Results of the work and consultations on

1

• Results of the work and consultations on
• initial training for respiratory therapists
• January 2009

2
Professional concerns

• Following a proposal from the professional order
  (Ordre professionnel des inhalothérapeutes du
  Québec - OPIQ) for reflection on initial training
  in respiratory therapy
• And in light of the undertaking by the 40th
  Convention of the FSSS to ensure the
  representation of our members professional and
  institutional concerns
• The FSSS set up two ad hoc committees
• The first committee analysed the impact of the
  reform proposed by the OPIQ for initial training
  in respiratory therapy in November 2006, this
  committee submitted a brief to the OPIQ setting
  out a number of findings and raising various
  concerns about the reform proposed by the OPIQ
• A second committee was charged with finding out
  what respiratory therapists working in various
  settings and regions thought about the proposed
  reform
• The work done gave us a better grasp of the
  situation and helped us undertake a broader
  process of thinking about it. We saw that it was
  necessary to take a stand on the issue, with a
  view to promoting the profession of respiratory
  therapist and helping those who practise it to
  meet the demands of the job market.

3
Reform of initial training in respiratory
therapy presented by the OPIQ

• CEGEP 3 years Content of CEGEP programme
  not specified
• B.A. 2 years Specialties
• Home care
• Anaesthesia
• Intensive care

4
Initial training at the present time

• CEGEP 3 years
• Content Year 1 theory
• Year 2 theory and internships
• Year 3 1 day a week of theory
• 4 days a week of internships

5
Report from the first committee on the reform of
initial training in respiratory therapy proposed
by the OPIQ

• FOUR THEMES
• 1- Positive aspects
• Training would correspond better to the diversity
  of clinical situations encountered in workplaces
• Training would correspond better to the evolution
  of practices in various specialties over the past
  15 years
• Recognition of respiratory therapy as a
  profession and of its value for the health-care
  system
• Potential impact on pay levels, in accordance
  with job evaluation criteria and maintenance of
  pay equity
• Updating of Bill 90
• Training given in Québec would correspond better
  to that given in the rest of Canada
• Attraction of the profession and Canada / Québec
  workforce mobility

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• 2- Negative aspects
• The reform would result in a distinction between
  two groups of respiratory therapists
  CEGEP-trained versus university-trained
• Longer training time / work force less available
• Problem of accessibility and availability of
  training in regions
• Economic impact / cost of training
• Problem in the organization of work (replacement
  of respiratory therapists on annual leave or sick
  leave, posting of positions, job title, etc.)
• Problem of the division of roles and
  responsibilities in the workplace
• Deficit of 230 hours of training at the CEGEP
  level, dating back to 1992

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3- Pertinence of a reform in the current context

• The committee is favourable to a review of the
  content and format of the current training in
  light of technological changes, responsibilities
  stemming from Bill 90 and the quality of services
  provided to the public
• However, the committee is not comfortable with
  the OPIQs proposal and notes that it would leave
  a vacuum, putting a stop to the availability of
  new resources to work in the sectors most
  affected by shortages intensive care,
  anaesthesia and home care

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4- Respiratory therapists reactions Our
perception

• Problem anticipated with respect to the
  obligation for respiratory therapists to
  undertake further studies versus recognition of
  experiential learning
• Apprehension about the problems of getting access
  to part-time, distance or correspondence
  university courses
• Of no interest to respiratory therapists at the
  end of their careers
• Problem of leave for studies in the context of
  labour shortages
• What about experienced respiratory therapists
  already working in the targeted sectors?
• No plans for additional pay
• What will be the place of new graduates in our
  public health-care system?

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Conclusion

• The extent of the repercussions of such a reform
  on respiratory therapists living and working
  conditions requires consultations with our
  members

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Report from the second committee on initial
training in respiratory therapy

• Following the previous consultations, this
  committee developed and set in motion broader
  consultations with respiratory therapists
  belonging to the FSSS.

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Here is the analysis of the resultsSample
sizeEight unions replied to the questionnaires,
for a total of

• 74 questionnaires filled out by respiratory
  therapists
• Mission
• CSSS
• CHU
• CH
• Regions
• Estrie
• Montréal
• Nord du Québec

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QUESTIONS 1- Respondents by age group

• Between 20 and 29 44
• Between 30 and 39 19
• Between 40 and 49 25
• Between 50 and 59 12
• 63 of the respiratory therapists who replied
  were under 40
• 37 of the respiratory therapists who replied
  were over 40, and one third of these were
  eligible for retirement
• Respondents job status
• Full-time 50
• Part-time 50

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2- Number of years of experience

• Between 0 and 5 years 39
• Between 6 and 15 years 18
• Between 16 and 25 years 27
• 26 years or more 16
• 3- Do you work in more than one sector of
  activity?
• Work done in more than one sector of activity
  72
• Work done in the same sector of activity 28
• Mobility among different sectors by choice 53
• Mobility among different sectors an obligation
  47

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4- In which sectors of activity do you work and
in which would you like to work?Sectors of
activity Sectors of activity
in which
you would like to work

• Operating room
• Surgery
• Medicine
• Intensive care
• Neonatalogy
• Cardiology
• Asthma clinic
• Respiratory rehabilitation
• Respiratory physiology
• Emergency

• Operating room
• Neonatalogy
• Intensive care
• Emergency
• Respiratory physiology
• Cardiology and hemodynamics
• Teaching and research
• Home care
• CHSLD
• Medicine / surgery

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5- Do you think the initial training is adequate
in the current context?

• Yes 51 74 people answered this question
• No 49
• 6- Should courses be added to initial training?
• Yes 70 64 people answered this question
• No 30

16

• 8- In which fields of work are there training
  gaps?
• Operating room (anaesthesia)
• Intensive care (hemodynamics, cardiology)
• Paediatrics / Neonatalogy
• Psychology and helping relationship
• Pharmacology

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9- At which level of education should this be
added?

• University 45
• CEGEP 31
• Dont know 24
• 50 of respondents consider that an additional
  year of training is necessary, regardless of the
  level at which the training is given

18
10- Are you interested in taking university-level
courses? 71 people answered this
question

• Yes 66 if conditions are favourable
  and recognition in the form of pay is added
• No 30
• 11- Are you in favour of the creation of two
  distinct respiratory therapist job titles?
• Yes 39
• No 41
• No answer 20

19
12- How many hours of work would constitute
reasonable equivalent experience for recognition
of university training?

• 1,500 hours equal one year of full-time work
• 1,500 hours 19
• 3,000 hours 23
• 4,500 hours 47
• Dont know 19

20
Summary of comments received in response to the
questionnaire
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• Initial training is inadequate in the current
  context, given treatments for complex diseases,
  specialized and ultra-specialized care and
  various technological developments
• Sectors requiring better internships
• Neonatalogy
• Intensive care
• Operating room
• Paediatric internships
• The internship is too short
• The internship is too superficial and lacks
  content

22
Initial training issues Apprehensions about
university training

• Difficulty of doing enriching practical
  internships (limited internship placements and
  intake capacity)
• Fewer prospects for internships in regions than
  in large cities like Montréal
• Intake structures established by institutions
  receiving interns seem less well-organized for
  respiratory therapists than for nurses
• Initial training doesnt meet more specific
  workplace requirements in certain sectors
• Initial training doesnt correspond to the
  development of the profession
• There is a shortage of specialized, stimulating
  settings to foster diversity in learning and
  contact with a variety of problems and issues
• For people living in the regions, accessibility
  and costs are an obstacle to raising training to
  the university level
• The lack of recognition of experiential learning
  for purposes of acquiring a university degree or
  credits for older and more experienced
  respiratory therapists

23
Fields in which a more advanced level of training
is necessary

• Critical care (neonatalogy, intensive care,
  emergency)
• Comprehensive and respiratory physiology
• Pharmacology
• Anaesthesia
• Psychology and helping relationship

24
Conditions that should be met before transferring
studies to the university level

• Continuation of a CEGEP programme in respiratory
  therapy as a prerequisite to university studies
• Better overall compensation for studies or
  equivalent work experience (4,500 hours)
• Possibility of leave from work with no loss of
  pay for continuing education
• Retention and accumulation of seniority
• Ease of access to near-by additional training at
  the university level
• Possibility of having positions that foster
  skills development
• Practical implementation of the deployment of
  activities reserved to respiratory therapists in
  their workplaces (Bill 90)

25
Based on these findings, the committee suggests

• Continuing to make representations to the
  relevant authorities on the need to review the
  respiratory therapy training programme at the
  CEGEP level
• Recognizing the points on page 24 as desirable
  conditions for establishing a post-CEGEP level of
  studies
• That the MSSS and the MESL recognize the sectors
  identified on page 23 as priority areas requiring
  a review of initial training
• Improving access to training and more diversified
  internship placements
• Planning for recognition of experiential learning
  for respiratory therapists already in the system
  if new post-CEGEP studies become a requirement
  for obtaining a licence to practise as a
  respiratory therapist
• Not favouring two distinct training paths for
  obtaining a licence, so as to avoid developing
  two categories of respiratory therapists
  instead, maintaining a standardized approach

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Thanks To members for the work done by the two
ad hoc committees

• First committee composed of
• Mélanie Maloin, SEE en soins infirmiers et
  cardio-respiratoires
• CSN, Sainte-Agathe des Monts
• Michel Grégoire, Syndicat des professionnels en
  soins infirmiers
• et cardiorespiratoires de lhôpital du Sacré-Cœur
  de Montréal
• Bertrand Du Sablond, Syndicat des professionnels
  en soins infirmiers et
• cardiorespiratoires de lhôpital du Sacré-Cœur de
  Montréal
• Marie Bergeron, FSSS-CSN staff representative
• Second committee composed of
• Michel Grégoire, Syndicat des professionnels
  en soins infirmiers
• et cardiorespiratoires de lhôpital du
  Sacré-Cœur de Montréal
• Bertrand Du Sablond, Syndicat des
  professionnels en soins infirmiers et
  cardiorespiratoires de lhôpital du Sacré-Cœur de
  Montréal
• Isabelle Leblanc, SEE en soins infirmiers et
  cardio-respiratoires
• CSN, Sainte-Agathe des Monts
• Marie Bergeron, FSSS-CSN staff representative