the Pulmonary Function Technologist Examination (PFT)?

A: 1. Applicants shall be 18 years of age or older.

2. Applicants shall satisfy ONE of the following requirements: a. Have a minimum of an associate degree from a respiratory therapy educational program; 1) supported or accredited by the Commission on Accreditation for Respiratory Care (CoARC); or 2) accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and graduated on or before November 11, 2009.

OR b. Be a Certified Respiratory Therapist (CRT) or Registered Respiratory Therapist (RRT) credentialed by the NBRC. OR c. Complete 62 semester hours of college credit from a college or university accredited by its regional association or its equivalent, including college credit level courses in biology, chemistry and mathematics. A minimum of six months of clinical experience in the field of pulmonary function technology is also required prior to applying for the examination.

Q: When will the new examination be available?

A: June 15, 2015 Q: What are the examination fees?

A: The PFT Examination will cost $200 for new applicants and $170 for repeat applicants.

Q: Is a Self-Assessment Examination available?

A: The Self-Assessment Examination will be available for the PFT Examination on January 1, 2015.

Q: Is a practice test available?

A: A free practice examination is available to candidates

at no charge to familiarize themselves with the content and types of questions that will be included on the regular exam.

The free PFT practice examination will be available from our website in October 2014.

Q: How many questions are on the PFT Examination?

A: 115 multiple-choice questions will be presented on the examination, 100 scored items and 15 pretest questions.

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2015 EXAMINATION CHANGES… º CONTINUED FROM PAGE 4

Q: What is the application process for the new examination?

A: Starting June 15, 2015, you may apply online using the

OR d. Be a Certified Pulmonary Function Technologist (CPFT) credentialed by the NBRC (for those individuals attempting the examination to achieve the higher cut-score and earn the RPFT credential).

I have already earned the CPFT credential but not the RPFT credential. What do I do now?

A: Any candidate who wishes to earn the RPFT credential

‘Submit Application’ link located on each examination page or complete and submit a paper application and appropriate fee when the admission requirements are satisfied. If mailing your application, the NBRC recommends using certified mail or a certificate of mailing and keeping your receipt as proof that your application was sent to the NBRC. Ineligible applications submitted to the NBRC will be returned, less a $50.00 processing fee.

Q: How will the examination changes affect the Continuing

the lower cut on the PFT Examination, will I lose my CPFT credential?

Q:

will need to take the PFT Examination and pass at the higher cut score.

Q: If I currently hold the CPFT credential and score below

Competency Program?

A: No. You can retake the PFT Examination as many times

A:

All credentials earned on or after July 1, 2002 are subject to recertification. Practitioners that earn the CPFT and/or RPFT credentials after 2015 will still be required to demonstrate their continued competence through the NBRC’s Continuing Competency Program (CCP). Practitioners can also retake and pass the respective examination for the highest credential held that is subject to the CCP. If that credential is the RPFT credential, individuals will need to retake and pass the PFT Examination at the higher cut score to recertify their RPFT credential.

as necessary to earn the RPFT credential without impacting the status of your current CPFT credential.

If you have any additional questions, please feel free to contact us at 888.341.4811 or nbrc-info@nbrc.org. m

APPLY NOW! LAMBDA BETA SCHOLARSHIP – DEADLINE IS OCTOBER 1, 2014

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ust a reminder that the deadline for Lambda Beta Scholarships is fast approaching! Several scholarships are available through the Lambda Beta Society. Each year, the Lambda Beta Society – the academic honor society for respiratory care – awards these scholarships to recognize and encourage academic excellence in respiratory care. If you are a student in an accredited respiratory care education program or are completing an advanced degree or a research project applicable to credentialing or education, the NBRC encourages you to apply for one of the available education recognition or research awards.

Applications are available from all Lambda Beta active chapters or through accessing the application page on the Lambda Beta website, and are due October 1, 2014. Click here to access the Lambda Beta Society Awards application. This year, the awards will be announced at the AARC Congress 2014 in Las Vegas, Nevada.

To apply for one of the Lambda Beta Scholarships, students should contact Glenda Hocker at the Lambda Beta Executive Office, 913.895.4610, 18000 W. 105th St., Olathe, KS 66061.

Go to http://lambdabeta.org/Pages/default.aspx for more details and requirements for each scholarship.

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HORIZONS R

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AARC CONGRESS 2014 TO BE HELD IN LAS VEGAS, NEVADA

espiratory therapists, physicians, nurses, and other healthcare providers and leaders from all over the world will gather December 9-12, 2014 for the AARC Congress 2014 at the Mandalay Bay Resort and Convention Center in Las Vegas, Nevada. Participating in four full days of educational programs with the ability to interact with faculty and other professionals in the field ensuring a great time and learning experience at the convention.

Connect with us at the NBRC booth at the largest respiratory care meeting in the world. Meet NBRC staff and have your questions answered regarding upcoming changes to the examinations, the Adult Critical Care Specialty Examination, the RRT Three-Year Time Limit for Eligibility, compliance with the Continuing Competency Program requirements and more. Exhibitors, including the NBRC and the Lambda Beta Honor Society, will be representing all aspects of the respiratory care industry and will be available on the convention floor. For those who have never participated, this event is a must. We expect the AARC Congress 2014 will be the best to date!

Don’t miss this important event in respiratory care! We look forward to your participation in the AARC Congress 2014 and hope to see you at the NBRC booth. Online registration is available at www.aarc.org.

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STUDENT SURVIVOR HOUR TO BE HELD AT THE AARC CONGRESS 2014 Students are once again invited to attend the popular Student Survivor Hour at the AARC Congress 2014 in Las Vegas, Nevada. The NBRC will co-host this valuable meeting for respiratory care students on Tuesday, December 9th, from 5:00 p.m. to 6:00 p.m. at the Mandalay Bay Resort and Convention Center.

This meeting will feature speakers representing the NBRC, AARC, CoARC, and Lambda Beta, and gives students an opportunity to find out what is in store for them as graduates of respiratory care education programs. Navigating the road from student to a credentialed practitioner active in the field of respiratory care can be challenging. Interacting with speakers representing the education, credentialing, and professional association areas of respiratory care will be an invaluable experience for students during this critical time of their professional development.

For students who have never participated, Student Survivor Hour is a must. We hope to see you at Student Survivor Hour and the AARC Congress 2014!

ANNUAL RENEWAL REMINDER 2014 RENEWAL DEADLINE APPROACHES! IMPORTANT NOTICE: The 2014 renewal cycle is quickly coming to a close. Renew now to utilize the benefits of keeping your status active.

Holding active status in the national groups of practitioners credentialed by the NBRC means you care about protecting your professional future. Your annual renewal fee helps the NBRC work for uniform licensure and develop examinations that uphold the standards of the respiratory care profession. Active status also has many other benefits:

●● Recognition

in the NBRC Directory and access to professionals across the country ●● An online subscription to NBRC Horizons, an informative quarterly newsletter communicating credentialing developments ●● Reduced fees for services and recredentialing examinations ●● For credentials that are subject to the Continuing Competency Program (CCP), keeping active status for all five years of the credential term allows participation in the CCP via the CEU route at no additional cost ●● Representation with major organizations and state agencies that impact the respiratory care profession ●● A voice in the future of your profession ●● Annual gift of appreciation To renew your 2014 active status online and update your contact information, please visit the NBRC’s website at www.nbrc.org or contact the Executive Office at 913.895.4900 or by email at nbrc-info@nbrc.org.

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EXAMINATION STATISTICS FOR THE FIRST HALF OF 2014

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uring the first six months of 2014, the NBRC administered 20,853 credentialing examinations and awarded a total of 9,040 new CRT, RRT, CPFT, RPFT, Neonatal/Pediatric Specialist, Sleep Disorders Specialist and Adult Critical Care Specialist credentials. Following are the examination statistics for each respective NBRC examination program.

CRT Examination Six thousand nine hundred and ninety-seven (6,997) candidates attempted the CRT Examination in the first half of 2014. A total of 4,735 individuals earned the CRT credential January 1 through June 30, 2014. As of publication, the total number of CRTs is 229,474.

RRT Examinations The RRT Examination consists of the Written Registry and Clinical Simulation Examinations (CSE). In the first half of 2014, 6,539 individuals attempted the Written Registry Examination and 6,110 candidates attempted the Clinical Simulation Examination. Three thousand four hundred and sixty (3,460) individuals earned the Registered Respiratory Therapist (RRT) credential by successfully completing both portions of the examination. A total of 139,013 practitioners have earned the RRT designation.

PASS RATES COMPARED

Below are the passing percentages for the NBRC credentialing examinations given January 1 through June 30 of 2012, 2013, and 2014. As the pass rates reflect, the percentages of first-time candidates passing the NBRC credentialing examinations have remained relatively stable.

Jan 1–Jun 30, Jan 1–Jun 30, Jan 1–Jun 30, 2014 2012 2013

CRT Examination Entry Level Graduates: New Candidates

66.7%

70.0%

68.8%

Repeat Candidates

14.7%

14.7%

13.5%

Advanced Level Graduates:

Pulmonary Function Technologist Examinations

New Candidates

82.7%

82.6%

84.2%

One hundred eighty-nine (189) candidates attempted the CPFT Examination during the first half of 2014, with 135 individuals earning the entry-level pulmonary function technologist credential. From January 1 through June 30, 2014, 28 CPFTs achieved the advanced RPFT credential.

To date, there have been 13,005 CPFTs and 4,353 RPFTs credentialed.

Repeat Candidates

26.5%

26.1%

26.1%

New Candidates

68.2%

70.4%

71.5%

Repeat Candidates

32.2%

33.3%

34.7%

New Candidates

66.7%

65.8%

64.4%

Repeat Candidates

52.8%

49.8%

49.8%

New Candidates

77.4%

70.1%

80.7%

Repeat Candidates

31.1%

61.0%

40.9%

New Candidates

85.4%

48.3%

60.6%

Repeat Candidates

40.0%

50.0%

53.3%

Neonatal/Pediatric Specialty Examination Five hundred and eighty-two (582) CRTs and/or RRTs attempted the Neonatal/Pediatric Specialty Examination during the first half of 2014.

Three hundred and sixty-four (364) individuals earned the CRT-NPS or RRT-NPS designations. Since this specialty examination began, 12,196 practitioners have achieved the CRT-NPS or RRT-NPS credentials

Sleep Disorders Specialty Examination Forty-one (41) CRTs and/or RRTs attempted the Sleep Disorders Specialty Examination during the first half of 2014 and 38 practitioners earned the CRT-SDS or RRT-SDS credentials. This specialty credential has been earned by a total of 285 practitioners.

Adult Critical Care Specialty Examination Three hundred and forty-seven (347) RRTs attempted the Adult Critical Care Specialty Examination. A total of 280 individuals earned the RRTACCS credential January 1 through June 30, 2014. This new specialty credential has been earned by a total of 717 individuals.

The Board of Trustees extends congratulations to the respiratory care professionals earning the 9,040 new credentials awarded by the NBRC during the first half of 2014. The NBRC has now awarded 399,043 credentials since its formation in 1960.

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RRT Written Examination

RRT CSE Examination

CPFT Examination

RPFT Examination

Neonatal/Pediatric Specialty Examination New Candidates

67.4%

72.1%

69.9%

Repeat Candidates

44.6%

46.8%

43.9%

Sleep Disorders Specialty Examination New Candidates

88.9%

85.0%

94.6%

Repeat Candidates

0.0%

60.0%

75.0%

Adult Critical Care Specialty Examination New Candidates

N/A

86.4%

84.4%

Repeat Candidates

N/A

47.1%

51.3%