Abstract
-
Purpose
Respiratory therapy (RT) has become a vital component of modern healthcare, particularly in managing acute and chronic pulmonary conditions. The rising global burden of respiratory diseases has amplified the demand for skilled RT professionals capable of performing high-risk, low-frequency procedures with precision. Despite the shift toward competency-based education in healthcare, RT training remains fragmented. Disparities in training quality, assessment methodologies, and simulation access result in inconsistent clinical competencies among RT graduates. The absence of a standardized, globally recognized competency framework further compounds these challenges, affecting workforce readiness and patient safety. To date, no global study has systematically quantified competency disparities across RT programs using a standardized framework, leaving a critical gap in comparative evidence needed to guide educational policy and global accreditation.
-
Methods
A cross-sectional survey was conducted targeting RT professionals, educators, and institutional leaders across multiple countries. Quantitative data were analyzed using descriptive statistics, chi-square tests, and gap percentage analysis to identify variations in training practices, competency expectations, and observed deficiencies.
-
Results
Findings revealed significant competency gaps, especially in advanced interventions like extracorporeal membrane oxygenation and lung ultrasound. Inconsistencies in assessment tools, simulation integration, and remediation protocols were noted across institutions. The majority of respondents emphasized the need for competency standardization.
-
Conclusion
The study confirms a pressing global need for a structured, evidence-based competency framework in RT education. Standardization will improve clinical consistency, facilitate workforce mobility, and enhance patient care outcomes worldwide.
-
Key Words: Clinical competence, Competency-based education, Professional education, Respiratory therapy, Simulation training
Introduction
Respiratory therapy (RT) profession has become increasingly important in managing both acute and chronic cardiorespiratory conditions. The rising prevalence of respiratory diseases such as asthma, chronic obstructive pulmonary disease, and interstitial lung diseases has significantly increased the demand for respiratory therapists (RTs). Acute conditions like acute respiratory distress syndrome and ventilator-associated complications such as ventilator-associated pneumonia and lung injury require specialized management due to their complex pathophysiology and critical care challenges, also reflects the need for highly skilled RTs. The COVID-19 (coronavirus disease 2019) pandemic further highlighted the critical role of RT professionals in managing complex ventilatory and extracorporeal life support procedures, emphasizing their importance in acute care settings [
1,
2].
Cornerstone to meeting these evolving healthcare demands are well-designed, comprehensive RT educational programs that equip graduates with advanced clinical skills, critical thinking, and evidence-based knowledge required for effective patient care. These programs ensure a competent workforce capable of delivering safe, high-quality care across diverse clinical settings, ultimately improving patient outcomes and advancing the profession globally.
RT education has transitioned significantly from informal apprenticeship models to structured competency-based education (CBE). CBE frameworks emphasize comprehensive competencies, combining cognitive knowledge, practical skills, and professional behaviors under diverse clinical conditions. This shift occurred due to inadequacies in traditional methods, which often relied on subjective evaluations and inconsistent clinical training. Despite the proven effectiveness of CBE in improving skill retention and procedure accuracy, global implementation remains uneven, causing variability in graduates’ readiness for clinical practice [
3].
Simulation-based education has emerged as an effective alternative to real-world clinical training, particularly for practicing high-risk, infrequently performed procedures. Various immersive methods, such as manikin simulations, augmented and virtual reality, and standardized patient interactions, have significantly improved skill retention and teamwork [
4,
5]. Despite its benefits, the adoption of simulation-based education in RT faces challenges such as high costs, limited equipment, lack of trained faculty, and unclear regulatory and implementation guidelines.
Globally, the lack of unified standards for RT competencies leads to inconsistent training and assessments. Although some national bodies, like the Commission on Accreditation for Respiratory Care (CoARC, USA), provide standards, these are not universally applicable [
6].
This study highlights the global inconsistency in RT education, emphasizing the need for a standardized, simulation-based competency framework. It identifies key gaps in training, assessment, and remediation that affect care quality and patient safety. The goal is to support a data-driven, globally adaptable model to unify RT education and practice. The main objectives are as follows: (1) to assess global variability in RT competency practices, focusing on gaps in high-risk, low-frequency procedures and simulation access; (2) to analyze links between experience, qualifications, and perceived competency readiness among RT leaders; and (3) to develop a data-driven, globally adaptable framework for standardized, simulation-integrated RT education and assessment.
2. Literature review
The evolution of CBE in healthcare has marked a paradigm shift from traditional didactic instruction to outcomes-focused training, aimed at producing clinically competent, adaptive, and ethically grounded professionals. CBE aligns educational outcomes with clearly defined clinical roles, ensuring that learners not only acquire knowledge but demonstrate proficiency in real-world performance. In RT, this transition has been driven by the increasing complexity of care, the expansion of interprofessional roles, and the demand for global workforce mobility. Despite these advancements, heterogeneity persists in how competencies are defined, taught, and assessed across training programs and national boundaries. This literature review synthesizes recent empirical and theoretical contributions between 2020 and 2025 to examine the current landscape of CBE in RT and allied fields, identify gaps, and frame the need for a globally harmonized competency framework.
Alismail and López [
7] explored the integration of Entrustable Professional Activities (EPAs) within CBE frameworks for Advanced Practice Respiratory Therapists. By aligning EPA design with CoARC-defined competencies, the authors emphasized the importance of structured assessment tools to evaluate clinical readiness and ensure safe task delegation in advanced practice roles. This approach offers a model for scalable competency validation in RT education.
From the broader allied health perspective, Tovin [
8] advocated for system-wide adoption of CBE across physical therapy education. He emphasized its role in producing reflective, adaptable, and socially responsive practitioners. However, the study also highlighted structural impediments to implementation, such as accreditation rigidity, faculty resistance, and imprecise assessment tools-issues that resonate with challenges observed in RT programs.
Henriksen et al. [
9] applied a Delphi methodology to derive consensus on core competencies in respiratory nursing using Kern’s curriculum development framework. Their findings suggested that a nationally standardized curriculum could directly improve care quality and patient safety by closing existing educational gaps, further substantiating the need for a unified, consensus-driven model applicable to RT as well.
Jones et al. [
10] focused specifically on RT programs and surveyed 136 accredited institutions to assess the inclusion and evaluation of critical non-technical competencies, such as communication, interprofessional collaboration, and telehealth. The study revealed significant variability in how these skills are embedded and assessed, particularly across degree levels, underlining a systemic inconsistency in competency expectations.
Feng et al. [
11] tested the integration of a multidisciplinary teaching model with CBE in a respiratory rehabilitation context through a randomized controlled trial. Statistically significant improvements (p<0.05) in theoretical knowledge, core competencies, and learner satisfaction confirmed that combining interdisciplinary instruction with competency frameworks can optimize both cognitive and procedural learning outcomes.
Sreedharan et al. [
12] conducted a narrative review on simulation-based education in respiratory care, emphasizing its critical role in bridging the theory-practice gap. They reported that simulation enhances procedural accuracy, clinical reasoning, and learner confidence, particularly in high-risk, low-frequency interventions. This underscores the importance of incorporating structured simulation into CBE models for RT.
In a pediatric context, Akl et al. [
13] evaluated competency-based training for nurses administering oxygen to infants with respiratory disorders. The intervention led to a statistically significant increase in post-intervention competence scores (p<0.001), showcasing how structured CBE programs can improve safety and performance in high-stakes environments-reinforcing the model’s transferability to RT practice.
Patel et al. [
14] assessed a structured RT residency program for early-career therapists. The integrated model combining simulation, didactic learning, and mentorship boosted learner confidence, skills, and knowledge, affirming competency-based transition programs’ effectiveness. However, standardization across institutions is lacking. Literature highlights CBE’s value in matching education to clinical needs, especially via simulation and assessments, but inconsistent competency definitions cause variable graduate readiness in critical areas like extracorporeal membrane oxygenation (ECMO) and lung ultrasound. This study addresses that gap by evidencing the urgent need for such a framework, providing data to inform future policy and educational reforms in RT.
Methods
1. Research design
This study adopts a quantitative, survey-based approach with a descriptive cross-sectional design to explore competency gaps and training frameworks in RT education. This design captures current insights from RT professionals and supports standardized data collection across diverse regions. The method allows for objective measurement of competency standards, perceived gaps, and institutional practices. A quantitative approach was selected for its ability to identify patterns and statistically significant trends across varied training systems, enhancing reliability and minimizing bias in competency assessment.
2. Study population and sampling
The study population comprises RT professionals in leadership roles, including RT managers, supervisors, clinical educators, and program directors as they directly influence competency evaluation, training implementation, and policy formulation within their respective institutions.
The inclusion criteria for participants were: (1) holding a senior or leadership position in an RT department, ensuring decision-making authority in competency evaluation; (2) working in an institution that trains, evaluates, or employs RT professionals at various competency levels; and (3) having direct experience with competency assessment frameworks, either through formal evaluation processes or training oversight.
The exclusion criteria were: (1) general RT workforce members who do not participate in competency evaluation and (2) students, interns, or RTs without formal involvement in competency training or assessment.
A stratified sampling approach was used to ensure representation across different countries, healthcare systems, and institutional types. This method helps control demographic variations and allows for meaningful comparisons across regions and training methodologies. Sample size was determined using the table by Krejcie and Morgan [
15] in 1970, which recommends approximately 180 participants for a population of 400–500 at 95% confidence and 5% margin of error. Our achieved sample of 181 valid responses therefore met the target and ensured representativeness.
The primary data collection tool for this study was a structured survey questionnaire, which is provided in
Appendix 1. The survey was meticulously designed to align with the study objectives and capture comprehensive insights into RT competency frameworks, skill deficiencies, and institutional training practices.
The questionnaire included the following sections: (1) demographic information: age, gender, country of practice, educational background, years of experience, and current designation; (2) competency frameworks: existing competency assessment checklists, institutional training protocols, and standardized assessment practices; (3) skill deficiencies and gap analysis: identification of specific clinical, procedural, and equipment-related competencies lacking in newly employed RTs; (4) training and remedial strategies: availability of simulation centers, dedicated RT educators, competency reassessment timelines, and structured skill development programs; and (5) perceptions on standardization: participants’ perspectives on the need for a global CBE framework in RT training programs.
The survey instrument was validated through expert review by five senior RT educators and clinicians to ensure content relevance, clarity, and alignment with study objectives. Additionally, a Cronbach’s alpha test was performed to determine the internal consistency and reliability of the survey responses, with a resulting value of 0.821, indicating high reliability. This validation strengthens the credibility of the findings and supports the conclusions drawn from the study.
4. Data collection procedure
The online survey was distributed through RT networks and institutions over 4 weeks, with reminders sent to boost responses. Anonymity was ensured to reduce bias, collecting only professional and institutional details.
5. Data analysis methods
Quantitative data collected through the structured survey instrument were subjected to a multi-tiered statistical analysis to ensure robustness and validity of inferences. Descriptive statistics (frequencies, percentages, and cross-tabulations) were used to summarize demographic variables, institutional practices, and the prevalence of competency frameworks. To evaluate competency deficiencies, a structured gap analysis was conducted by comparing the reported mandatory competencies with those observed as deficient among newly employed RTs. Inferential statistics, including chi-square tests (p<0.05), assessed links between experience, qualifications, and perceptions of competency, standardization, and training practices.
6. Ethical considerations
Ethical approval was obtained from the Institutional Review Board of Srinivas University (6/AHSfeb/2023). Informed consent was secured from all participants through a statement at the beginning of the survey, which outlined the study’s purpose, voluntary nature, and confidentiality. Only those who selected “yes” were allowed to proceed.
Results
In this section, we present the outcomes of our cross-sectional survey distributed to leaders in RT education and clinical practice. The majority were aged 20–40 years (71.83%), representing early to mid-career leadership. Male professionals constituted 55.25%, while females comprised 44.20%. Geographically, India (20.99%) and the United States (13.81%) had the highest participation, along with several other countries worldwide, reflecting diverse global perspectives. Educational qualifications predominantly included a Bachelor of Science in RT (BS-RT) (56.35%), aligning with the global standard that requires a bachelor’s degree for RT professionals. Additionally, 19.34% held Master of Science in RT (MS-RT) degrees, indicating a trend toward advanced specialization. Experience-wise, 30.39% had 2–5 years, ensuring perspectives from emerging leaders, while 19.34% had over 20 years, bringing seasoned expertise. The current designations of respondents were led by in charge RTs (31.49%) and lead RTs (29.28%), with heads/directors of respiratory departments comprising 17.13%. Respiratory therapy supervisors and managers together accounted for roughly one-fifth of the sample (9.94% and 9.39%, respectively), while medical directors made up a small fraction (2.76%). The full demographic breakdown is provided in
Table 1.
Descriptive statistics were performed to summarize key trends in competency frameworks and training structures among RT leaders, providing insights into existing practices and the need for standardization. The summary of descriptive statistics on competency frameworks across institutions is presented in
Fig. 1. The majority (88.35%) reported having competency and skill checklists in place for new hires, while 94.17% confirmed the presence of foundational competencies such as basic life support and infection control protocols. Clinical case-based competencies are established in 80.58% of departments, and 77.67% assess specific equipment competencies. Standardizing generic competencies across RT programs was supported by 72.82%, while 61.17% indicated having simulation facilities to address skill deficiencies. Dedicated RT educators were present in 66.02% of departments. Initial assessment methods to evaluate strengths and weaknesses were implemented by 57.77%, and 78.64% provided structured training before competency evaluations. High-risk, low-volume competencies were incorporated in 54.37% of departments. Critical thinking and time management were integrated into competency frameworks in 76.21% of cases. A near-unanimous 96.12% recognized the necessity of specific clinical, equipment-based, and procedural competencies, while 97.57% supported CBE to standardize existing practices. The call for a global CBE framework in RT programs was endorsed by 96.59%, highlighting strong consensus on the need for standardization. These findings directly evaluate current competency standards and analyze the role of CBE in standardizing RT training globally.
One of the study’s key findings pertains to the competency gaps identified among newly employed RT professionals. Gap analysis is a strategic assessment tool used to measure the difference between the actual state (mandatory competency levels) and the desired state (deficient competency levels). In the context of competency-based training and education, gap analysis helps identify areas where individuals lack the necessary skills, knowledge, or proficiency to meet predefined standards. The required value is the total number of respondents who stated that a specific competency is mandatory for newly employed RTs (
Table 2). Whereas the deficient value entered in the table is the total number of respondents who stated that a specific competency is frequently found deficient in newly employed RTs.
The gap (%) measures how large the deficiency is relative to the expected standard and is calculated using the formula:
Findings reveal critical gaps (over 300%) in ECMO and lung ultrasound, signaling an urgent need for structured training (
Table 3). High-gap areas (100%–299%) include polysomnography and arterial line insertion, while medium gaps (50%–99%) affect common competencies such as bronchoscopy assistance and pulmonary function testing. Even low-gap skills (25%–49%) like extubation and oxygen therapy show room for improvement. This gap framework underscores the importance of prioritizing targeted, skill-specific training in RT education.
Cross-tabulation of competencies by country, experience, and qualifications revealed marked disparities in the reporting of advanced skills (
Table 4). Respondents from Yemen, Canada, Oman, Saudi Arabia, UAE, and the United States disproportionately identified arterial line insertion, intubation, lung ultrasound, aerosol therapy, and ECMO as areas of deficiency. Mid-to-late career professionals (>10 years) were more likely to report gaps in invasive procedures, with the 15–20-year group showing the highest residuals. Qualification level also influenced the pattern of responses, with Doctor of Medicine (MD) and Doctor of Philosophy (PhD) highlighting oxygen therapy, lung ultrasound, and ECMO, while diploma and certification holders emphasized arterial line insertion and airway management. Chi-square tests confirmed that these differences are statistically significant across all three factors: country (χ
2=595.89, p<0.001), experience (χ
2=599.67, p=0.038), and qualification (χ
2=745.63, p=0.030). These findings indicate that training gaps in advanced RT skills are influenced by region, experience level, and educational background, underscoring the need for a globally standardized, simulation-integrated competency framework.
The data recorded highlights that both career stage and educational background significantly influence perceptions of RT competency frameworks (
Table 5). While early-career and experienced professionals express higher confidence in current training, mid-career practitioners are more skeptical. Similarly, MDs and BS-RT holders are more confident than MS-RT and certification-only holders.
Despite different opinions on training adequacy, there is a huge support for standardizing competency frameworks. Moreover, the ones who hold certifications also seem less enthusiastic. The study also revealed critical gaps and inconsistencies in training and assessment, reassuring the need for a globally standard evidence-based framework to better prepare professionals and improve patient care.
Discussion
The relationship between training gaps, simulation use, and competency outcomes is visually illustrated (
Fig. 2). The results obtained from the analysis highlight significant competency deficiencies among newly employed RTs. To address these gaps effectively, it is recommended to develop a Comprehensive Competency-Based Framework that ensures no competency is overlooked, making the framework all-inclusive and structured for progressive learning.
Key implementation strategies for recommendations are listed as follows: (1) Critical competencies (e.g., ECMO, lung ultrasound) can be integrated into mandatory training modules to address urgent skill deficiencies. (2) High-gap competencies can be structured into progressive learning phases—beginner, intermediate, and advanced—ensuring a stepwise approach to competency development. (3) Medium and low-gap competencies can be incorporated as core skills in early training, ensuring foundational competency before advancing to specialized skills.
To operationalize the recommendations, the study proposes the following five-phase plan: (1) Phase 1 (designing the draft framework): development of the initial draft of the competency framework, incorporating validated skill domains, critical procedural areas, and simulation-based training strategies; (2) Phase 2 (consensus building via Delphi method): engaging a panel of international experts through a structured Delphi process to validate and refine the competency indicators, ensuring relevance and comprehensiveness; (3) Phase 3 (pilot testing): implementing the validated framework in collaboration with 3–5 representative educational institutions across different regions to assess feasibility, adaptability, and preliminary learning outcomes; (4) Phase 4 (accreditation alignment): aligning the refined framework with international RT certification and accreditation standards to promote global recognition and applicability; and (5) Phase 5 (institutional implementation and evaluation): collaborating with educational institutions for widespread rollout and impact evaluation, focusing on student competency development, clinical readiness, and patient safety outcomes.
1. Limitations
This study has a few limitations that should be acknowledged for transparency. First, the reliance on self-reported survey data may introduce response bias, as respondents could unintentionally or deliberately misrepresent their practices, competencies, or experiences. Second, participation was limited in regions where RT education and training are still emerging, potentially restricting the generalizability of the findings to global settings. Lastly, the cross-sectional design adopted in this study captures data at a single point in time, limiting the ability to establish causality or track changes and developments in CBE frameworks over time.
2. Conclusion
This study provides empirical evidence highlighting the significant inconsistencies of RT education and competency assessment across institutions and regions. The findings demonstrate widespread gaps in core and advanced competencies—especially in high-risk, low-frequency procedures such as ECMO, lung ultrasound, and advanced airway management. The calculated gap percentages and the variability in institutional practices regarding simulation training, reassessment protocols, and remediation strategies reveal systemic shortcomings that directly impact professional readiness. Through statistical analysis, the study identified key associations between practitioner experience, educational background, and perceptions of competency sufficiency. It also confirmed that non-technical competencies such as communication, teamwork, and decision-making are frequently neglected in assessment, further contributing to performance variability among newly employed RTs. The study proposes the need for a globally standardized, evidence-based competency framework tailored to the demands of RTs. Such a framework should align with the best international practices, integrate structured simulation-based training, and enable consistent benchmarking across educational systems. The conclusion emphasizes that standardization is essential to improving clinical preparedness, patient safety, and workforce mobility. By presenting comprehensive data on training disparities and skill gaps, this research supports an urgent call for coordinated reforms in RT education and accreditation at the global level.
3. Future recommendations
To enhance the global applicability of the proposed competency framework, future initiatives should focus on pragmatic strategies that address both resource constraints and implementation barriers. High-cost technologies such as ECMO simulators and advanced ultrasound modules may limit feasibility in low- and middle-income countries; therefore, scalable solutions such as low-fidelity simulation models, virtual reality platforms, and regional shared simulation centers should be prioritized. Faculty development programs, supported by international respiratory societies, are essential to reduce training burdens and ensure sustainability of competency assessment. A phased implementation strategy, beginning with integration of critical competencies like ECMO and lung ultrasound into modular curricula, can allow gradual adoption while minimizing institutional disruption. Global collaborations, such as cross-border accreditation partnerships and the creation of open-access training repositories, can foster equity by enabling resource-limited settings to align with international benchmarks. Finally, embedding periodic competency reassessment and continuous feedback loops into institutional policies will help ensure that the framework is not only implemented but also iteratively improved. These recommendations will strengthen the framework’s capacity to unify RT education worldwide, improve workforce mobility, and enhance patient outcomes through standardized, evidence-based practice
Acknowledgements
The authors express their sincere gratitude to all individuals who contributed to the successful completion of this study.
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest
No potential conflict of interest relevant to this article was reported.
Author contributions
Conceptualization: TAS, MK. Data collection: TAS. Data analysis and interpretation: TAS, MK, UKR. Manuscript drafting: TAS, MK. Critical revision: TAS, MK. Final approval: all authors.
Fig. 1.
Descriptive Statistics on Competency Frameworks across Institutions
a)Question (Q) labels correspond to items listed in
Appendix 1.
Fig. 2.
Proposed Framework for Critical Gaps
ECMO: Extracorporeal membrane oxygenation.
Table 1.Demographic Distribution of Respondents
Table 1.
|
Characteristic |
No. (%) |
|
Age (yr) |
|
|
20–30 |
67 (37.02) |
|
>30–40 |
63 (34.81) |
|
>40–50 |
26 (14.36) |
|
>50 |
25 (13.81) |
|
Gender |
|
|
Male |
100 (55.25) |
|
Female |
80 (44.20) |
|
Transgender |
1 (0.55) |
|
Country |
|
|
India |
38 (20.99) |
|
USA |
25 (13.81) |
|
Saudi Arabia |
19 (10.50) |
|
Canada |
15 (8.29) |
|
UAE |
14 (7.73) |
|
Oman |
12 (5.52) |
|
Yemen |
10 (4.42) |
|
Qatar |
7 (3.86) |
|
Pakistan |
7 (3.86) |
|
Colombia |
5 (2.76) |
|
Philippines |
5 (2.76) |
|
Ghana |
3 (1.65) |
|
Jamaica, Singapore, Jordan, Egypt, Bahrain, Kuwait (2 respondents each) |
12 (6.63) |
|
México, Argentina, Palestine, Dammam, Turkey, Al-Razi, Australia, Italy, Ethiopia (1 respondent each) |
9 (4.97) |
|
Educational qualification |
|
|
BS-RT |
102 (56.35) |
|
MS-RT |
35 (19.34) |
|
Diploma/AS-RT |
19 (10.50) |
|
PhD |
13 (7.18) |
|
MD |
5 (2.76) |
|
Certification in RT |
9 (4.97) |
|
Years of professional experience |
|
|
2–5 |
55 (30.39) |
|
>5–10 |
42 (23.20) |
|
>20 |
35 (19.34) |
|
>10–15 |
26 (14.36) |
|
>15–20 |
23 (12.71) |
|
Current designation |
|
|
In charge RT |
57 (31.49) |
|
Lead RT |
53 (29.28) |
|
Head/director–RT department |
31 (17.13) |
|
RT supervisor |
18 (9.94) |
|
RT manager |
17 (9.39) |
|
Medical director–RT department |
5 (2.76) |
Table 2.
Table 2.
|
Competency |
Required |
Deficient |
Gap (%) |
|
Extracorporeal membrane oxygenation |
23 |
93 |
404.35 |
|
Lung ultrasound |
33 |
101 |
306.06 |
|
Polysomnography |
43 |
85 |
197.67 |
|
Arterial line insertion |
75 |
76 |
101.33 |
|
Inhaled nitric oxide |
91 |
86 |
94.51 |
|
Pulmonary function diagnostics |
92 |
64 |
69.57 |
|
Supraglottic airway devices |
96 |
58 |
60.42 |
|
Bronchoscopy assistance |
128 |
76 |
59.38 |
|
Endotracheal intubation |
131 |
74 |
56.49 |
|
Tracheostomy tube change |
124 |
67 |
54.03 |
|
Non-conventional modes of ventilation |
132 |
71 |
53.79 |
|
Arterial puncture |
141 |
59 |
41.84 |
|
Arterial line sampling |
125 |
48 |
38.40 |
|
Tracheostomy tube care |
162 |
52 |
32.10 |
|
Mechanical ventilation set up |
183 |
58 |
31.69 |
|
Non-invasive respiratory support |
179 |
54 |
30.17 |
|
Oxygen therapy devices |
183 |
52 |
28.42 |
|
Aerosol therapy |
168 |
47 |
27.98 |
|
Extubation |
169 |
43 |
25.44 |
Table 3.
Table 3.
|
Gap category |
Gap range (%) |
Competencies |
|
Critical |
≥300 |
Extracorporeal membrane oxygenation, lung ultrasound |
|
High |
100–299 |
Polysomnography, arterial line insertion |
|
Medium |
50–99 |
Inhaled nitric oxide, pulmonary function diagnostics, supraglottic airway devices, bronchoscopy assistance, endotracheal intubation, tracheostomy tube change, non-conventional modes of ventilation |
|
Low |
25–49 |
Arterial puncture, arterial line sampling, tracheostomy tube care, mechanical ventilation set up, non-invasive respiratory support, oxygen therapy devices, aerosol therapy, extubation |
Table 4.Highest Over-reported Competencies
Table 4.
|
Category |
Highest over-reported competency (standardized residual) |
Chi-square test results |
|
Country×competencies |
|
χ2=595.89, df=492, p=0.00089 |
|
Yemen |
Arterial line insertion+supraglottic airway devices cluster (+3.29) |
|
|
Canada |
Arterial line insertion+endotracheal intubation cluster (+3.15) |
|
|
Oman |
Aerosol therapy+arterial line insertion cluster (+3.07) |
|
|
USA |
Endotracheal intubation (+2.77) |
|
|
Saudi Arabia |
Arterial line insertion+ECMO (+2.72) |
|
|
UAE |
Aerosol therapy+lung ultrasound+ECMO cluster (+2.72) |
|
|
India |
Arterial line insertion+endotracheal intubation cluster (+1.84) |
|
|
Experience×competencies |
|
χ2=599.67, df=540, p=0.038 |
|
>15–20 yr |
Arterial puncture+arterial line insertion+intubation cluster (+3.70) |
|
|
>10–15 yr |
Arterial puncture+arterial line insertion+intubation cluster (+3.15) |
|
|
>20 yr |
Arterial line insertion+endotracheal intubation cluster (+2.75) |
|
|
5–10 yr |
Arterial line insertion+supraglottic airway devices cluster (+2.18) |
|
|
2–5 yr |
Arterial line insertion+endotracheal intubation cluster (+1.71) |
|
|
Qualification×competencies |
|
χ2=745.63, df=675, p=0.030 |
|
MD |
Oxygen therapy+aerosol therapy cluster (+7.10) |
|
|
PhD |
Inhaled nitric oxide+lung ultrasound+ECMO cluster (+6.40) |
|
|
Certification in RT |
Arterial puncture+arterial line insertion+intubation cluster (+5.95) |
|
|
Diploma/AS-RT |
Arterial line insertion+supraglottic airway devices cluster (+3.83) |
|
|
MS-RT |
Arterial line insertion+endotracheal intubation cluster (+2.55) |
|
|
BS-RT |
Lung ultrasound (+0.96) |
|
Table 5.Influence of Experience and Qualification
Table 5.
|
Q12a) (yes responses%) |
Q13a) (yes responses%) |
Q14a) (yes responses%) |
Q15a) (yes responses%) |
|
Experience |
|
|
|
|
|
2–5 |
76.36 |
96.36 |
100.00 |
98.18 |
|
>5–10 |
64.29 |
95.24 |
100.00 |
100.00 |
|
>10–15 |
73.08 |
96.15 |
96.15 |
92.00 |
|
>15–20 |
60.87 |
100.00 |
91.30 |
91.30 |
|
>20 |
80.00 |
94.29 |
94.29 |
94.29 |
|
Qualification |
|
|
|
|
|
BS-RT |
77.45 |
97.06 |
98.04 |
98.04 |
|
Certification in RT |
55.56 |
100.00 |
77.78 |
66.67 |
|
Diploma/AS-RT |
68.42 |
89.47 |
100.00 |
94.74 |
|
MD |
100.00 |
100.00 |
100.00 |
100.00 |
|
MS-RT |
57.14 |
94.29 |
97.14 |
97.06 |
|
PhD |
76.92 |
100.00 |
100.00 |
100.00 |
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Appendices
