Thomas M. Fuhrman, M.D., M.M.Sc., F.C.C.M., F.C.C.P., Chair
Committee on Respiratory Care

he ASA Committee on Respiratory Care is the official avenue through which ASA maintains its influence within the domain of the respiratory care practitioner (RCP). ASA and its members have always been involved as RCPs have progressed from being oxygen cylinder delivery technicians right through the heyday of intermittent positive pressure breathing to the present and future of critical care and with the growing importance of home health care.

A principal charge of the Committee on Respiratory Care is the appointment of representatives to organizations that rely on ASA for guidance as they further the field of respiratory care. These organizations include the National Board for Respiratory Care (NBRC), the Board of Medical Advisors (BOMA) to the American Association for Respiratory Care (AARC) and the Committee on Accreditation for Respiratory Care (CoARC). ASA representatives in turn are active and vital members of these organizations.

Those formal organizations with ASA representation work in consultation with AARC, the parent organization. Meetings between the organizations are undoubtedly assisted by the ASA Committee on Respiratory Care members who use their advisory capacities to facilitate the promotion and education of respiratory care.

Five members of ASA represent our Society on NBRC. This organization is responsible for developing, writing, editing and administering examinations for credentialing RCPs as registered respiratory therapists (RRTs), certified respiratory therapists (CRTs), certified and registered pulmonary function technologists and neonatal/pediatric RC specialists. The CRT examination is recognized as the basis for licensing in 48 states. NBRC administered 25,298 examinations to RCP candidates in 2006 through its secure computer-based testing system.

Two members represent ASA on the Committee on Accreditation for Respiratory Care (CoARC). CoARC is responsible for ensuring that respiratory therapy education programs comply with the standards adopted by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). All respiratory therapy educational programs are accredited through CoARC reviews and site visits. (Several former and present Committee on Respiratory Care members also serve as volunteer site visitors for CoARC.)

ASA has four representatives to the AARC Board of Medical Advisors. (Other societies with representatives on BOMA include the American Thoracic Society, the American College Chest Physicians, the American Academy of Pediatrics, the American College of Allergy and Immunology and the Society of Critical Care Medicine.)

The Committee on Respiratory Care also is responsible for providing annual reports of activities of NBRC, CoARC and BOMA to the ASA membership. These reports are presented to and reviewed by the House of Delegates at the ASA Annual Meeting.

The ASA Committee on Respiratory Care is chaired by Thomas M. Fuhrman, M.D., Professor of Anesthesiology and Perioperative Medicine at the Medical College of Georgia. Dr. Fuhrman, C. Alvin Head, M.D., the former chair of the Committee, and past committee member Robert A. May, M.D., were all respiratory therapists prior to medical school.

What’s new in the field of respiratory care? Currently NBRC is undertaking a very thorough study that may result in a credential for RCPs working in the specialized area of sleep disorder testing and therapeutic intervention. Also, of special interest to ASA members involved in critical care, NBRC has had a request to consider an adult critical care specialty examination by AARC. When such requests are received from NBRC sponsors such as AARC, the Board of Trustees follows a five-step process in considering the matter. The first step with respect to a possible adult critical care specialty examination, a viability study, was conducted on September 16-17, 2006, by a committee of experts representing organizations interested in respiratory care and, more specifically, adult critical care (including several ASA members).

If it is decided to move to the next step, a personnel survey will seek to determine an accurate estimate of the number of respiratory therapists performing adult critical care, their typical job titles and other significant information. The results of the personnel survey would then be used by NBRC to further evaluate whether or not a sufficient population exists to support the development of a specialty credentialing examination in adult critical care.

Next a job analysis/test specification (role delineation) is performed. This concerns research that determines the tasks performed by practitioners in a particular job and identifies the more important tasks for testing on national examinations. Then NBRC will undertake examination development from test specifications — that is, construction of questions that are directly linked to job analysis tasks.
Finally the validation study is performed, which will determine the correlations between an individual’s job performance as rated by an immediate supervisor and that individual’s examination score (criterion-related or predictive validity). Also, content validity is documented by the linking of test questions to important job tasks.

Only after all of those important steps will a credential in critical care be offered by NBRC. This may take several years, but the field of respiratory care will be enhanced by this project and the efforts of the members of the Committee on Respiratory Care.

Thomas M. Fuhrman, M.D., M.M.Sc., F.C.C.M., F.C.C.P., is Professor of Anesthesiology and Perioperative Medicine and Residency Program Director, Medical College of Georgia, Augusta, Georgia.