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Microsoft PowerPoint - developing an ASTEP and physician ...

  1. 1. Marietta B. Bibbs, BA, RPSGT Morton Plant Mease Medical Center Clearwater, FL A-STEP Program description A-STEP for Students & Providers The A-STEP Process Becoming an A-STEP Provider Benefits of being an A-STEP Provider A-STEP Application A-STEP Standards A-STEP Syllabus Physician Training Program The Accredited Sleep Technology Education Program was developed by the American Academy of Sleep Medicine to standardize sleep technologists education and training. The program is designed to equip students with the knowledge and skills to be successful in the field of polysomnography. It also provides a level of formal education for RPSGT candidates which is one area that has been lacking in polysomnography
  2. 2. The Introductory Course: A minimum of 80-hours of educational training provided by an accredited A- STEP provider. The A-STEP curriculum consists of basic instruction about sleep, sleep disorders, sleep studies and patient care, and it concludes with an online examination. Programs are now permitted to present 30% of their instruction through on-line education Students who complete the Introductory course proceed to begin the AASM A- STEP Self-Study Modules. A-STEP Self Study Modules A web-based program of 14 online educational modules. It is suggested that the modules be taken while working during 18 months of supervised, on-the-job training in a sleep disorders center. New entrants to the profession who need a basic understanding of sleep, sleep disorders and sleep technology. Previously, included all on-the-job trainees who are candidates for the Registered Polysomnographic Technologist (RPSGT™) Examination in 2010; however this pathway is delayed.
  3. 3. Candidates taking the new Pathway #4 for the registry examination. This pathway was developed specifically to accommodate individuals who have completed both an A-STEP Introductory Course and the A-STEP Self-Study Online Modules, (or a BRPT-designated alternative educational program). Pathway #4 is available to candidates submitting proof of completion of both an A-STEP Introductory Course and the A-STEP Self-Study Online Modules (or a BRPT-designated alternate educational program). Duties must be within a 3-year period prior to the exam. The new Pathway #4 will be available to candidates beginning with the December 2009 testing window. Students must have completed high school prior to beginning the program Students must be able to perform the duties specified in the AASM/AAST/BRPT Job descriptions for a trainee Currently, Registry certificants are NOT required to take the A-STEP Introductory course unless they are using Pathway #4 to qualify or the RPSGT examination. Effective July 1, 2009, technicians who are not certified by the BRPT and are working in accredited sleep disorders centers, will need to be enrolled in A-STEP, or enrolled in a CAAHEP Program (CoA PSG, Co ARC or CoA END). Previously, the rule was that in 2012, A-STEP would no longer be required and all BRPT certificants would need to be graduates of a CAAHEP program. This option has been delayed. Note: BRPT has changed these requirements for 6-month Candidates.
  4. 4. A-STEP students are high school graduates at the “trainee” level. Trainees advance to “sleep technician” once they have an overall understanding of polysomnography. The A-STEP program prepares students with the comprehensive education and practical training needed to pass the BRPT Registry examination. When technicians work in the field for 18 months and pass ALL the A-STEP modules, they qualify to take the registry examination. When the technician passes the registry examination, he or she becomes a Registered Polysomnographic Technologist (RPSGT™) The student enrolls in an AASM A-STEP Introductory Course and complete the 80 hours of educational instruction. The A-STEP program director signs a completed notification form and sends it to the AASM by fax or mail to verify that the student has completed the course. The students must take an online examination after completing the Introductory course at a cost of $50. Students have 30 calendar days to earn a score of 70% or higher on the 106 question, multiple choice, three-hour examination. The A-STEP provider determines whether or not the exam is open- book. Students have three chances to pass the examination. If the student fails the examination three times, then he or she must repeat the 80-hour course and pay the $50 exam fee again. Accredited sleep disorders centers and academic institutions that are affiliated with an AASM-accredited sleep disorders center. Once the application is approved, the facility becomes an accredited provider of the AASM A-STEP Introductory Course. A-STEP providers now have the option to place a portion of the 80 hours on-line (24 hours)
  5. 5. Need for standardized educational programs in Polysomnography—problems with respiratory licensure laws Provides a solid background for trainees to enter the field. Enables trainees to better understand information presented in the AASM online educational modules Benefits your practice, your staff, sleep trainees and technicians, and the field. Becoming an A-STEP Provider demonstrates to both colleagues and patients the commitment of your sleep disorders program to the assurance of quality care. As an A-STEP provider, the tools become available to provide standardized training and education to current and future employees. Becoming an AASM A-STEP Provider allows you to take advantage of the opportunity to educate and train technicians for the hundreds of candidates that take the RPSGT examination. Application Syllabus Outcomes Assessment Fair Practices Policies & Procedures
  6. 6. The Program Director must be a RPSGT The Clinical Director must be a Boarded Sleep Specialist The Technical Director must be a RPSGT Instructors can be RPSGT, RRT, R.EEG T, Physicians and other certified allied health professionals PSG equipment must be available for training in recording and treatment. A classroom for didactic instruction available if more than four students enroll. The program’s library must include: The International Classification of Sleep Disorders, Second Edition The AASM Clinical Practice Parameters The AASM Manual for the Scoring of Sleep & Associated Events CPR/AED for the Professional Rescuer
  7. 7. Programs must submit the syllabus for the AASM A-STEP Introductory Course with the application. The course must provide a MINIMUM of eighty hours of instruction. PURPOSE: To provide a program that follows the guidelines and standards established by the American Academy of Sleep Medicine and to ensure content also includes areas covered in the RPSGT Examination Content Outline. POLICY: The program’s curriculum follows AASM standards 9-19 with additional courses offered to students. PROCEDURES: (my program) • The program includes 102.5 hours of continuous training over a 14-day period. • The Program includes 55 hours of didactic instruction, 41.5 hours of practical/interactive instruction; and 3 examinations (2 mid-point examinations and 1 final examination). • The curriculum includes an introduction to the history of sleep and overview of the sleep disorders (Reference: Course 101)
  8. 8. A basic understanding of the nervous, respiratory, skeletal and cardiovascular systems (Reference: Course 101) Training in patient safety, infection control, fall precautions and recognition of emergencies (Reference: Course 101) Training in obtaining patient histories, interpersonal communication and management of the difficult patient (Reference: Courses 101 and 103) Training in patient confidentiality, informed consent and HIPAA regulations (Reference: Course 101) Instruction in patient preparation and equipment preparation for polysommography (Reference: Course 103) Procedures for polysomnographic recording equipment and electrical safety (Reference: Courses 102 and 103) Introduction to sleep stage scoring and polysomnographic event detection (Reference: Courses 104, 105, 106 and 107) Standard polysomnographic procedures and covers the Multiple Sleep Latency Test and Maintenance of Wakefulness Test (Reference: Courses 102, 103, 108 and 109) Application of positive airway pressure, supplemental oxygen and nocturnal ventilation (Reference: Course 106)
  9. 9. Course Description Hours of Instruction The history of sleep medicine 0.50 - Didactic Normal sleep architecture 0.50 - Didactic Overview of the sleep disorders 0.50 - Didactic Review of Systems (Nervous, Respiratory, Cardiovascular, Muscoskeletal) 0.75 - Didactic Effects of sleep deprivation 0.50 - Didactic Somnopharmacology 0.50 - Didactic EEG pattern recognition 0.50 - Didactic The technologists role in the sleep disorders laboratory 0.50 - Didactic Patient care in the sleep laboratory 0.50 - Didactic Medical ethics and Professional behavior 0.25 - Didactic HIPPA and patient confidentiality and informed consent 0.50 - Didactic Chart review 0.50 - Didactic Patient safety 0.50 - Didactic Infection control 0.50 - Didactic Emergency protocols & Cardiopulmonary Resuscitation 0.50 - Didactic Documentation during recording 0.25 - Didactic Summarizing the PSG report 0.25 - Didactic Total Hours of Instruction 8.00- Didactic Course Objectives: ♦ Understand the evolution of sleep medicine ♦ Describe the most common sleep disorders ♦ Recognize EEG patterns ♦ Identify the role of the sleep technologist in the sleep laboratory ♦ Explain HIPPA, privacy rules, medical ethics and standards of conduct ♦ Discuss patient safety and infection control ♦ Devise emergency protocols Course Requirements, Student Evaluation and Grading: ♦ Classroom Instruction – 100% ♦ Attendance Policy: ♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies: ♦ Kryger, Roth, Dement, Principles and Practice of Sleep Medicine-4th Edition, 2005 ♦ American Academy of Sleep Medicine, The International Classification of Sleep Disorders, 2nd. Edition, 2005 ♦ Egan, Scanlan, Wilkins, Stoller, Eagen’s Fundamentals of Respiratory Care, 2003 ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 1, 1983. ♦ CPR/AED for the Professional Rescuer by the American Red Cross Course Description Hours of Instruction Operation of DC and AC amplifiers 0.50- Didactic 0.50 - Practical Ancillary equipment 0.50 - Didactic Electrical safety 0.25 -Didactic Digital vs analog recording equipment 0.25- Didactic Theory of operation of PSG recording equipment 0.50 - Didactic Sensitivity, voltage and amplitude of waveforms 0.50 - Didactic 0.50 - Practical Low and high frequency filters in PSG recording amplifiers 0.50 – Didactic 0.50 - Practical Aliasing, screen resolution and sampling rate 0.50 - Didactic 0.50 - Practical Total Hours of Instruction 3.50 Didactic 2.00 Practical
  10. 10. Course Objectives: ♦ Practice electrical safety ♦ Demonstrate an understanding of instrumentation and ancillary equipment used in polysomnography ♦ Calculate sensitivity, voltage and amplitude of waveforms ♦ Understand filters, aliasing, screen resolution and sampling rate ♦ Understand the theory of operation of AC and DC amplifiers Course Requirements, Student Evaluation and Grading: ♦ Classroom Instruction (60%); Practical Instruction (40%) Course Activities: Didactic & Practical Attendance Policy: ♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies: ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 1, 1983. ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 2, 1983. Course Description Hours of Instruction Hardware and software calibration 0.50 – Didactic 1.00 - Practical Data acquisition and patient monitoring procedures 0.50 - Didactic 1.00 - Practical Patient assessment, taking a history, managing difficult patients 0.50 - Didactic Equipment interface 0.50 – Didactic 0.50 - Practical Recording montages 0.50 - Didactic 1.00 - Practical Documentation during recording 1.00 - Didactic Recognition and response to critical events during sleep 0.75 – Didactic 1.00 – Practical The 10-20 system of electrode placement 1.00 - Didactic 2.00 – Practical Ancillary devices placement 0.75 – Didactic 1.00 - Practical Baseline polysomnography 1.00 - Didactic CPAP titration polysomnography 1.00 – Didactic Split-night polysomnography 1.00 – Didactic Recording and monitoring procedures for MSLT and MWT 0.50 – Didactic Recognition and response to parasomnias 0.50 – Didactic 0.50 – Practical Recognition and resolution of artifacts 0.50 – Didactic 1.00 – Practical Pediatric polysomnography 1.00 - Didactic 1.00 - Practical Total Hours of Instruction 11.5 – Didactic 10.0- Practical Course Objectives: ♦ Perform both pediatric and adult polysomnogram procedures ♦ Monitor and record various types of sleep studies that may be ordered ♦ Create and revise recording montages as needed to record appropriate data ♦ Apply electrodes following the10-20 system of electrode placement ♦ Recognize and respond to critical events that may occur during sleep ♦ Troubleshoot and resolve artifacts Outline of Instruction: ♦ Pediatric and adult polysomnography ♦ The 10-20 System of Electrode Placement ♦ Recording montages ♦ Monitoring and documentation during recording ♦ Recording Protocols Course Activities: Didactic/Practical/Examination Mid-Point Assessment: 2.0 hour examination Course Requirements, Student Evaluation and Grading: ♦ Classroom Instruction (55%); Practical Instruction (45%) Attendance Policy: ♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies: ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 1, 1983. ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 2, 1983. ♦ Chokroverty, Sleep Disorders Medicine Basic Science, Technical Considerations and Clinical Aspects, 2nd. Editiion, 1999. ♦ The 10-20 System of Electrode Placement ♦ Ferber, Kryger, Principles and Practice of Sleep Medicine in the Child , 4th Edition, 2005 ♦ Kryger, Roth, Dement, Principles and Practice of Sleep Medicine-4th Edition, 2005 ♦ CPR/AED for the Professional Rescuer by the American Red Cross ♦ AASM Clinical Practice parameters from the Standards of Practice Committee
  11. 11. Course Description Hours of Instruction Sleep Stage Scoring in Adults 1.00 – Didactic 2.00 – Practical Sleep Stage Scoring in Pediatrics 1.00 – Didactic 2.00 – Practical Arousal scoring 0.50 – Didactic 0.50 - Practical Abnormal EEG and sleep-related seizures 1.00 – Didactic 0.50 - Practical Anatomy, physiology and mechanics of breathing 1.00 - Didactic Use of oximetry in polysomnography 0.50 - Didactic Respiratory disorders 1.00 - Didactic Scoring apnea 1.00 – Didactic 1.00 - Practical Scoring Hypopnea 0.50 – Didactic 0.50 - Practical Scoring Respiratory effort related arousals 0.50 – Didactic 0.50 - Practical Scoring Cheyne Stokes breathing 0.50 – Didactic 0.50 - Practical Cardiac anatomy and physiology 1.00 - Didactic Scoring ECG arrhythmias and cardiac abnormalities 1.00 - Didactic 1.00 - Practical Scoring periodic limb movement disorder 0.75 – Didactic 0.75 - Practical Identifying bruxism 0.25 – Didactic 0.25 - Practical 0.25 – Didactic Identifying restless legs syndrome 0.25 - Practical Identifying disorders of arousal 0.50 – Didactic 0.25 - Practical Identifying REM and non-REM parasomnias 0.50 – Didactic 0.50 – Practical Identifying Circadian rhythm disorders 0.25 - Didactic Identifying Seizure disorders and appropriate intervention 0.50 – Didactic 0.50 - Practical Total Hours of Instruction 13.50 – Didactic 11.00 - Practical Course Objectives: ♦ Score the stages of sleep in adult and pediatric populations using the American Academy of Sleep Medicine Scoring rules ♦ Score apnea, hypopnea, and upper airway resistance ♦ Identify Cheyne Stokes respiration, periodic breathing and hypoventilation ♦ Understand the principle of operation of oximeters ♦ Evaluate the oximetry recordings ♦ Recognize and score cardiac events according to established guidelines ♦ Respond to cardiac events according to clinical practice guidelines ♦ Score limb movements according to established clinical practice ♦ Score other movement disorders, e.g. bruxism ♦ Identify other movement disorders, e.g. hypnagogic foot tremor, alternating leg muscle activation, rhythmic movement disorder, and excessive fragmentary myoclonus ♦ Identify disorders of arousal ♦ Identify REM Sleep Behavior Disorder ♦ Summarize scored data and generate a technician’s report Outline of Instruction: ♦ Historical development of sleep scoring rules ♦ The new AASM scoring rules ♦ Adult and pediatric sleep ♦ Scoring Respiratory Events ♦ Scoring Cardiac Events ♦ Scoring movement disorders Course Activities: Didactic/Practical Course Requirements, Student Evaluation and Grading: ♦ Classroom Instruction (60%); Practical Instruction (40%) ♦ Attendance Policy: ♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies: ♦ American Academy of Sleep Medicine, The AASM Manual for the Scoring of Sleep and Associated Events, 2007. ♦ Rechtschaffen and Kales, A manual of standardized terminology, techniques and scoring system for the sleep stages of human subjects, 1968 ♦ Thaler, The only EKG book you’ll ever need, 1999 ♦ Egan, Scanlan, Wilkins, Stoller, Egan’s Fundamentals of Respiratory Care, 8th edition, 2003 ♦ Berry, Sleep Medicine Pearls, 1999 ♦ Chokroverty, Sleep Disorders Medicine, Basic Science, Technical Considerations and Clinical Aspects, 2nd. Edition, 1999
  12. 12. Course Description Hours of Instruction Continuous positive airway pressure titration 1.00 – Didactic 2.00 – Practical Bilevel positive airway pressure 1.00 – Didactic 2.00 – Practical CPAP and BPAP split-night titration procedures 0.50 – Didactic 0.50 – Practical Non-invasive ventilation 1.00 – Didactic 1.00 – Practical Oxygen titration 0.50 – Didactic 0.50 – Practical Total Hours of Instruction 4.00 – Didactic 6.00 – Practical Course Objectives: ♦ Understand and apply PAP devices according to protocol ♦ Educate and acclimate the patient to PAP therapy ♦ Interface PAP recording devices to PSG recording equipment ♦ Titrate PAP pressure according to written protocols ♦ Perform split-night polysomnography ♦ Perform oxygen titration according to protocol ♦ Use oxygen simultaneously during PAP titration ♦ Understand and titrate using non-invasive ventilation Outline of Instruction: ♦ PAP titration ♦ Non-invasive ventilation ♦ Oxygen titration Course Activities: Didactic/Practical Course Requirements, Student Evaluation and Grading: ♦ Classroom Instruction (60%); Practical Instruction (40%) Attendance Policy: ♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies: ♦ American Academy of Sleep Medicine, The AASM Manual for the Scoring of Sleep and Associated Events, 2007. ♦ Chokroverty, Sleep Disorders Medicine Basic Science, Technical Considerations and Clinical Aspects, 2nd. Editiion, 1999. ♦ AASM Clinical Practice parameters from the Standards of Practice Committee ♦ Egan, Scanlan, Wilkins, Stoller, Egan’s Fundamentals of Respiratory Care, 8th edition, 2003 ♦ Berry, Sleep Medicine Pearls, 1999 ♦ Chokroverty, Thomas, Bhatt, Pulmonary Pathophysiology: The Essentials, 6th. edition, 2005 Course Description Hours of Instruction Evaluation of hypersomnia 0.50 - Didactic MSLT & MWT Tests and questionnaires 0.25 – Didactic 0.25 – Practical/Interactive Data acquisition procedure 0.50 – Didactic 0.50 - Practical Scoring procedures 0.25 – Didactic 0.25 - Practical Quality assurance during PSG testing 0.75 – Didactic Hands-on clinical instruction: (patient wiring, monitoring 8.00 – Practical/Interactive and troubleshooting) Total Hours of Instruction 2.25 – Didactic 9.00 - Practical
  13. 13. Course Objectives: ♦ Calibrate PSG equipment for recording MSLT or MWT ♦ Perform the MSLT and the MWT ♦ Record, score and summarize the MSLT and the MWT ♦ Understand quality assurance activities for the sleep center ♦ Understand interscorer reliability ♦ Recognize appropriate data storage procedures ♦ Perform troubleshooting during polysomnography ♦ Skill in clinical activity in the sleep laboratory ♦ Outline of Instruction: ♦ Recording the MSLT and MWT ♦ Recording montages for the MSLT and MWT ♦ Clinical procedures during the MSLT and MWT ♦ Quality Assurance in the sleep center ♦ Interscorer reliability ♦ Clinical laboratory exposure Course Activities: Didactic/Practical Course Requirements, Student Evaluation and Grading: ♦ Classroom Instruction (50%); Practical Instruction and Exam (50%) Attendance Policy: ♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies: ♦ AASM Clinical Practice parameters from the Standards of Practice Committee Summary of Instruction: Total Hours: 102.5 Didactic Instruction: 55.0 hrs. = 53.7% Practical/Interactive Instruction: 41.5 hrs. = 40.5% Midpoint and Final Examination: 6 hours = 5.9% Completion of the AASM A-STEP Introductory Course requires completion of the online 106-item, three-hour examination with a score of 70% or better.
  14. 14. Maintain records of student’s performance Maintain objective measures of success Students take a standardized sleep technology trainee test Assess students preparation for work after a period of work experience Assess employer’s satisfaction with the trainee’s education STUDENT ASSESSMENT POLICY (A-STEP Standards 20, 21, 22) PURPOSE: Students’ assessment of the program allows objective measures to serve as markers of success of the program. Program assessment serves as a quality assurance measure that refines and improves training within the program. POLICY: • Assessment of general education is accomplished through course projects, performance evaluations and examinations administered at midpoint and the end of the course. • Student outcomes are measured through sampling and analysis of courses. • Samples of student work are selected from program courses following each course and are evaluated to determine the level of student achievement. • Results of these direct measures are compared with indirect measures such as employer surveys, graduate surveys, and student satisfaction surveys.
  15. 15. Student Assessment Policy (cont.) PROCEDURES: Assessments and Tools: The methods of evaluation for this course are assignments, on- site “hands-on” performance, two mid-point examinations and the final examination. “Hands-on” performance includes skills testing. Student Assessment Policy (Cont.) 1. Grading: Didactic Instruction (59.5%) a. Assignments – 10% b. Mid-point examination #1 – 10% GRADE PERCENT c. Mid-point examination #2 – 10% A 90-100% d. Final Examination – 70% B 80-90% Practical Instruction (40.5%) C 70-80% a. Assignments – 10% D 60-70% b. Skills Testing – 90% F <60% 2. Student Performance and Attendance Records are maintained at the Florida Sleep School for a period of 7 years. Student Enrollment and Attendance Assessment Date of # of Students # Students Attending All #Students taking # Students Taking # Students Course Enrolled Classes Mid-Point Exam Final Exam Passing the Course
  16. 16. Performance Improvement Plan Summary of Indicators Indicator Standard Definition Source Frequency 1. Students’ Evaluation 90% a) Students complete an assessment of the and Satisfaction course Following Student Assessment Form Survey b) Students assess their preparation for each course work 2. Students’ Performance a.) Student performance on mid-term and final Student Performance Evaluation 90% examinations is assessed During and Evaluation Form b.) Student ability to gain employment following following the course is assessed each course 3. Performance measure on a.) Students are contacted while employed to Standardized Sleep 90% determine if they are enrolled in A-STEP Technology Trainee module training while training at work Examinations and the b.) Student performance on exams in A-STEP Student Performance on National Registry Exam modules are assessed Trainee Examinations Bi-Annually c.) Students contacted when eligible to take the Form RPSGT examination to determine intent d.) Students performance on RPSGT examination is assessed 6. Employer Satisfaction 90% a.) Employers contacted to determine level of Employer Satisfaction Bi-Annually satisfaction of Program Graduates Form 7. Program Self-Assessment 90% a.) The Florida Sleep School self-assesses the Program Self-Assessment program to determine adherence to A-STEP Yearly Form Standards STUDENT PERFORMANCE EVALUATION Date of # of Students # Passing Mid # Passing Final # Employed (6 % Student # of Course Enrolled Point Exam Examination months post-course) Attendance Students Student Performance on Standardized Trainee Exams and the RPSGT Exam Y ea r S tu de nt’ s N a m e G r a d ua tio n P a ssed T ra ine e s P a ssed R P S G T D a te R e g ist ry D a te E x am Ex am A c hiev e d
  17. 17. STUDENT PERFORMANCE ON STANDARDIZED TRAINEE EXAMS AND THE RPSGT EXAM Year Student’s Name Graduation Passed Trainees Passed RPSGT Date Registry Date Exam Exam Achieved YEAR PASS/FAIL PERCENTAGE ON PASS/FAIL PERCENTAGE ON STANDARDIZED EXAMS RPSGT EXAM EMPLOYMENT RATE OF STUDENTS (POST-COURSE) Student’s Name FSS Course Completion Date Contact Date Employed (Yes/No) Employer’s Name Employer’s Address Employer’s Phone Number Hire Date Student Assessment of theE S NO Th e F lo rida S leep S ch oo l’s L ib ra ry inc lu d ed: Y Program C O M M E N TS ♦ Intern ational Cla ss ific ation of S leep Dis orders ♦ C lin ic al P ractic e P aram eters ♦ A A S M S c oring M anual, A dult and P edia tric S c oring M anuals ♦ C P R/A E D for the P rofess io nal R es c uer by the A m eric an R ed C ros s A M inim um 80 hours of ins truc tion was prov ided T he c ours e prov ided an introduc tion to the his tory of s leep an d an ove rvie w of s le ep dis orders and s leep m e dicine T he c ours e prov ided a bas ic und ers tand ing of th e nervo us , res piratory, s k eletal and c ardiov asc u lar s y stem T he c ours e prov ided training in patient s afety inc orpora ting infec tion c ontrol tec hniq ues , fall prec a ution s and rec og nizing em ergenc ies T he c ours e prov ided training in obtainin g patien t his to ries, interpers onal c om m unic ation and m anagem en t o f the diffic ult patie nt T he c ours e prov ided training in patient c o nfiden tiality , inform ed c onse nt an d dis c uss ion of H IP A A regulations T he c ours e prov ided ins truction in preparation o f th e patient an d equipm ent for poly s om nograp hy T he c ours e prov ided an introduc tion to p olys om nog raphic rec ording, treatm ent e quipm ent and elec tric al s afe ty T he c ours e prov ided an introduc tion to s leep s tage sc oring a nd poly s om nog raphic ev ent detec tion T he c ours e prov ided ins truction in stan dard poly s om n ographic proc edures , inc lu ding th e M S L T and M W T T he c ours e prov ided inc luded ins truc tion in the applic ation of P A P a nd s upplem ental o xyge n the rapy as well as dis c us sion of nocturn al ventilation T he c ours e prov ided an ev aluation at the m idpoin t of the program that allo ws fo r c orrec tion of d efic ienc ies in kn owledg e T he progra m m us t m aintain rec ords of s tu dent pe rfo rm anc e an d attendan ce I fe el that I obtained s uffic ient k nowled ge to s e ek em plo ym ent in a s le ep dis ord ers c enter M a y w e co n tact yo u r fu tu re e m p lo ye r fo r a fo llow -u p su rve y co n cern in g you r on -th e-job p erfo rm an ce *
  18. 18. EMPLOYER ASSESSMENT OF STUDENT ON-THE-JOB PROFICIENCY Dear Employer: You have recently hired a former student of the Florida Sleep School, who completed the accredited sleep technology training program (A-STEP) in ________________, 200 . We always seek to improve the quality of training received by our students, and we value input from employers who have hired our former trainees. As part of our performance improvement, we send out surveys to employers who have hired the graduates of our A-STEP program. ____________________________ has notified us that he/she is currently employed at your sleep disorders center and has agreed to participate in the employer survey at the time of graduation. Please complete the information below and return the form in the included postage-paid envelope to Florida Sleep School, 6350 Techster Boulevard, Suite #2, Fort Myers, FL 33966. Thank you for your participation. Sincerely yours, Marietta B. Bibbs, RPSGT Program Director ============================================================================ Employee’s Name:__________________________________________ Hire Date: _________________ EMPLOYER ASSESSMENT OF STUDENT ON-THE-JOB PROFICIENCY Description Yes No N/A Is proficient in sleep medicine terminology Dresses appropriately Interacts well with patients and exhibits professional behavior Understands HIPAA and patient privacy Is able to assess the patient Understands the theory of Polysomnography Is able to perform Polysomnography- preparation and setup Is able to calibrate PSG equipment Performs physiological calibration and recognizes Is proficient in the 10-20 System of Electrode Placement Recognizes the stages of sleep Recognizes and can distinguish the types of sleep apnea and other breathing disorders Understands and performs PAP titration Understands and performs oxygen titration Recognizes and responds appropriately to cardiac arrhythmias Recognizes movement disorders Recognizes and responds to artifact Has basic understanding of seizures and Understands Pediatric polysomnography Recognizes and responds to emergencies in the sleep lab Is able to perform the duties of a PSG Trainee specified in the AASM/AAST/BRPT Job description of a PSG Trainee School’s Yearly Self-Assessment Program Director is RPSGT or ABSM Diplomat Clinical Director is an ABSM Diplomat Technical Director is an RPSGT Faculty is adequate Associated with a comprehensive accredited Sleep Disorders Center Access to PSG recording and treatment equipment Classroom for classes larger than 4 students Library includes (minimal): ♦ International Classification of Sleep Disorders -2005 Edition ♦ Clinical Practice Parameters ♦ AASM Scoring Manual, Adult and Pediatric Scoring Manuals ♦ CPR/AED for the Professional Rescuer by the American Red Cross
  19. 19. School’s Yearly Self-Assessment Minimum 80 hours of instruction 10 Curriculumincludes an introduction to the history of sleep and an overview of sleep disorders and sleep medicine 11 Curriculumincludes a basic understanding of the nervous, respiratory, skeletal and cardiovascular system 12 Curriculumincludes training in patient safety incorporating infection control techniques, fall precautions and recognizing emergencies 13 Curriculumincludes training in obtaining patient histories, interpersonal communication and management of the difficult patient 14 Curriculumincludes training in patient confidentiality, informed consent and discussion of HIPAA regulations 15 Curriculumincludes instruction in preparation of the patient and equipment for polysomnography 16 Curriculumintroduces the student to polysomnographic recording, treatment equipment and electrical safety 17 Curriculumintroduces the students to sleep stage scoring and polysomnographic event detection Table of Contents Statement of Understanding …………………………………………….… 3 Student Acceptance, Anti-discrimination, Local, Federal, Sate laws…..…. 4 Grievance Policy……………………………………………………….….. 4 Dress Policy…………………………………………………………….….. 5 Smoking and Cell Phone Policy…………………………………………… 5 Class Attendance Policy…………………………………………………… 5 Organizational Chart ……………………………………………………… 6 Personnel…………………………………………………………….…….. 7 Program Resources………………………………………………….…….. 8 Curriculum policy…………………………………………………..……… 9 Student Assessment Policy…………………………………………..…….. 10 Student Enrollment & Attendance Assessment……………………….…… 10 Outcomes Assessment…………………………………………………….. 11 Performance Improvement Plan…………………………………………… 11 Student Performance Evaluation……………………………………………11 Student Performance on standardized tests and RPSGT Examination……..12 Employment rate of students………..………………………………………12 Student assessment of the Program……………………………………….. 13 Employer’s assessment of Student on-the-job performance………………. 14 Yearly Self-Assessment…………………………………………………… 15-16 Syllabus……………………………………………………………………. 17-34 Curriculum………………………………………………………………… Grievance Policy • Students who feel that they have been discriminated against can report the activity to the Equal Employment Commission, the _____ Department of Education and the Regional Director of the U.S. Department of Education. • Students should also report any deficiencies in education, educational methods, teacher deficiencies, etc. to the American Academy of Sleep Medicine, the Accrediting agency for Accredited Sleep Technology Training Program.
  20. 20. Student Acceptance and Equal Opportunity Policy 1.) A ll students accepted into the program m ust have a m inim um high school education. 2.) S tudents m ust be proficient in the E nglish lan guage. The Florida Sleep School requires that instructors act with integrity and striv e to engage in equitable verbal and nonverbal behavior with respect to differen ces in age, gen der, race, handicap and religion. 3.) A ll Students m eeting criteria are accepted into the p rogram based on availability of classroom space. 4.) A ll Students accepted into the program m ust be ab le to perform the duties specified in the AA SM /AP T/B RPT job description for P olysomn ographic T rainee. 5.) T he Florida Sleep S chool follow s all local, state an d fed eral laws regarding student and faculty recruitment and em ploym ent practices. 6.) It is the policy of T he Florida Sleep School not to discriminate in admission to or participation in its program s and activities on th e basis of race, color, national origin, ancestry, creed, religio n, fam ily or m edical leave, disability, age, sex , sexual orientation, arrest record o r conviction record. 7.) A ll students 8.) A ll students have access to the policies and procedures of the Flo rida Sleep S choo l. DRESS POLICY Students are allowed to dress in casual attire during the didactic instruction of the course; however, students must keep in mind that as a future employee in a healthcare environment, they must promote an image of professionalism. During didactic instruction, students must: • maintain an appearance of a well-groomed individual • No hats/caps in the classroom • No distracting or clothing considered vulgar in nature (halter tops, shorts) 3.) During Practical and “hands-on” instruction, students must dress professionally, have an appropriate appearance and demeanor so as to maintain the image of the affiliated Sleep Disorders Laboratory: Student should: a. wear scubs during practical instruction in the affiliated Sleep Disorders Laboratory b. be mindful of personal hygiene c. place long hair into a pony tail or a clip d. avoid wearing open-toed shoes 3.) Students who violate the dress policy will be asked to correct the discretion prior to returning to class or the laboratory. Smoking and Cell Phone Policy Smoking is not allowed at The Florida Sleep School. If students smoke, they must smoke outside of the building and clean up all cigarette butts after smoking Cellular phones must be turned off or on silent mode during class and while engaged in practical and “hands-on” instruction. Students may use personal computers to take notes during class, but internet access is not allowed during class.
  21. 21. Class Attendance Successful completion of the course requires attendance at all didactic classes as well as practical/interactive sessions and in-laboratory “hands-on” sessions There is no “make-up” class or “make-up” examination. Assignments must be turned in on time or they will be docked 5% for each day late. All announcements, catalogs and publications that advertise the program must be accurate The policies and procedures must be available to students The program must have a student grievance procedure The program must follow federal, state and local regulations regarding student and faculty Purpose: • Develop a training program that physician’s can attend to learn the basics of sleep and sleep disorders. Enrollees: • Family Practice, Pulmonologists, Internal Medicine, Psychiatrists, etc. who are preparing for the Board Exam of those planning to set up a sleep center in their practice
  22. 22. Most physicians who plan to take the exam this year must also review 200 PSGs and 45 MSLTs. Review must be documented by a DABSM. Psychiatry Boards must be completed next year. After this year, physicians that become boarded in sleep medicine must complete a Fellowship Training Program. There will always be a group of physicians who will set up sleep disorders services within their practice There will always be a focus on accreditation There will always be a need for continuing education—not necessarily having a focus on becoming a DABSM
  23. 23. Topic The Spectrum and Classification of Sleep Disorders Sleep Assessment- Clinical Approach Sleep Assessment- Laboratory Approach Adult Polysomnography (PSG, MSLT, MWT, HST) PSG Scoring Workshop 1 - Normal Adult - Obstructive Sleep Apnea - Multiple Sleep Latency Test Sleep Related Breathing Disorders Narcolepsy & Other Causes of Sleepiness Insomnia (1’, PPI, ISH, PLMD, RLS, Psy, Circadian) Insomnia Treatment (Pharmacologic & Nonpharmacologic) PSG Scoring Workshop 2 - Complex Sleep Apnea - Positive Airway Pressure Titration - Mask Fitting and Adjustment
  24. 24. Topic Pediatric Sleep Polysomnography & Scoring Parasomnia & Seizures Preparing a Clinical Report PSG Reading Workshop - Split Night PSG - Composite Night Study Topic Safety in the sleep Laboratory Sleep Laboratory protocols, policies & procedures Instrumentation, Filters, Sensitivity PAP Titrations and Interpretations & PSG Scoring Sleep Report Calculations Intrascorer Reliability Quality Assurance B Protocols and Policies development Post Course Examination

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