Learning and Respiratory Care Problem-Based

¶ … Learning and Respiratory Care Problem-Based Learning Approach to Teaching Respiratory Care The field of medicine is rapidly changing as new treatment options become available and technology advances. Therefore, healthcare education programs must be able to meet the needs of students in these fields and create a flexible curriculum that can change as clinical practice evolves. Problem-based learning approach was introduced teach critical thinking and decision-making skills to respiratory therapists through the direct application of theory to practice.

In respiratory therapy, where a practitioner's role has evolved from passive to becoming an active part of the treatment team, these skills are becoming increasingly important. Teaching Respiratory Therapy through Problem-Based Learning Approach Allied healthcare professionals including respiratory therapists are increasingly in demand due to the steady growth in the number of patients, possibly due to the aging of the baby boom era, that are presenting themselves to the healthcare system (Andrews, Byington, Masini, Keene, & Burker, 2008).

Yet studies have shown that respiratory care education programs have a higher attrition rate than that of other allied health professions (Andrews et al., 2008). This increasing demand for respiratory professionals is not currently being met through traditional education means which has led to the exploration of alternative techniques to engage and retain students (Murphy, Hartigan, Walshe, Flynn, & O'Brien 2010). The goal of any teaching program is to prepare students for the ability to effectively interact with the ever changing expectations of their profession (Murphy et al. 2010).

This is true in the field of respiratory therapy which has undergone major changes over the last five decades due to rapid advancements in technology, information available to consumers, and the aging of the population (Ceconi, Op't Holt, Zip, Olson, & Beckett, 2008). Respiratory therapists have become increasingly responsible for the assessment of their patients condition, making judgments about the appropriate course of treatment, and evaluating the effectiveness of treatment through patient outcomes, modifying the treatment plan where necessary (Hill, 2002).

This requires that these therapists have a high level of critical thinking, assessment, and problem solving skills (Hill, 2002). Traditionally training programs for respiratory therapists took place in hospital settings where the educators were physicians and practitioners (Hill, 2002). These programs typically lasted under a year. Over time, respiratory therapy programs transitioned to accredited colleges as undergraduate programs and are now taught by educators that are not only practitioners but also are well trained in the theories of classroom instruction (Hill, 2002).

These programs must work to meet the increasing demands of the healthcare industry including the documentation of positive outcomes, cost containment, and efficient patient care (Hill, 2002). The programs must give respiratory therapists the skills necessary to think critically and make decisions rather than simply follow a physicians orders (Hill, 2002). Problem-based learning (PBL) has emerged as a student focused technique for use in educating respiratory therapists as well as other medical professionals.

PBL emerged out of the work of Harold Barrows who acknowledged that students needed alternative learning methods in order to convert the subject matter learned in their classes into clinical practice (Rogal & Snider, 2008). PBL has been developed out of the constructivist theory of education in which learning is active knowledge development where interaction is utilized to foster the incorporation of new information into existing knowledge (White et al., 2004; Beachey, 2007). Traditional classroom curriculum emphasizes the presentation of content information and concepts through lecture format.

Students are then expected to analyze, prioritize, and structure this new knowledge (Hill, 2002). Individual classes have specific focuses and learning curricula planned with specific knowledge content as the desired result. In this model, the professor is the expert on the information and determines how the classroom interactions and what activities will take place. Students are expected to take course content and apply it to real life scenarios. On the other hand, the PBL method relies on real life problems to facilitate a self-directed learning process (Beachey, 2007).

The PBL learning environment is student focused with the student partnering in the learning process through the use of real life scenarios to uncover solutions and create their own knowledge (Mishoe, 2007, Beers, 2005; Beachey, 2007). This approach gives the student responsibility for analyzing information and communicating it to other students in their class (Beers, 2005). Specific content information is not necessarily introduced into the classroom rather the knowledge obtained comes specifically from solving the individual case presented.

In the PBL model, the application of learning may be limited to the current situation due to its emergence from a specific scenario. In this manner, the traditional learning method has broader applicability because the information is introduced in a more general context. PBL has been incorporated in various degrees into the curricula for allied health, nursing, and medical professions (Beachey, 2007). Some educational institutions such as ____ have take the purist PBL approach, while others have created a hybrid case-based program that seeks to maximize resources (Mishoe, 2002).

Researchers have distinguished purist PBL as being concerned with solving a presenting problem whereas case based and hybrid programs have integrated content knowledge and resources into the problem solving process (Mishoe, 2002). Hwang and Kim (2006) identify that the lack of evidence-based research on the efficacy of PBL on learning outcomes as one of the factors that have led to the design of hybrid models.

Literature suggests that the goal of this integration of PBL is to develop illustrative models and learning cues that can be utilized for rapid recall when in a clinical context allowing previously learned information to be transferred to the current situation (White et al., 2004; ). It is hypothesized that PBL will enhance the critical thinking and decision making skills of respiratory therapists and a result should be applied in the education of these professionals.

The literature regarding the efficacy of PBL for teaching respiratory therapy is divided with proponents claiming that there are significant benefits while others claim that it is not better than traditional approaches to learning. Hwang and Kim (2006) conducted one of few studies that showed a significant relationship between PBL and the clinical knowledge scores of students compared to their counterparts who received traditional lecture education methods. These advantages included the acquisition and retention of information regarding basic clinical reasoning, clinical knowledge, and independent learning (Hwang & Kim, 2006).

The goal of the respiratory programs compared here is to prepare respiratory therapists to operate at the Registered Respiratory Therapist (RRT) level. Students must also be prepared to take and pass the NBRC Clinical Stimulation examination (CSE) as part of the credentialing process. This is an area where studies have shown that PBL students have scored equal to or higher than their traditionally educated peers and in fact some studies have shown student scores at a rate that is higher than the national average (Beers, 2005; Distlehorst, 2005; Op't Hoyt, 2005; Beachey, 2007).

____ ( ) found that the rate of PBL students passing the CSE was 68% as compared the 53% in traditional curriculum students. Ceconi et al. (2008) also explored students exposed to either traditional curricula or PBL and found that there were statistically significant differences in examination scores between the two curricula with the PBL students having higher mean scores, therefore supporting the integration of PBL in respiratory care programs.

Further studies showed that PBL curriculum enhances the development of decision making skills in respiratory care through the use of case studies to provide stimulus for the specific issue that the lesson introduces (Ceconi et al., 2008; Op't Hoyt, 2005). Students in the PBL program engage in self-directed learning, a process by which they must continually seek out information through research to solve these real life case scenarios (Beers, 2005; Op't Hoyt, 2005).

PBL students learn in small groups with a faculty tutor or facilitator where information is obtained in a progressive-disclosure model (Op't Hoyt, 2005). Students are assessed through the use of written examinations, self- and peer evaluation, and with an individual case study method (Op't Hoyt, 2005). This.