Can J Respir Ther Vol 57 129
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Published online at https://www.cjrt.ca on 8 October 2021
RESEARCH ARTICLE
Exploring the professionalization of respiratory
therapy in Canada
Marco Zaccagnini, PhD (c), MSc, RRT-CCAA, FCSRT1,2, André Bussières, DC, PhD1,2,3, Peter Nugus, MA(Hons), PhD4,5,
Andrew West, EdD, FCSRT6, Aliki Thomas, OT (c), PhD1,2,4
M Zaccagnini, A Bussières, P Nugus, A West, A Thomas. Exploring the professionalization of respiratory therapy in Canada. Can J Respir Ther
2021;57:129–137. doi: 10.29390/cjrt-2021-046.
Introduction: A recurrent challenge facing respiratory therapists (RTs) is their legitimacy as professionals. RTs are often referred to as technologists, voca-
tionalists, or technicians and must often justify their status as full professionals rather than “professional technicians”. There is currently little exploration
of what it means to be a profession and the process of professionalization in respiratory therapy.
Approach: Drawing from sociological theory, the purpose of this paper is to discuss the professionalization of respiratory therapy in Canada using Andrew
Abbott’s theory, the “system of professions”. We will use this theory as a lens to propose areas of consideration for professional development regarding two
pervasive themes in the respiratory therapy community, RTs’ specialized body of knowledge and professional autonomy.
Findings: Abstract knowledge is believed to be essential in the evolution from occupation to profession and is valuable to a profession in three ways: it can influ-
ence the profession’s legitimacy, it can be used for conducting research, and it promotes higher education. RTs possess jurisdictional professional autonomy within
Canada. The privilege of self-regulation allows RTs to act according to their knowledge and judgement without direct oversight from other professions.
Conclusion: Based on Abbott’s theoretical position, RTs can rightly justify their position as professionals. However, RTs need to acknowledge that profession-
alization is a dynamic and continuous process that requires creative changes to innovate within the profession and support future efforts to reinforce their
position as professionals. Throughout this paper, we offer suggestions for how RTs can contribute to the ongoing professionalization of respiratory therapy.
Key Words: professional practice; respiratory therapy; allied health personnel; social theory; societies; professionalization
INTRODUCTION
In Canada, there are over 12,000 practicing respiratory therapists (RTs) who
possess clinical expertise, kno ...
Professionalism in medicine encompasses a set of values including competence, integrity, compassion, respect and dedication to service. It emerged as a concept in the 1990s in response to the growing business model of healthcare and need to reinforce ethical principles. Professionalism is important for medical students to understand as it forms the basis of the patient-physician relationship and trust. While professional values have long existed, it is important for students to dedicate themselves to living according to these ideals from the beginning of their training through compassionate care for patients.
A guide to clinical research writing on public health for clinical researcher...Pubrica
• Clinical research writing is a specialized field requiring the expertise of Scientific Medical Writing who in addition to providing medical writing help, also help conform to the requirements of the Journal, ensure publication and make relevant contribution to the field of medical research.
Full Information: https://bit.ly/2CPJ255
Reference: https://pubrica.com/services/physician-writing-services/
Why pubrica?
When you order our services, we promise you the following – Plagiarism free, always on Time, outstanding customer support, written to Standard, Unlimited Revisions support and High-quality Subject Matter Experts.
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Web: https://pubrica.com/
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The document discusses three marketing strategies for a sleep clinic:
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The document discusses three marketing strategies for a sleep clinic:
1) Educating local doctors about sleep disorders and providing them brochures and screening information to share with patients.
2) Advertising on local radio and television to raise public awareness of sleep issues.
3) Partnering with local gyms and fitness centers to post flyers and discuss sleep apnea screening. The strategies aim to increase referrals by educating doctors and the public.
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2) In early weeks, the student assessed their healthcare setting's needs and identified potential project topics, focusing on reducing health disparities.
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4) Later weeks discuss exploring telehealth nursing and considering new policies, technologies, and how they can ethically benefit patients while maintaining standards of care.
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This document presents a Canadian national position statement on patient-reported outcomes (PROs) from a steering committee of PRO experts.
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3. The overarching recommendations are that resources should be invested to integrate PROs into care, a national PRO body is needed for guidance, and PRO tools must
Professionalism in medicine encompasses a set of values including competence, integrity, compassion, respect and dedication to service. It emerged as a concept in the 1990s in response to the growing business model of healthcare and need to reinforce ethical principles. Professionalism is important for medical students to understand as it forms the basis of the patient-physician relationship and trust. While professional values have long existed, it is important for students to dedicate themselves to living according to these ideals from the beginning of their training through compassionate care for patients.
A guide to clinical research writing on public health for clinical researcher...Pubrica
• Clinical research writing is a specialized field requiring the expertise of Scientific Medical Writing who in addition to providing medical writing help, also help conform to the requirements of the Journal, ensure publication and make relevant contribution to the field of medical research.
Full Information: https://bit.ly/2CPJ255
Reference: https://pubrica.com/services/physician-writing-services/
Why pubrica?
When you order our services, we promise you the following – Plagiarism free, always on Time, outstanding customer support, written to Standard, Unlimited Revisions support and High-quality Subject Matter Experts.
Contact us :
Web: https://pubrica.com/
Blog: https://pubrica.com/academy/
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United Kingdom: +44-74248 10299
The document discusses three marketing strategies for a sleep clinic:
1) Educating local doctors about sleep disorders and providing them brochures and screening information to share with patients.
2) Advertising on local radio and television to raise public awareness of sleep issues.
3) Partnering with local gyms and fitness centers to post flyers and discuss sleep apnea screening. The strategies aim to increase referrals by educating doctors and the public.
The document discusses three marketing strategies for a sleep clinic:
1) Educating local doctors about sleep disorders and providing them brochures and screening information to share with patients.
2) Advertising on local radio and television to raise public awareness of sleep issues.
3) Partnering with local gyms and fitness centers to post flyers and discuss sleep apnea screening. The strategies aim to increase referrals by educating doctors and the public.
1) The document discusses a student's reflective journal entries for their capstone practicum project over 10 weeks.
2) In early weeks, the student assessed their healthcare setting's needs and identified potential project topics, focusing on reducing health disparities.
3) For one topic on implementing negative pressure wound therapy, the student created objectives to improve outcomes and safety through new approaches.
4) Later weeks discuss exploring telehealth nursing and considering new policies, technologies, and how they can ethically benefit patients while maintaining standards of care.
The ethics of performance monitoring-private sector perspectiveDavid Quek
Increasingly medical practice is coming under intense scrutiny as to what is appropriate and affordable care, including serious considerations of patient safety issues and protection. Medical professionalism must be consciously adhered to as we try and find the best health care for our patients at the best value and outcomes for our patients themselves, and also for society at large. In view of escalating health care costs, physician autonomy to practice as he or she likes or deems fit has now come under siege with more and more performance monitoring, not just for appropriateness, but also for outcomes, necessity and cost-effectiveness. Physician' vested interests must be tempered with evidence-based benefits or at least be associated with no increase in harm or incur affordability issues. Fraudulent physician malfeasance are now being uncovered via whistle-blowers, or through greater more meticulous audit of various validated performance measures, and those physicians found to have flouted these due to pecuniary self-interests, overuse of tests or procedures have been found guilty and sanctioned with heavy fines, return of reimbursements as well as imprisonment, and erasure from medical registries and the removal of license to practice.
A Catalyst For Transforming Health Systems And Person-Centred Care Canadian ...Becky Gilbert
This document presents a Canadian national position statement on patient-reported outcomes (PROs) from a steering committee of PRO experts.
The key points are:
1. PROs capture the patient perspective on health and quality of life and can improve care, but their use is not consistent in Canada. This position statement aims to support greater PRO implementation.
2. The position statement was developed through an expert consensus process and stakeholder feedback. It contains recommendations in 4 areas: patients and families, health policy, clinical implementation, and research.
3. The overarching recommendations are that resources should be invested to integrate PROs into care, a national PRO body is needed for guidance, and PRO tools must
This document discusses a student's weekly reflective journal entries for their capstone practicum course. The journal covers several topics, including identifying health disparities in the community, creating objectives for a proposed negative pressure wound therapy project, discussing new approaches like telehealth nursing, and understanding how health policy and clinical systems work. The student demonstrates several competencies, including identifying health disparities, setting measurable objectives, considering the role of technology, and understanding how new practices are implemented in healthcare organizations.
Health Care Reform (The Affordable Care Act) .docxisaachwrensch
Health Care Reform (The Affordable Care Act)
“
ANA believes that health care is a basic human right (ANA, 1989, ANA, 1998, ANA 2005). Thus, ANA reaffirms its support for a restructured health care system that assures universal access to a standard package of essential health care services for all citizens and residents.”
“ANA believes that the development and implementation of health policies that reflect the six Institute of Medicine (IOM) aims (Safe/Effective/Patient-centered/Timely/Efficient/Equitable) and are based on outcomes research will ultimately save money.”
“The system must be reshaped and redirected away from the overuse of expensive, technology-driven, acute, hospital-based services in the model we now have, to one in which a balance is struck between high-tech treatment and community-based and preventive services, with emphasis on the latter. The solution is to invert the pyramid and focus more on primary care, thus ultimately requiring less costly secondary and tertiary care.”
Activity:
Please read the attached Health Policy Brief on Basic Health Program and “Nursing’s Role in healthcare reform” from American Nurse Today.
Please go to
www.rnaction.org
, go to the Take Action tab above to access the following information regarding health care reform and the new Affordable Care Act. Scroll down the page to the heading Resources and Supreme Court Challenge to learn more about the health care reform and how it affects you as a nurse and as an individual with a family. Check out all the different information.
HealthCare.gov
Keeping health care reform healthy, patients informed
New Animation Explains Changes Coming for Americans Under Obamacare
(7/13)
Health Care Transformation: The Affordable Care Act and How it Affects Nurses
(3/12)
Health Care Reform Legislation Timeline
ANA Policy and Provisions of Health Reform Law
National Conference of State Legislatures Health Reform Site
Kaiser Family Foundation Health Reform Page
The Supreme Court Decision Matters for Registered Nurses, their Families, and their Patients
ANA Analysis: Supreme Court Arguments on the ACA
ANA to Supreme Court: ‘Individual Mandate’ Needed to Make Health Reform Work
Then proceed to the Kaiser Foundation to watch the following:
http://kff.org
““Health Care Reform Hits Main Street on the Kaiser Foundation website or Youtube. (2010)
“New Animation Explains Changes Coming to Americans under Obamacare” (2013) Youtube or Kaiser Foundation
“
Health insurance Explained: YouToons Have it Covered”
(
2014) Youtube or Kaiser Foundation
If you would like more information regarding the ACA, the Kaiser Foundation is a great source and cover many issues.
http://kff.org
Link:
http://kff.org/health-reform/press-release/new-animation-explains-changes-coming-for-americans-under-obamacar.
How to plan and write a research proposal cancer research writing - PubricaPubrica
o To get it how cancer cell develops and advance in the natural, comparison between the healthy cells and cancer cells.
o There are several approaches to treat cancer cells like immune therapy, gene therapy which resists the patients from cancer cells.
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Reference: https://pubrica.com/services/physician-writing-services/research-proposal/
Why pubrica?
When you order our services, we promise you the following – Plagiarism free, always on Time, outstanding customer support, written to Standard, Unlimited Revisions support and High-quality Subject Matter Experts.
Contact us :
Web: https://pubrica.com/
Blog: https://pubrica.com/academy/
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United Kingdom: +44-74248 10299
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Ht ai 2015 poster final - The Maximum of Information in a Minimum of WordsREBRATSoficial
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This document discusses the development of a harmonized framework of core competencies for clinical research professionals. It notes that while regulations have increased in complexity, requirements for clinical research professionals remain vague. Several organizations have developed competency frameworks but they focus on specific roles or areas.
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3) Recommendations include incorporating international standards of competency, enhancing educational opportunities, and improving collaboration between organizations involved in medical education.
Sharing about “A typical day in the life as Radiation Therapy Technologist (RTT)” includes their roles, responsibilities, duties, working protocols, management, working stress, daily challenges in this modern radiotherapy era. As well as a bit information about how to become a RTT in India.
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The document describes four stages of evolution for the design of health care organizations. Stage 1 is characterized by a fragmented system with autonomous physicians and organizations. Stage 2 sees the formation of referral networks and multidisciplinary teams. Stage 3 incorporates more patient-centered care, greater use of teams, and modest use of information technology. Stage 4, described as the vision for the 21st century, aims to fully redesign care processes around patient needs with state-of-the-art use of information and a coordinated, integrated delivery system. The document recommends workshops to help organizations progress toward this Stage 4 model.
Ian Graham Regenstrief Conference Slides October 4 2007ShawnHoke
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College Writing II Synthesis Essay Assignment Summer Semester 2017.docxclarebernice
College Writing II Synthesis Essay Assignment Summer Semester 2017
Directions:
For this assignment you will be writing a synthesis essay. A synthesis is a combination of two or more summaries and sources. In a synthesis essay you will have three paragraphs, an introduction, a synthesis and a conclusion.
In the introduction you will give background information about your topic. You will also include a thesis statement at the end of the introduction paragraph. The thesis statement should describe the goal of your synthesis. (informative or argumentative)
The second paragraph is the synthesis. You will combine two summaries of two different articles on the same topic. You will follow all summary guidelines for these two paragraphs. The synthesis will most likely either argue or inform the reader about the topic.
The conclusion paragraph should summarize the points of your essay and restate the general ideas.
For this essay you will read two research articles on a similar topic to the previous critical review essay as you can use this research in your inquiry paper. You will summarize both articles in two paragraphs and combine the paragraphs for your synthesis. In the synthesis you must include the main ideas of the articles and the author, title, and general idea in the first sentences.
This essay will be three pages long and the first draft and peer review are due June 15. You must turn them in hardcopy in class so you can do a peer review.
Running head: THESIS DRAFT 1
THESIS DRAFT 3Thesis Draft
Katelyn B. Rhodes
D40375299
DeVry University
Point-of-Care Testing (PoCT) has dramatically taken over the field of clinical laboratory testing since it’s introduction approximately 45 years ago. The technologies utilized in PoCT have been refined to deliver accurate and expedient test results and will become even more sensitive and accurate in order to dominate the field of clinical laboratory testing. Furthermore, there will be a dramatic increase in the volume of clinical testing performed outside of the laboratory. New and emerging PoCT technologies utilize sophisticated molecular techniques such as polymerase chain reaction to aid in the treatment of major health problems worldwide, such as sexually transmitted infections (John & Price, 2014).
Historic Timeline
In the early-to-mid 1990’s, bench top analyzers entered the clinical laboratory scene. These analyzers were much smaller than the conventional analyzers being used, and utilized touch-screen PCs for ease of use. For this reason, they were able to be used closer to the patient’s bedside or outside of the laboratory environment. However, at this point in time, laboratory testing results were stored within the device and would have to then be sent to the main central laboratory for analysis.
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Demonstrating Mastery of Evidence-Based PracticeIntroductionTh.docxsimonithomas47935
Demonstrating Mastery of Evidence-Based Practice
Introduction
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Completion of the capstone experience is evidence that students are able to more fully participate in research and evidence-based practices through their ability to:
Identify clinical problems requiring investigation
Utilize evidence-based literature to answer clinical questions
Critically analyze and critique qualitative studies
Critically analyze and critique quantitative studies
Critically synthesize the literature to make best practice decisions
Assist novice nurses, peers, and interdisciplinary health care workers to utilize evidence-based literature and synthesize research information
Influence the selection of appropriate methods of data collection
Collect data, evaluate data, disseminate findings, and implement best practices in a wide variety of patient care settings
Diffusion of Innovation
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Each category has characteristics that help managers, educators, and researchers determine if someone is ready to adopt a new innovation. As the predictable pattern suggests, innovation will first be accepted and integrated into practice first by early adopters, then by the majority.
Cochrane Collaboration
The Cochrane Collaboration is a great example of dedicated health professionals committed to researching, synthesizing, and disseminating best evidence for providing best practices to help health care workers guide practice. It is the longest running electronic publication in health care.
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This document discusses nursing ideologies and their application to practice. It addresses three topics: factors that influence evidence-based care, the philosophy of caring, and managing care delivery. Regarding evidence-based practice, it notes that political and professional bodies support it but implementation can be delayed due to various barriers. Nurses must critically analyze evidence and understand that research is just one part of clinical decision making. It also discusses Simone Roach's caring theory and the importance of the five C's, especially confidence, in developing trusting nurse-patient relationships. Finally, it examines how chronic obstructive pulmonary disease care can be delivered in primary and secondary care settings according to current guidelines.
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The document provides an overview of clinical ethics support in New Zealand's healthcare system. It finds that compared to similar countries, NZ has less access to formal clinical ethics advice. Several models are discussed, including Clinical Ethics Advisory Groups within District Health Boards. The report recommends establishing a national clinical ethics network to provide support locally. Key actions include developing education resources, setting terms of reference for advisory groups, and clarifying the relationship between clinical ethics and governance. Establishing a national network could help raise standards and improve quality of care across New Zealand.
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Childhood Abuse and Delinquency 150 Words Research regarding.docxTawnaDelatorrejs
Childhood Abuse and Delinquency 150 Words
Research regarding spanking children has had mixed results, do you think spanking contributes to delinquency or helps to prevent it? Justify your response.
Please remember to use netiquette when responding to your classmates
.
Childrens StoryKnowing how to address a variety of situations in .docxTawnaDelatorrejs
Children's Story
Knowing how to address a variety of situations in the early childhood setting and effectively partnering with parents to do so are important skills for all teachers and caregivers. For this assignment, you will choose one of the following scenarios:
Shane has a difficult time separating from his mother each morning. At drop off, he clings to her and screams uncontrollably. After she leaves, Shane continues to scream and cry until you are able to soothe him.
Lisa often gets frustrated when trying to play with other children. She takes toys from their hands and even hits children with the toys.
Next, address each of the following points according to the teaching approach/setting that best reflects your style in your desired classroom setting (e.g. Montessori, Reggio Emilia, Waldorf, traditional preschool, etc.):
Outline a specific plan for addressing the discipline or guidance scenario.
Explain how your plan would support the teaching approach/setting.
Describe how you will create an effective partnership with parents to address the discipline or guidance scenario.
Describe one or two possible obstacles you might encounter when implementing your plan.
Discuss how you will address these obstacles.
The paper should be three to four pages in addition to the title page and the reference page. Use at least two scholarly sources in addition to your text. Your paper should also be formatted according to APA style as outlined in the Ashford Writing Center.
Description
:
Total Possible Score
: 6.00
Outlines a Specific Plan for Addressing the Discipline or Guidance Scenario
Total: 1.25
Distinguished - Outlines in detail a specific plan for addressing the discipline or guidance scenario. The plan is well supported by scholarly sources.
Proficient - Outlines a specific plan for addressing the discipline or guidance scenario. The plan is supported by scholarly sources but is missing minor details.
Basic - Vaguely outlines a plan for addressing the discipline or guidance scenario; however, the plan may not be sufficiently supported by scholarly sources and is missing relevant details.
Below Expectations - Attempts to outline a plan for addressing the scenario; however, the plan is not sufficiently supported by scholarly sources and is missing significant details.
Non-Performance - The outline of a specific plan is either nonexistent or lacks the components described in the assignment instructions.
Explains How the Plan Supports the Teaching Approach/Setting
Total: 0.50
Distinguished - Clearly and comprehensively explains how the plan supports the chosen teaching approach/setting. The explanation is well supported by scholarly sources.
Proficient - Explains how the plan supports the chosen teaching approach/setting. The explanation is supported by scholarly sources but is slightly underdeveloped.
Basic - Briefly explains how the plan supports the chosen teaching approach/setting. The explanation may not be sufficiently supported by s.
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This document discusses a student's weekly reflective journal entries for their capstone practicum course. The journal covers several topics, including identifying health disparities in the community, creating objectives for a proposed negative pressure wound therapy project, discussing new approaches like telehealth nursing, and understanding how health policy and clinical systems work. The student demonstrates several competencies, including identifying health disparities, setting measurable objectives, considering the role of technology, and understanding how new practices are implemented in healthcare organizations.
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ANA believes that health care is a basic human right (ANA, 1989, ANA, 1998, ANA 2005). Thus, ANA reaffirms its support for a restructured health care system that assures universal access to a standard package of essential health care services for all citizens and residents.”
“ANA believes that the development and implementation of health policies that reflect the six Institute of Medicine (IOM) aims (Safe/Effective/Patient-centered/Timely/Efficient/Equitable) and are based on outcomes research will ultimately save money.”
“The system must be reshaped and redirected away from the overuse of expensive, technology-driven, acute, hospital-based services in the model we now have, to one in which a balance is struck between high-tech treatment and community-based and preventive services, with emphasis on the latter. The solution is to invert the pyramid and focus more on primary care, thus ultimately requiring less costly secondary and tertiary care.”
Activity:
Please read the attached Health Policy Brief on Basic Health Program and “Nursing’s Role in healthcare reform” from American Nurse Today.
Please go to
www.rnaction.org
, go to the Take Action tab above to access the following information regarding health care reform and the new Affordable Care Act. Scroll down the page to the heading Resources and Supreme Court Challenge to learn more about the health care reform and how it affects you as a nurse and as an individual with a family. Check out all the different information.
HealthCare.gov
Keeping health care reform healthy, patients informed
New Animation Explains Changes Coming for Americans Under Obamacare
(7/13)
Health Care Transformation: The Affordable Care Act and How it Affects Nurses
(3/12)
Health Care Reform Legislation Timeline
ANA Policy and Provisions of Health Reform Law
National Conference of State Legislatures Health Reform Site
Kaiser Family Foundation Health Reform Page
The Supreme Court Decision Matters for Registered Nurses, their Families, and their Patients
ANA Analysis: Supreme Court Arguments on the ACA
ANA to Supreme Court: ‘Individual Mandate’ Needed to Make Health Reform Work
Then proceed to the Kaiser Foundation to watch the following:
http://kff.org
““Health Care Reform Hits Main Street on the Kaiser Foundation website or Youtube. (2010)
“New Animation Explains Changes Coming to Americans under Obamacare” (2013) Youtube or Kaiser Foundation
“
Health insurance Explained: YouToons Have it Covered”
(
2014) Youtube or Kaiser Foundation
If you would like more information regarding the ACA, the Kaiser Foundation is a great source and cover many issues.
http://kff.org
Link:
http://kff.org/health-reform/press-release/new-animation-explains-changes-coming-for-americans-under-obamacar.
How to plan and write a research proposal cancer research writing - PubricaPubrica
o To get it how cancer cell develops and advance in the natural, comparison between the healthy cells and cancer cells.
o There are several approaches to treat cancer cells like immune therapy, gene therapy which resists the patients from cancer cells.
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A SWOT Analysis Of The Physiotherapy Profession In KuwaitJim Webb
This research article conducted a SWOT analysis of the physiotherapy profession in Kuwait through 17 key informant interviews. The interviews identified strengths like funding for services and motivated professionals, as well as weaknesses such as lack of education, resources, marketing, and standardized practices. Opportunities mentioned were untapped demand, development of the physiotherapy association, and collaboration. Threats included low public awareness, challenges with interprofessional practice, and cultural views on health. The analysis concluded that opportunities exist to advance the profession through the physiotherapy association advocating for standards, research, and collaboration.
Ht ai 2015 poster final - The Maximum of Information in a Minimum of WordsREBRATSoficial
This document discusses the challenges of knowledge transfer for medical auditors in Brazil's private healthcare system. It finds that medical auditors must handle a large volume of complex issues and authorization requests within limited timeframes. They often lack knowledge of evidence-based practices and coverage policies can vary between companies. To address these challenges, the document recommends producing more concise guidelines, improving communication strategies, and increasing motivation for guideline use through workshops and discussions. A survey of medical auditors found they use technical advice in practice but communication and formatting of advice could be improved.
This document discusses the development of a harmonized framework of core competencies for clinical research professionals. It notes that while regulations have increased in complexity, requirements for clinical research professionals remain vague. Several organizations have developed competency frameworks but they focus on specific roles or areas.
The Joint Task Force for Clinical Trial Competency was formed to align these various competency statements into a single, globally-applicable framework. They identified 8 domains of competency and harmonized knowledge, skills, and attitude statements within each domain from different frameworks. The result is a Core Competency Framework intended to shift the focus from regulatory compliance to professional competency and improve clinical research quality and safety.
1) Postgraduate medical education in Pakistan faces several challenges including a lack of guidance for career paths, poor working conditions, and minimal training in family medicine.
2) The authors conducted a survey of postgraduate trainees that identified deficiencies and made recommendations for improving competence assessment and diversifying training programs.
3) Recommendations include incorporating international standards of competency, enhancing educational opportunities, and improving collaboration between organizations involved in medical education.
Sharing about “A typical day in the life as Radiation Therapy Technologist (RTT)” includes their roles, responsibilities, duties, working protocols, management, working stress, daily challenges in this modern radiotherapy era. As well as a bit information about how to become a RTT in India.
Details distribution, posting, or copying of this pdf is stnand15
The document describes four stages of evolution for the design of health care organizations. Stage 1 is characterized by a fragmented system with autonomous physicians and organizations. Stage 2 sees the formation of referral networks and multidisciplinary teams. Stage 3 incorporates more patient-centered care, greater use of teams, and modest use of information technology. Stage 4, described as the vision for the 21st century, aims to fully redesign care processes around patient needs with state-of-the-art use of information and a coordinated, integrated delivery system. The document recommends workshops to help organizations progress toward this Stage 4 model.
Ian Graham Regenstrief Conference Slides October 4 2007ShawnHoke
The document discusses how knowledge translation (KT), which involves moving research into practice, can be a strategy for transformative change in healthcare. It outlines KT approaches at the Canadian Institutes of Health Research (CIHR), including end-of-grant KT and integrated KT. Integrated KT involves engaging stakeholders in the research process. The document argues that applying existing research more effectively and conducting the right collaborative, interdisciplinary research could significantly improve health outcomes. It asserts KT must focus on adapting research for local contexts and evaluating real-world impacts to drive transformative change.
Ic farticle Ic farticle Ic farticle Ic farticleMuhammadAfiqJ
This article describes a tool to facilitate clinical reasoning, reflection, and mentoring for physical therapists. The tool incorporates the International Classification of Functioning, Disability and Health (ICF) framework and the Guide to Physical Therapist Practice patient management model. It was implemented with staff at a large academic hospital with varying experience levels. Preliminary results found it helped develop clinical reasoning skills and improved patient care through facilitated mentoring sessions. While initial outcomes were promising, more research is needed on its effectiveness. The tool provides a structured way for clinicians to reflect critically on patient cases using established frameworks to advance autonomous practice.
Medical Professionalism in the New Millennium: A Physician Chartermeducationdotnet
The document introduces a charter on medical professionalism created by physicians from Europe and the United States. It aims to address concerns that changes in healthcare systems threaten medical professionalism and physicians' commitment to patient welfare. The charter outlines three fundamental principles: primacy of patient welfare, patient autonomy, and social justice. It also lists 10 commitments that uphold these principles and define physicians' responsibilities. The charter seeks to promote discussion of professionalism across cultures and affirm its universal values.
College Writing II Synthesis Essay Assignment Summer Semester 2017.docxclarebernice
College Writing II Synthesis Essay Assignment Summer Semester 2017
Directions:
For this assignment you will be writing a synthesis essay. A synthesis is a combination of two or more summaries and sources. In a synthesis essay you will have three paragraphs, an introduction, a synthesis and a conclusion.
In the introduction you will give background information about your topic. You will also include a thesis statement at the end of the introduction paragraph. The thesis statement should describe the goal of your synthesis. (informative or argumentative)
The second paragraph is the synthesis. You will combine two summaries of two different articles on the same topic. You will follow all summary guidelines for these two paragraphs. The synthesis will most likely either argue or inform the reader about the topic.
The conclusion paragraph should summarize the points of your essay and restate the general ideas.
For this essay you will read two research articles on a similar topic to the previous critical review essay as you can use this research in your inquiry paper. You will summarize both articles in two paragraphs and combine the paragraphs for your synthesis. In the synthesis you must include the main ideas of the articles and the author, title, and general idea in the first sentences.
This essay will be three pages long and the first draft and peer review are due June 15. You must turn them in hardcopy in class so you can do a peer review.
Running head: THESIS DRAFT 1
THESIS DRAFT 3Thesis Draft
Katelyn B. Rhodes
D40375299
DeVry University
Point-of-Care Testing (PoCT) has dramatically taken over the field of clinical laboratory testing since it’s introduction approximately 45 years ago. The technologies utilized in PoCT have been refined to deliver accurate and expedient test results and will become even more sensitive and accurate in order to dominate the field of clinical laboratory testing. Furthermore, there will be a dramatic increase in the volume of clinical testing performed outside of the laboratory. New and emerging PoCT technologies utilize sophisticated molecular techniques such as polymerase chain reaction to aid in the treatment of major health problems worldwide, such as sexually transmitted infections (John & Price, 2014).
Historic Timeline
In the early-to-mid 1990’s, bench top analyzers entered the clinical laboratory scene. These analyzers were much smaller than the conventional analyzers being used, and utilized touch-screen PCs for ease of use. For this reason, they were able to be used closer to the patient’s bedside or outside of the laboratory environment. However, at this point in time, laboratory testing results were stored within the device and would have to then be sent to the main central laboratory for analysis.
Technology in the mid-to-late 1990’s permitted analyzers to be much smaller so that they may be easily carried to the patient’s location. Computers also became more ...
A Clinical Internship Model For The Nurse Practitioner ProgrammeCharlie Congdon
This clinical internship model for nurse practitioner students requires them to complete a clinical internship with a qualified clinical mentor. The internship aims to develop the students' advanced clinical skills in areas like assessment, prescribing, and leadership. Students work with their mentor to create a clinical learning plan and meet weekly to achieve the objectives. The internship incorporates nationally recognized nurse practitioner competencies to guide students. Feedback from students on the internship was generally positive, noting benefits of working with an expert clinical mentor and opportunities for clinical skills development and case presentations. The clinical internship allows students to gain essential knowledge and experience in their specialty area with support from an expert mentor.
Demonstrating Mastery of Evidence-Based PracticeIntroductionTh.docxsimonithomas47935
Demonstrating Mastery of Evidence-Based Practice
Introduction
The American Nurses Association (ANA) has a reading room where nurses and consumers can read a variety of position statements. One position statement discusses the expectation that "at the baccalaureate level, education for research prepares nurses to read research critically and to use existing standards to determine the readiness of research for utilization in clinical practice" (American Nursing Association, 2006, p. 8). Developing a project proposal that requires students to critically appraise research and addresses clinical problems through a well-developed solution is a means by which professional studies students at Grand Canyon University meet this expectation and demonstrate mastery of baccalaureate essential skills.
Completion of the capstone experience is evidence that students are able to more fully participate in research and evidence-based practices through their ability to:
Identify clinical problems requiring investigation
Utilize evidence-based literature to answer clinical questions
Critically analyze and critique qualitative studies
Critically analyze and critique quantitative studies
Critically synthesize the literature to make best practice decisions
Assist novice nurses, peers, and interdisciplinary health care workers to utilize evidence-based literature and synthesize research information
Influence the selection of appropriate methods of data collection
Collect data, evaluate data, disseminate findings, and implement best practices in a wide variety of patient care settings
Diffusion of Innovation
Vital information regarding best practices may be disseminated to a broad community of nurses, but it does not necessarily mean nurses will apply the knowledge. What, therefore, is the next step? One theory to consider is diffusion of innovations, originally proposed by Rogers in 1962 (Rogers, 2003). Rogers (2003) postulates that adopters of any new innovation or idea can be categorized based on a bell curve. The categories are: innovators, early adopters, early majority, late majority, and laggards. Awareness, interest, evaluation, trial, and adoption influences an adopter's willingness and ability to adopt a new innovation.
Each category has characteristics that help managers, educators, and researchers determine if someone is ready to adopt a new innovation. As the predictable pattern suggests, innovation will first be accepted and integrated into practice first by early adopters, then by the majority.
Cochrane Collaboration
The Cochrane Collaboration is a great example of dedicated health professionals committed to researching, synthesizing, and disseminating best evidence for providing best practices to help health care workers guide practice. It is the longest running electronic publication in health care.
Cochrane was instrumental in making it known that health care prac.
This document discusses nursing ideologies and their application to practice. It addresses three topics: factors that influence evidence-based care, the philosophy of caring, and managing care delivery. Regarding evidence-based practice, it notes that political and professional bodies support it but implementation can be delayed due to various barriers. Nurses must critically analyze evidence and understand that research is just one part of clinical decision making. It also discusses Simone Roach's caring theory and the importance of the five C's, especially confidence, in developing trusting nurse-patient relationships. Finally, it examines how chronic obstructive pulmonary disease care can be delivered in primary and secondary care settings according to current guidelines.
Advanced Practiced Nurses Research Discussion.docxwrite22
The document summarizes perspectives from seven nursing leaders on the future of nursing education. Key recommendations included ensuring nursing students learn competencies for quality improvement and population health management. Leaders also emphasized the importance of interprofessional education and clinical training through partnerships between schools and practice settings. There was consensus that nursing education needs to shift to baccalaureate and graduate-level programs and include post-graduate residencies to better prepare nurses for future practice.
The document provides an overview of clinical ethics support in New Zealand's healthcare system. It finds that compared to similar countries, NZ has less access to formal clinical ethics advice. Several models are discussed, including Clinical Ethics Advisory Groups within District Health Boards. The report recommends establishing a national clinical ethics network to provide support locally. Key actions include developing education resources, setting terms of reference for advisory groups, and clarifying the relationship between clinical ethics and governance. Establishing a national network could help raise standards and improve quality of care across New Zealand.
Sepsis a Case Study
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Similar to Can J Respir Ther Vol 57 129This open-access article is di (20)
Childhood Abuse and Delinquency 150 Words Research regarding.docxTawnaDelatorrejs
Childhood Abuse and Delinquency 150 Words
Research regarding spanking children has had mixed results, do you think spanking contributes to delinquency or helps to prevent it? Justify your response.
Please remember to use netiquette when responding to your classmates
.
Childrens StoryKnowing how to address a variety of situations in .docxTawnaDelatorrejs
Children's Story
Knowing how to address a variety of situations in the early childhood setting and effectively partnering with parents to do so are important skills for all teachers and caregivers. For this assignment, you will choose one of the following scenarios:
Shane has a difficult time separating from his mother each morning. At drop off, he clings to her and screams uncontrollably. After she leaves, Shane continues to scream and cry until you are able to soothe him.
Lisa often gets frustrated when trying to play with other children. She takes toys from their hands and even hits children with the toys.
Next, address each of the following points according to the teaching approach/setting that best reflects your style in your desired classroom setting (e.g. Montessori, Reggio Emilia, Waldorf, traditional preschool, etc.):
Outline a specific plan for addressing the discipline or guidance scenario.
Explain how your plan would support the teaching approach/setting.
Describe how you will create an effective partnership with parents to address the discipline or guidance scenario.
Describe one or two possible obstacles you might encounter when implementing your plan.
Discuss how you will address these obstacles.
The paper should be three to four pages in addition to the title page and the reference page. Use at least two scholarly sources in addition to your text. Your paper should also be formatted according to APA style as outlined in the Ashford Writing Center.
Description
:
Total Possible Score
: 6.00
Outlines a Specific Plan for Addressing the Discipline or Guidance Scenario
Total: 1.25
Distinguished - Outlines in detail a specific plan for addressing the discipline or guidance scenario. The plan is well supported by scholarly sources.
Proficient - Outlines a specific plan for addressing the discipline or guidance scenario. The plan is supported by scholarly sources but is missing minor details.
Basic - Vaguely outlines a plan for addressing the discipline or guidance scenario; however, the plan may not be sufficiently supported by scholarly sources and is missing relevant details.
Below Expectations - Attempts to outline a plan for addressing the scenario; however, the plan is not sufficiently supported by scholarly sources and is missing significant details.
Non-Performance - The outline of a specific plan is either nonexistent or lacks the components described in the assignment instructions.
Explains How the Plan Supports the Teaching Approach/Setting
Total: 0.50
Distinguished - Clearly and comprehensively explains how the plan supports the chosen teaching approach/setting. The explanation is well supported by scholarly sources.
Proficient - Explains how the plan supports the chosen teaching approach/setting. The explanation is supported by scholarly sources but is slightly underdeveloped.
Basic - Briefly explains how the plan supports the chosen teaching approach/setting. The explanation may not be sufficiently supported by s.
Children build their identities based on what they are exposed to, a.docxTawnaDelatorrejs
Children build their identities based on what they are exposed to, as well as how adults and peers interact with them. After having read this Module's materials, let's discuss this further.
What do you think are the most influential factors in the building of multicultural identities in children?
How do you raise children to be sensitive, multicultural adults
.
Child poverty and homelessness are two of the most complex problems .docxTawnaDelatorrejs
Child poverty and homelessness have increased significantly in recent decades in the US. The number of children living in poverty grew from 11.6 million to 15 million between 2000 and 2015, with over 20% of children now living below the federal poverty level. Additionally, between 1-2% of children experience homelessness at some point, a number that rose due to the recent recession. Growing up in poverty puts children at greater risk of physical, cognitive, emotional and social problems. However, politicians and policymakers often disagree on the causes of and solutions to child poverty, leading to vigorous public debate.
Child abuse and neglect are critical issues inherent in the field of.docxTawnaDelatorrejs
Child abuse and neglect are critical issues inherent in the field of human services. You will likely encounter clients who are abused and neglected. Review the characteristics of neglected children in Chapter 4, and answer the following questions:
How does the presence of child abuse or neglect affect a child’s normal development?
How might you respond to a child who indicates that he or she is being abused or neglected?
What agencies would you contact and why?
.
Check.DescriptionI need help with this one-page essay Please!Co.docxTawnaDelatorrejs
Check.
Description:
I need help with this one-page essay Please!Compare and contrast the postcolonial elements that define the works of a range of world authors, including Derek Walcott, Chinua Achebe, Deepika Bahri, W.B. Yeats, Seamus Heaney, E. M. Forster, Salman Rushdie, and Arundhati Roy.
.
Check the paper you write and add your perspective I forgot to say s.docxTawnaDelatorrejs
Check the paper you write and add your perspective I forgot to say some instructions. put some opinion about torah
Write a 3 page paper on what you have learned about Judaism that new for you and which is somehow significant to your understanding about this religion and how it affected your thinking.
Could you add some perspectives to paper you wrote...
i dont want you write new paper just add some opinion to paper
.
Check out attachments and read instructions before you make Hand Sh.docxTawnaDelatorrejs
"Check out attachments and read instructions before you make Hand Shake. Otherwise, I can't sign the agreement"
The most
IMPORTANT
things for me:
1)
Use very simple language, I'm an international student
.
2) Follow ALL instructions carefully 100%.
3) Finish it
on time
.
4) Last but not least,
Originality
.
====
I will run the paper through Copyscape that homework market provides, and the result MUST be = ZERO.
Thanks in advance,
.
check out the attachment, it has prompt, use the 4 website to quote .docxTawnaDelatorrejs
check out the attachment, it has prompt, use the 4 website to quote AND paraphrase (both are required) that i pasted on there. 800 words. APA style
download the attachment and follow the requiremen
1. A Swiveling Proxy That Will Even Wear a Tutu
By ROBBIE BROWNJUNE 7, 2013
http://www.nytimes.com/2013/06/08/education/for-homebound-students-a-robot-proxy-in-the-classroom.html?_r=0
2. How One Boy With Autism Became BFF With Apple’s Siri
By JUDITH NEWMANOCT. 17, 2014
http://www.nytimes.com/2014/10/19/fashion/how-apples-siri-became-one-autistic-boys-bff.html
3. The Ethical Frontiers of Robotics
Noel Sharkey*
http://webpages.uncc.edu/~jmconrad/ECGR4161-2011-05/notes/Science_Article_Robotics_Ethics2.pdf
4. THE ROBOTIC MOMENT
sherry turkle
In late November 2005, I took my daughter Rebecca, then fourteen, to the Darwin exhibition
at the American Museum of Natural History in New York. From the moment you step into
the museum and come face-to-face with a full-size dinosaur, you become part of a celebration
of life on Earth, what Darwin called “endless forms most beautiful.” Millions upon millions of
now lifeless specimens represent nature’s invention in every corner of the globe. There could
be no better venue for documenting Darwin’s life and thought and his theory of evolution by
natural selection, the central truth that underpins contemporary biology. The exhibition aimed
to please and, a bit defensively in these days of attacks on the theory of evolution, wanted to
convince.
At the exhibit’s entrance were two giant tortoises from the Galápagos Islands, the bestknown
inhabitants of the archipelago where Darwin did his most famous investigations. The
museum had been advertising these tortoises as wonders, curiosities, and marvels. Here,
among the plastic models at the museum, was the life that Darwin saw more than a century
and a half ago. One tortoise was hidden from view; the other rested in its cage, utterly still.
Rebecca inspected the visible tortoise thoughtfully for a while and then said matter-of-factly,
“They could have used a robot.” I was taken aback and asked what she meant. She said she
thought it was a shame to bring the turtle all this way from its island home in the Pacific, when
it was just going to sit there in the museum, motionless, doing nothing. Rebecca was both
concerned for the imprisoned turtle and unmoved by its authenticity.
It was Thanksgiving weekend. The line was long, the crowd frozen in place. I began to talk
with some of the other parents and children. My question—“Do you care that the turtle is
alive?”—was a welcome diversion from the boredom of the wait. A ten-year-old girl told me
that she would prefer a robot turtle because aliveness comes with aesthetic inconvenience:
“Its water looks dirty. Gross.” More usually, votes for the robots echoed my daughter’s sentiment
that in this setting, aliveness didn’t seem worth the trouble. A twelve-year-old girl was
adam.
Charles Mann is not only interested in how American societies arrive.docxTawnaDelatorrejs
Charles Mann is not only interested in how American societies arrived, developed, and
evolved, but also how they adapted to the multiple environments of the Americas. How
did indigenous Americans find ways to overcome environmental obstacles? What
techniques, attitudes, or actions did indigenous Americans share? What techniques were
unique to certain areas? Why did some communities and societies thrive in the years
before 1492 while others fell apart and disbanded into new groups or the landscape? How did scholars of the eighteenth, nineteenth, and twentieth centuries differ on their ideas of American Indian development?
.
Check out attachments and read instructions before you make Hand Sha.docxTawnaDelatorrejs
Check out attachments and read instructions before you make Hand Shake.
Otherwise
, I can't sign the agreement"
The most
IMPORTANT
things for me:
1)
Use very simple language, I'm an international student
.
2) Follow ALL instructions carefully 100%.
3) Finish it
on time
.
4) Last but not least, Originality.
====
I will run the paper through Copyscape that homework market provides, and the result MUST be = ZERO.
.
Chapters 5-8. One very significant period in Graphic Design History .docxTawnaDelatorrejs
Chapters 5-8. One very significant period in Graphic Design History was the Renaissance. Maybe a person or object of art made you start thinking about how it was done. here's the link for the chaper that u need to look at
https://www.youtube.com/watch?v=3vCNvvQwCos&list=PLxPtyllY6Cx_Xar71rcNFqX2bDB7Wzfll
.
childrens right in Pakistan.6 pagesat least 7 referencesAPA s.docxTawnaDelatorrejs
children's right in Pakistan.
6 pages
at least 7 references
APA style
References, citation needed
outline:
1.
Country in context
2.
Demographics
3.
History
4.
Culture and socio-economic context: official language, religion,
5.
Legislation/policies addressing rights
6.
Health status of child
7.
Education
8.
Well-being and quality of life: human develop index
9.
Status of children with special needs
10.
summary
.
CHAPTER ONEIntroductionLearning Objectives• Be able to concept.docxTawnaDelatorrejs
CHAPTER ONEIntroduction
Learning Objectives
• Be able to conceptualize the “information explosion” and how it relates to the brain sciences.
• Be able to describe pharmacodynamics and pharmacokinetics.
• Be able to articulate the benefits of an integrative approach to psychopharmacology.
ENCOURAGEMENT TO THE READER
Some of you may begin this book with some anxiety because this is a new area for you. You may imagine that psychopharmacology is exclusively a “hard science,” and perhaps you don't think of yourself as a “hard science” kind of person. You may even feel uncertain about your ability to master basic psychopharmacological concepts. First, let us assure you one more time that our goal is to make this topic accessible to readers who are practicing as or studying to be mental health professionals, many of whom may not have a background in the physical or organic sciences. Second, we recommend to those teaching a course in psychopharmacology that, because of the rapid nature of change in the field, teaching styles that rely on memorization are of limited use in this area. We recommend helping students master basic concepts and then applying these concepts to cases. To facilitate that process, we supply cases and objectives/review questions for main sections of the book. Finally, we invite you students to join us in an incredible journey centering on the most complex organ known to humanity—the human mind and brain. We hope you can revel in the complexity of the brain and the sheer magnitude of its power. We hope you can resist the temptation to want simple and concrete answers to many of the questions this journey will raise. We also hope you learn to appreciate the ambiguous nature of “mind” and its relationship to the brain. As authors and researchers who have traveled this path before us will attest, there are no simple or even known answers to many of the questions that arise (Grilly & Salmone, 2011; Schatzberg & Nemeroff, 1998). We encourage a mixture of trying to comprehend the information while dwelling in the mystery that is the context for the information. Before moving on, we offer a mantra to help you implement this recommendation.
A MANTRA
Even though psychopharmacology is in its embryonic stage, it is a vast and complex topic. Several years ago I (Ingersoll) engaged in some multicultural counseling training with Paul Pederson. In that training, Dr. Pederson commented, “Culture is complex, and complexity is our friend.” We offer a paraphrase as a mantra for psychopharmacology students: “Reality is complex, and complexity is our friend.” We remind the reader of this mantra throughout the book. You might try saying it aloud right now: “Reality is complex, and complexity is our friend.” If you reach a passage in this book that is challenging for you or that arouses anxiety, stop, take a deep breath, and practice the mantra.
The primary audience for this book is mental health clinicians who may not have had much training in biology.
Chapter TenThe Federal JudiciaryBrian M. MurphyLearnin.docxTawnaDelatorrejs
Chapter Ten
The Federal Judiciary
Brian M. Murphy
Learning Objectives
After covering the topic of the federal judiciary, students should
understand:
1. The relationship of state courts to the federal judiciary.
2. The jurisdiction of federal courts.
3. The structure of the federal judicial system.
4. The procedures of the U.S. Supreme Court.
5. The powers of the federal judiciary.
Abstract
The udicial y e i he i ed a e i a ed he d c ri e
federalism. Two court systems exist side-by-side, national and state, and
each has a distinct set of powers. State courts, for the most part, are
responsible for handling the legal issues that arise under their own laws. It
is primarily when a federal uestion is presented that the federal udicial
system can become in ol ed in a state court. therwise, state udiciaries
are generally autonomous even from one another. The Constitution
precisely outlines the types of cases that can be heard by federal courts,
yet it is almost impossible to force a federal court to hear a case that falls
under its urisdiction if the udge s wants to avoid it. The authority of
the U.S. Supreme Court has slowly grown over time, largely through the
power of udicial review. onetheless, federalism has managed to remain
a signi cant barrier against federal courts becoming too powerful. The
udicial system designed by the framers continues to survive and function
after 200 years.
Introduction
The federal judicial system is the least commonly known and least
understood branch of American government. In 2007, 78% could not
name the current Chief Justice of the U.S. Supreme Court but 66% were
able to identify at least one of the judges on the T show American
Idol (Jamieson, 2007). Much of judicial work is conducted out of the
limelight and courts are not considered an important in uence in the daily
lives of people. It is clear the framers believed that the federal judicial
system would be the weakest of the three branches because, as Alexander
amilton wrote, it has no in uence over either the sword or the purse
(Hamilton, 1961, 465). In other words, courts cannot command an army
(or even police) to ensure that decisions are enforced or allocate money to
implement one of their rulings. Judges must depend on the other branches
in order to get anything done. According to an oft-repeated story, President
Andrew Jackson supposedly mocked a decision by Chief Justice John
Marshall with the words, John Marshall has made his decision, now let
him enforce it’’ (Schwartz, 1993, 94).
But times and the role of the federal judiciary have changed. One
scholar even concluded that the United States is now operating under a
government by judiciary’’ because the U.S. Supreme Court can revise
the Constitution by how it interprets the wording (Berger, 1997). As Chief
Justice Charles vans Hughes once uipped, e are under a Constitution,
but the Constitution is what the judges say it is’’ (Hughes, 1916, 185). .
Chapter 9 provides a discussion of the challenges of identifying ELL.docxTawnaDelatorrejs
Chapter 9 provides a discussion of the challenges of identifying ELLs’ as having a learning disability or being gifted with their lower than grade-level proficiency in English. After reading Chapter 9, write a post that addresses the following questions:
What kinds of disabilities might an ELL have?
What are the challenges of determining whether an ELL has a learning ability or is gifted?
What kinds of interventions are used once an ELL has been identified as having a learning disability?
What kinds of interventions are used once an ELL is determined to be gifted?
If you were teaching a class with some ELLs in it, what signals would you look for in the behavior or they ELLs to determine whether they might need to be tested for learning disabilities or being gifted?
How might you adapt your curriculum for an ELL student with a learning disability or who is gifted?
.
Chapter 8 -- Crimes
1. Conduct that may be a misdemeanor in one state may be a felony in another state.
2. A required element for a crime is that the criminal party voluntarily commits the prohibited act (think “gun to head”).
3. A person cannot commit a crime if the person does not know that his or her conduct is criminal (think “Honduran bony fish or short lobster).
4. The Fourth Amendment prohibits ALL government searches of businesses.
5. Traditionally, extortion involves wrongful demands made by public officials.
6. A company cannot be found guilty of a crime that is committed by its agent.
7. If an employee wrongfully keeps money that was entrusted to the employee by his or employer, the employee has committed the crime of embezzlement.
8. Government officers do not need a search warrant in order to inspect property that is in "plain view".
9. The Constitution guarantees individuals the right to a speedy trial in criminal cases.
10. The Digital Millennium Copyright Act allows a person to thwart encryption devices that copy right holders place on copyrighted material if the person has purchased the copyrighted item in question.
Chapter 9 -- Torts
11. One wrongful act may be both a crime and a tort.
12. A person is not entitled to recover for EVERY injury or loss that is caused by another person.
13. In general, tort liability will not be imposed for an involuntary act even if the act harms another.
14. Under tort law, one owes a duty to society to conform his or her conduct to a required standard (think: does society sue the tortfeasor does the “somebody done me wrong” individual plaintiff sue the tortfeasor?).
15. The U.S. government cannot be sued for harm caused by the negligence of federal employees.
16. In some states, a plaintiff may recover for emotional distress that is negligently caused by another.
17. Companies can now make commercial use of the name or likeness of celebrities without first obtaining the celebrities permission to do so because most states do not recognize the tort of invasion of the right to publicity.
Chapter 10
18.
Patents are granted by state governments, not by the federal government.
19.
Trademarks may be protected for up to three years prior to the time that they are actually used.
20. A “term” acquires a secondary meaning when, through prolonged use, the public has come to associate that term with a particular product.
21. In general, mere ideas and concepts cannot be copyrighted or patented.
22.
A trade secret may be disclosed without losing its legal .
chapter 5 Making recommendations for I studied up to this .docxTawnaDelatorrejs
chapter 5
Making recommendations for I studied up to this point, what should now be study after I have written about what I found. All chapter 5 about chapter 4 what all things I discovered, what senses do they make to you what would you have study more if you have more time, what I think about , what I found
.
Chapter 4. Terris, Daniel. (2005) Ethics at Work Creating Virtue at.docxTawnaDelatorrejs
Chapter 4. Terris, Daniel. (2005) Ethics at Work: Creating Virtue at an American Corporation. Brandeis University Press. Apply critical thinking skills
in evaluating Lockheed Martin's efforts.
1. What do you think about the notion presented by Terris that Lockheed's ethics program does little to prevent ethical breaches at the highest level of the organization?
2. Are the efforts put forth—such as making sure higher level executives participate in training—enough to help executives navigate what Terris calls the 'ethical minefield' faced by leadership in such an organization?
3. What are some things that could be done to address the issue related to ethics at higher executive levels of the organization?
4. Terris points out that the company's program is overly focused on individuals and that it doesn't really address group dynamics that can impact ethical situations. For instance, there can be a tendency for groups to ‘go with the flow’ of the group decision making process and overlook ethical issues in the process. What would you recommend that Lockheed Martin do to address this situation?
(Hint: reviewing p. 128 and the following pages – before section headed “Personal Responsibility, Collective Innocence” - of the text might be helpful).
Assignment Expectations: Write a 4- to 5-page paper, not including title page or references page addressing the issue.
Your paper should be double-spaced and in 12-point type size.
Your paper should have a separate cover page and a separate reference page. Make sure you cite your sources.
.
Chapter 41. Read in the text about Alexanders attempt to fuse Gre.docxTawnaDelatorrejs
Chapter 4
1. Read in the text about Alexander's attempt to fuse Greek and Eastern cultures (116-120 -see box Alexander meets an Indian King, 115). Then go to:
Alexander the Great
- a from a BBC documentary. The video will have to be opened in a new window.
Write a brief review after watching the documentary (You don't have to watch the entire hour). What does Wood have to say about the scope of Alexander the Great's accomplishments? Does watching a video set in the actual landscape of Macedonia and Turkey help understand the history of an ancient civilization? How?
2. Go to:
Building of the Parthenon
and
Optical 'tricks' at the Parthenon
to see the accomplishments of Greek architects and politicians. What is the connection between Athenian politics and the building of the Parthenon? What illusions were utlitzed by the architects and engineers to emphasize the grandeur of the Parthenon?
Chapter 5
Select TWO of the following questions and complete the links assignments: Remember to mention source material in your response.
(Select 3 for extra credit
1. Go to:
Roman Writers view their world
and choose 2 authors to write an essay on entertainments and past times of Roman citizens and how eyewitnesses wrote about their world. Who are they? What position did they hold in Roman society? Is this important to their view point?
2. Go to
Christian symbolism
and
Colors in religious art
and write about how a largely illiterate (slave and lower class Romans and client state residents) society could learn about this new "Christian" religion through art, symbolism and color. How would this help the conversion process?
3. Go to
Sights along the Silk Road
. Click on the interactive maps and visit several of the stops along the Silk Road. What did you find? Learn? Then go to :
Silk Road Project
. Click on "Music and Artists." Then "Listen to Music."
Click on a title for ex: "Arabian" to listen to sample of the music and instrument. Write on your findings.
You may have to update your "Flash" player to hear music
.
Elevate Your Nonprofit's Online Presence_ A Guide to Effective SEO Strategies...TechSoup
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This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
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THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
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إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
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Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Can J Respir Ther Vol 57 129This open-access article is di
1. Can J Respir Ther Vol 57 129
This open-access article is distributed under the terms of the
Creative Commons Attribution Non-Commercial License (CC
BY-NC) (http://
creativecommons.org/licenses/by-nc/4.0/), which permits reuse,
distribution and reproduction of the article, provided that the
original work is
properly cited and the reuse is restricted to noncommercial
purposes. For commercial reuse, contact [email protected]
Published online at https://www.cjrt.ca on 8 October 2021
RESEARCH ARTICLE
Exploring the professionalization of respiratory
therapy in Canada
Marco Zaccagnini, PhD (c), MSc, RRT-CCAA, FCSRT1,2,
André Bussières, DC, PhD1,2,3, Peter Nugus, MA(Hons),
PhD4,5,
Andrew West, EdD, FCSRT6, Aliki Thomas, OT (c), PhD1,2,4
M Zaccagnini, A Bussières, P Nugus, A West, A Thomas.
Exploring the professionalization of respiratory therapy in
Canada. Can J Respir Ther
2021;57:129–137. doi: 10.29390/cjrt-2021-046.
Introduction: A recurrent challenge facing respiratory therapists
(RTs) is their legitimacy as professionals. RTs are often
referred to as technologists, voca-
tionalists, or technicians and must often justify their status as
full professionals rather than “professional technicians”. There
2. is currently little exploration
of what it means to be a profession and the process of
professionalization in respiratory therapy.
Approach: Drawing from sociological theory, the purpose of
this paper is to discuss the professionalization of respiratory
therapy in Canada using Andrew
Abbott’s theory, the “system of professions”. We will use this
theory as a lens to propose areas of consideration for
professional development regarding two
pervasive themes in the respiratory therapy community, RTs’
specialized body of knowledge and professional autonomy.
Findings: Abstract knowledge is believed to be essential in the
evolution from occupation to profession and is valuable to a
profession in three ways: it can influ-
ence the profession’s legitimacy, it can be used for conducting
research, and it promotes higher education. RTs possess
jurisdictional professional autonomy within
Canada. The privilege of self-regulation allows RTs to act
according to their knowledge and judgement without direct
oversight from other professions.
Conclusion: Based on Abbott’s theoretical position, RTs can
rightly justify their position as professionals. However, RTs
need to acknowledge that profession-
alization is a dynamic and continuous process that requires
creative changes to innovate within the profession and support
future efforts to reinforce their
position as professionals. Throughout this paper, we offer
suggestions for how RTs can contribute to the ongoing
professionalization of respiratory therapy.
Key Words: professional practice; respiratory therapy; allied
health personnel; social theory; societies; professionalization
INTRODUCTION
In Canada, there are over 12,000 practicing respiratory
therapists (RTs) who
3. possess clinical expertise, knowledge, and skills in
cardiorespiratory health
care [1–3]. Despite the involvement of RTs across a broad range
of health
services, public knowledge of the respiratory therapy profession
remains
superficial. This is in part perpetuated by variability in the
respiratory ther-
apy workforce globally. For instance, outside of North America,
only a few
countries have the services of RTs incorporated into their health
care sys-
tems. In countries without RTs, professionals such as
physiotherapists,
nurses, or physicians who chose to specialize in the respiratory
field typically
provide respiratory care. Respiratory therapy is in a state of
transition world-
wide [4, 5]. Only recently, amidst the global changes caused by
the coronavi-
rus (COVID-19) pandemic, have RTs been featured as key
members of
interprofessional teams and critical to the health care system
[6–10].
A recurrent challenge facing RTs is the inconsistency regarding
their
legitimacy as professionals. They are often referred to as
technologists,
vocationalists, or technicians and must often justify their status
as full
professionals rather than “professional technicians” [11]. There
is cur-
rently little exploration of what it means to be a profession and
the pro-
cess of professionalization in the context of respiratory therapy.
4. A deeper
and theory-driven inquiry regarding the process of RTs
professionalization
journey may provide valuable insights into how it might evolve
to meet its
societal obligations and continue to develop as a profession.
The purpose of this paper is to discuss the professionalization
path-
way of respiratory therapy in the Canadian context. We use
Andrew
Abbott’s [12] “system of professions” theory to propose areas
of consid-
eration for the future professionalization of RTs regarding two
pervasive
themes in the respiratory therapy community, namely RTs’
specialized
body of knowledge and professional autonomy.
The emergence of respiratory therapy in Canada
Respiratory therapy is a relatively young area of practice.
Respiratory ther-
apy became officially established in 1947 in the United States
followed by
Canada in 1964. Canadian respiratory therapy was born out of a
need
during the post-World War II era when the Canadian health care
system
was undergoing rapid technological, environmental, and societal
changes.
Spurred by the poliomyelitis (polio) epidemic of 1950–1954,
new technol-
ogy was appearing rapidly. These innovations included
developing positive
pressure mechanical ventilators as an alternative to negative
5. pressure
(“iron lung”) ventilators, new technology to alleviate patient’s
hypoxemia,
and new pharmacological agents in anesthetics, bronchodilator
therapy,
and broad-spectrum antibiotics [13]. The emergence of this new
1School of Physical and Occupational Therapy, McGill
University, Montréal, QC, Canada
2Centre for Interdisciplinary Research in Rehabilitation of
Greater Montréal, Montréal, QC, Canada
3Département Chiropratique, Université du Québec à Trois-
Rivières, Trois-Rivières, QC, Canada
4Institute of Health Sciences Education, McGill University,
Montréal, QC, Canada
5Department of Family Medicine, McGill University, Montréal,
QC, Canada
6The Canadian Society of Respiratory Therapists, Saint John,
NB, Canada
Correspondence: Aliki Thomas, McGill University, 3654
Promenade Sir William Osler, Montréal, QC H3G 1Y5, Canada.
E-mail: [email protected]
http://creativecommons.org/licenses/by-nc/4.0/�
http://creativecommons.org/licenses/by-nc/4.0/�
mailto:[email protected]
mailto:[email protected]
Zaccagnini et al.
130 Can J Respir Ther Vol 57
technology required physicians to seek assistants to help them
manage and
apply the new technology to patients, thereby creating the
6. “oxygen orderly”
occupation. These orderlies were individuals with various
backgrounds
(e.g., war veterans, engineers, surgeon’s assistants) who held
various posi-
tions throughout the hospital (e.g., in the engineering
departments) and
possessed some mechanical knowledge of gas distribution
systems [13].
The orderly’s educational emphasis in the respiratory field was
on the tech-
nical knowledge needed to provide a safe oxygen delivery
service rather
than acquiring medical literacy skills related to
cardiopulmonary diseases
and their treatments. The tasks of orderlies included cleaning,
managing,
storing, and delivering high-pressure oxygen cylinders and
related oxygen
equipment to the patient’s bedside, ensuring oxygen humidity
bottles were
filled with water, and servicing anesthesia and mechanical
ventilators [13].
As technology continued to expand, so too did the diversity of
the tasks
performed by the oxygen orderly. This expansion resulted in
physicians
(notably anesthesiologists and respirologists) relying
increasingly on the
oxygen orderlies [13].
In June of 1961, the movement to officially define and
formalize the
inhalation technician (formally known as oxygen orderly)
occupation
began. The Canadian Anesthesia Society (CAS) and the
7. Canadian
Medical Association (CMA) created the pilot committee on
inhalation
therapy. The mandate of the CAS–CMA was to make
recommendations
on the minimum educational qualifications required to practice
as a tech-
nician and to establish standards of care [14]. The CAS–CMA
concluded
that inhalation technicians require 1 year of technical and
academic train-
ing within the hospital under direct medical supervision to
remain an
asset in Canadian hospitals [14, 15]. These physician groups
drove the cre-
ation of respiratory therapy, contributed to the licensing exam,
and sup-
ported the development of dedicated inhalation therapy schools
across
Canada. Simultaneously, the inhalation technicians established
the
Canadian Association of Inhalation Therapists (CAIT) in 1964
to act as a
certification agent in response to medical employers’ demands
for educa-
tional standardization. The CAIT also created a scientific
journal dedi-
cated to empirical research of inhalation technology of Canada:
The
Canadian Inhalation Therapy Journal [16] and officially
changed the profes-
sional title from inhalation technician to respiratory therapist.
The empha-
sis on “therapist” suggested that RTs were steadily becoming
more clinically
and patient-oriented rather than being merely technical support.
8. In Canada, the respiratory therapy curricula evolved to include
phys-
iology and pathology, a greater focus on clinical observation
and diagno-
sis, and explicit content on understanding and selecting
techniques to
fulfill therapeutic objectives [13]. As a result, in 1967, hospital
training
programs began to integrate with educational institutions. The
first
Canadian community college–hospital-affiliated training
program
appeared in Edmonton, Alberta, at the Northern Alberta
Institute of
Technology. College-based programs at Fanshawe College in
London,
Ontario, and the Toronto Institute of Medical Technology,
Toronto,
Ontario, quickly followed [13]. There is no documented
information
regarding why these programs chose to merge with technical
schools. It
may have been due to RTs identifying with the school’s
technological
orientation or simply a matter of availability. The education
level for
Canadian RTs was deemed appropriate at the college-diploma
level [14,
15]. Despite the numerous developments of the respiratory
therapy pro-
fession over time, it is unclear at which point and how the
occupation of
an inhalation technician became the profession of respiratory
therapy.
Sociologist’s Andrew Abbott’s theory of the “system of
9. professions” [12]
may help clarify aspects of professionalization within the
respiratory
therapy profession.
Process of professionalization
Professionalization is the social process and evolutionary path
by which
an occupation evolves through an occupational hierarchy [17,
18]. This
process is used to garner professional status, expertise, establish
a market
for specific services, and gain a heightened social positioning
[18–23].
Professionalization is a broad and complex area of study often
found in
sociology (i.e., the study of social life) because work
encompasses a large
part of what it means to be a social being [24].
A review of the many theories of professionalization is beyond
the
scope of this article and has been published elsewhere (see
Martimianakis
et al. [25]). For the purposes of this discussion, we applied
Abbott’s [12]
theory of professionalization as it is the most recent
comprehensive the-
ory of professions. Before Abbott, theories of
professionalization mostly
focused on how professions were organized, how much power
they held,
and how they developed unidirectionally. On the other hand,
Abbott
argued that to understand the progress of a profession, we must
consider
10. its social and professional surroundings, and the process in
which it
interacts with those surrounding [26–28].
The system of professions
Andrew Abbott, in his “System of Professions”, postulated that
profes-
sions do not develop in isolation from one another and that
profession-
alization is not a unidirectional process but a dynamic process
[12].
Specifically, professions constantly fluctuate because they
develop and
exist within a complex and expansive professional, social, and
economic
environment. Abbott revolutionized the study of professions by
suggest-
ing that they be studied within a broader ecological and
evolving system
to better understand their status. He suggested that the focus be
on four
interacting elements that may influence the development,
maintenance,
and fate of professions: work, jurisdiction, competition, and
abstract
knowledge [12]. We describe each one next.
Work
Professionals are tasked with addressing complex human
problems that
require specific domains of expertise. They must demonstrate
their work
expertise through a logical sequence of tasks and by engaging in
activities
that comprise the classification of a problem and by reasoning
on and
11. then acting on a given problem. This sequence represents the
“how” a
professional performs their work. It is the “how” professionals
work and
the cognitive structure (i.e., the sequence of logic and
engagement)
required to solve a problem that justifies their claims of
jurisdiction.
Jurisdiction
Abbott defines jurisdiction as the vital link between a
profession and the
tasks that compose its work. Jurisdiction (or control over work)
is where
a profession solicits society’s recognition of its cognitive
structure
through exclusive rights (e.g., professional autonomy, public
payments,
rights of self-discipline) [12]. However, claiming jurisdiction is
only pos-
sible in three areas: the workplace, public opinion, and the legal
system
(e.g., legislation). Together, these three jurisdictions create
temporary
stability in the profession because its members convey an image
of a
well-defined boundary surrounding the profession. However,
these juris-
dictions are never permanent and are constantly under
competitive pres-
sure in a system of professions such as when a task or clinical
expertise is
shared by two different professions, like complementary and
alternative
medicine, who may advocate for a jurisdiction to independently
treat
12. patients who are traditionally cared for by physicians [29].
Competition
While jurisdiction is the core tenet of a profession, by no means
is it
permanent. Professions “live” in proximity to one another in an
interde-
pendent system, in that each profession competes with others
for work
(e.g., “fight for turf”) and the right to a jurisdiction. A shift in
any profes-
sion will likely affect the entire system of professions [12]. One
example
of this shift appeared in the late 1980s when orthopedic
surgeons
decided to limit their practice to desirable aspects of their job
rather
than more routine ones (e.g., performing surgery instead of
office coun-
selling), paving the way for other providers (podiatrists) to
claim this
newly vacant jurisdiction [30, 31].
Competition for jurisdiction begins from external forces (i.e.,
opening
or closing jurisdictions as a response to cultural and
technological shifts)
or internal forces (i.e., professionals reformulating their
knowledge base,
developing new knowledge, and (or) developing new skills to
expand into
other jurisdictions (e.g., nurse practitioners prescribing
medication)) [32].
Achieving and maintaining professional jurisdiction requires
that a pro-
fession controls the abstract knowledge needed to perform the
13. tasks [12].
Professionalization of respiratory therapy in Canada
Can J Respir Ther Vol 57 131
Abstract knowledge
Abstract knowledge is the key to establishing, expanding, and
maintain-
ing jurisdictional boundaries for any given profession. It
consists of the
formal and necessary information, principles, and concepts that
are
foundational for professionals to do their work [12, 33–37].
This knowl-
edge is constantly evolving, transformi ng, and growing in ways
that help
to affirm its value. Certain members of the profession
constantly scruti-
nize, discuss, document, and test this knowledge to ensure that
health
care professionals are equipped to fulfill society’s ever -
changing needs
[38]. Abbott suggested that professionals who possess abstract
knowledge
provide the profession with a degree of power and prestige.
Activities
and services performed without this foundational abstract
knowledge do
not convey the same authoritative influence over individuals
receiving
the services [12]. Abstract knowledge is believed to be essential
in the
evolution from occupation to profession and is of value to a
14. profession
in three ways: (i) it can influence the profession’s legitimacy,
(ii) it is used
to conduct research, and (iii) it promotes higher education,
which we
discuss next [12].
Abbott’s system of profession underscores the notion that
profes-
sionalization is complex and can be influenced by the economy,
the orga-
nization, the local and national politics, culture, power
differences, and
society, often occurring in a non-linear fashion [12, 17, 39, 40].
We
applied Abbott’s theory as a lens to the respiratory therapy
profession in
Canada to understand its professionalization and make
suggestions
about future opportunities related to two major themes: RTs’
specialized
body of knowledge and professional autonomy.
Professionalization and abstract knowledge in respiratory
therapy
Abstract knowledge (i.e., specialized body of knowledge) is the
key to
maintaining the power and prestige needed to secure and retain
jurisdic-
tions. Abbott argued that “any occupation can obtain licensure
(e.g., beauti-
cians) or develop an ethics code (e.g., real estate). But only a
knowledge system
governed by abstraction can redefine its problems and tasks”
[12] (p. 9). It is
essential to consider all aspects of abstract knowledge (i.e.,
15. developing a
specialized body of knowledge) to determine its influence on
profession-
alization and how to further develop abstract knowledge to
reinforce and
evolve the professionalization of respiratory therapy.
The original motivation for training RTs (oxygen orderlies at
the
time) was to fill vacant technical positions caused by the rapid
evolution
of technology in hospitals. Many orderlies did not have
preparatory edu-
cation or continuing education and they trained on the job,
focusing on
the technical aspects of oxygen equipment. The educational
emphasis on
the technical component of work highlights that their
foundational
knowledge did not include any degree of abstraction.
Knowledge tied to
the routine use of a piece of equipment did not suggest any
abstract
decision-making; as such, the oxygen orderly’s work was akin
to a craft
[11, 12]. Oxygen orderlies were technicians (i.e., craftsmen)
whose foun-
dational knowledge and work were defined and confined to the
machines
and devices they serviced and maintained (i.e., mechanical
ventilators).
This link proved to be both a blessing and a curse in RTs’ r oute
towards
professionalization as they used their understanding and use of
mechan-
ical ventilators as the springboards for creating their own
16. abstract
knowledge.
RTs were fortunate to have robust physician support in their
forma-
tive years. Arguably, physicians’ sponsorship was responsible
for creating
and elevating RTs’ abstract knowledge base. A landmark article
from the
CMA proposed a training program for technicians, which
included a
blend of both technical and academic training—specifically
including
advanced training such as physiology and cardiovascular
pathology but
within the confines of the mechanical ventilator [14]. During
the 1970s,
RTs continued to create accredited educational programs,
trained a sub-
stantial number of RTs, and successfully created hospital
positions for
individuals with respiratory therapy credentials. As RTs
obtained regular
positions in the hospital hierarchy, they looked for ways to
distinctly
evaluate and take care of hospital patients to safeguard their
value as
professionals and legitimize their role. At the time, other
professions
(e.g., physiotherapy) chose to cut ties with their routine use of
machines (e.g., electrotherapy) and adopted a more patient-
focused
approach [41, 42]. It seemed that RTs leveraged their
mechanical roots to
define their abstract knowledge and claim their expertise.
17. RTs’ mechanical roots proved invaluable when new
technological
innovations in medicine allowed them to extend their
mechanical venti-
lator knowledge and skills into new categories of respiratory
assistance
[11, 13]. This assistance included the routine use of positive
pressure
ventilation and the routine application of positive end-
expiratory pres-
sure (PEEP) to treat respiratory failure and oxygenation [43].
These
modalities became widespread in Canadian hospitals and
required a
precise calibration of the pressure level specific to each patient
case and
required safe and constant monitoring and regulation of the
applied
positive pressure. These techniques became a curative modality
that
required expert knowledge that was directly rooted in the daily
use of
mechanical ventilators [11, 13]. This modality revolutionized
the care for
patients and revolutionized RTs’ tasks. Finally, the mechanical
ventilator
work of RTs evolved from a technical aspect to a therapeutic,
patient-cen-
tred modality that succeeded in abstracting some of the RTs’
knowledge.
This abstract knowledge successfully positioned RTs to fill a
vacancy in
knowledge and allowed them to achieve a degree of jurisdiction
and to
move towards professionalization. However, possessing abstract
18. knowl-
edge alone isn’t enough; one must apply the abstract knowledge
in
unique ways to further contribute to the professionalization of
respira-
tory therapy.
Legitimacy
The foundation of abstract knowledge in respiratory therapy is
the ther-
apeutic application of mechanical ventilators and other
technology-based
respiratory care therapeutics. Notably, the constant evolution,
refine-
ment, increased sophistication, and expanded clinical
application of
mechanical ventilation has been a driving force in developing
RTs’
abstract body of knowledge, which legitimizes the work (and
profession)
of RTs [44]. Since the innovation of PEEP in the 1970s, RTs
have success-
fully defended and innovated within the domain of their unique
abstract
knowledge relating to the application and management of
mechanical
ventilation [45]. RTs have successfully applied such abstract
knowledge
to other clinical practice areas, whose foundations are linked to
mechan-
ical requirements (e.g., anesthesia, sleep lab, home ventilation
case man-
agement), and have consistently ensured that their approach to
mechanical application is always patient-centred, holistic, and
therapeu-
tic [46].
19. Despite RTs’ successful application of abstract knowledge to
other
clinical venues, further developments are necessary if the
profession is to
continue to innovate. To impact respiratory therapy practice and
research, RTs and researchers will need to develop the ability to
apply
respiratory therapy knowledge from different disciplines (e.g.,
epidemiol-
ogy, social science). This can be achieved through deeper
considerations
of a range of knowledge paradigms (e.g., post-positivism,
constructivism),
which legitimize sources of knowledge other than those
obtained
through, for example, quantitative methodologies (i.e., using
qualitative
and mixed-method methodologies). Doing so will require that
they make
explicit their views on what can be learned (ontology), whether
that
knowledge is considered to be valid or legitimate
(epistemology), and how
that knowledge is obtained (methodology) [47]. Currently, this
breadth
and depth of unique respiratory therapy knowledge is lacking.
Research
Abstract knowledge is also used to conduct research. The
primary aim of
research is to create new knowledge in a way that shapes and
changes the
current and future professional knowledge base (e.g.,
developing new
ways that professionals may treat or diagnose the problems of
20. profes-
sional work) [12]. Information about RTs whose primary
mandate is to
conduct research is scarce. Few RTs hold any research-related
positions,
and no data exist on if and how they receive financial support to
conduct
research [48, 49].
According to the results of a cross-sectional study by Martins
and
Kenaszchuk [50], RTs strongly believe that they should be the
ones who
formulate and test hypotheses on topics likely to advance
respiratory
therapy practice. Indeed, RTs are the end-users of the
technological or
Zaccagnini et al.
132 Can J Respir Ther Vol 57
therapeutic modality and are thus well-suited to generate
questions and
add to RTs’ knowledge base [50]. Some suggestions to support
RTs’
efforts to further professionalize include (i) professional
organizations or
governing bodies to advocate for academic or clinical positions
for RTs
that hold protected time for research and (ii) capacity-building
activities
for RTs interested in research using empirically supported
frameworks
21. (see Matus [51] for an overview). Respiratory care research led
by RTs can
play a significant role in contributing to abstract and evidence -
informed
knowledge in the profession, further legitimizing the work RTs
do.
Instruction (higher education)
Abstract knowledge is particularly useful for developing and
promoting
higher education for RTs [12]. As mentioned in the historical
overview,
the original Canadian RTs’ education level was deemed
appropriate at
the college-diploma level. Today, official professional
statements have
advocated for raising the entry-level diploma training to an
undergradu-
ate degree to meet the complex requirements of the health care
environ-
ment and to remain competitive compared with other allied
health
professions [52–54]. Additionally, in Canada, there is no
graduate edu-
cation for RTs. Comparatively, in the United States, 13
programs offer
graduate degrees in respiratory therapy; however, there are no
available
doctoral-level programs [55]. The argument for developing
higher educa-
tion needs to be supported by empirical evidence showing the
benefits
while also acknowledging societal, economic, and socio-
political trends
requiring higher levels of education in its RTs.
22. Using Abbott’s theory [12], we can begin to see how all levels
of
higher education function within the complex system of
professions. In
addition to educating the next generation of health care
professionals,
higher education contributes to developing abstract knowledge
and to
the development of a profession. The current curricula for
respiratory
therapy training are loaded with the foundational knowledge,
skills, and
attributes required by students to function as a professional in
the cur-
rent health care system. However, core curricula will need to be
revised
to include training in research methods, scientific writing, and
the prin-
ciples of science, which contributes to developing abstracting
knowledge
for respiratory therapy [56–59]. In the current North American
educa-
tional system, the first step is an undergraduate degree in
respiratory
therapy (i.e., B.RT) [60]. Undergraduate degrees introduce
students to a
broader range of competencies directly related to the profession
and its
functioning within the system (e.g., public health, health policy,
leader-
ship, etc.) [61]. For example, while undergraduate medicine
students
learn about anatomy and diagnosis, they integrate principles
deemed
essential for Canadian physicians (e.g., health policy, research)
outlined
23. by the CanMEDS competency framework [62].
Undergraduate programs are designed to include space to
integrate
topics such as research that may contribute to the growth of a
profession,
including potentially exploring career directions, building
transferable
skills, learning how to publicly advocate for and defend the
work of RTs,
and create knowledge to impact patient care [63–65]. Graduate
respira-
tory therapy degrees (e.g., MSc. RT) promote RTs to develop
advanced
practice and integrate introductory research skills in their
practice,
enabling graduates to enter the workforce with advanced
competencies
[66–68].
Developing advanced professional knowledge that optimizes
and
bridges the research–practice gap is the main purpose of
professional
doctorates (e.g., Doctor of Nursing Practice (DNP), Doctor of
Occupational Therapy (OTD)) [38, 69, 70]. These programs
build upon
a foundation of knowledge gained during graduate studies and
further
focus on the development of scholarly practitioners and their
ability to
successfully apply and develop theory related to everyday
problems of
professional practice within the workplace [71]. Although
professional
doctorates have a strong focus on advanced practice, training in
24. and
contribution to research has the potential to increase the use of
evidence
in practice. Graduates of professional doctorates are in a unique
position
to apply and extend knowledge in areas such as quality
improvement,
interprofessional collaboration, patient outcomes, health poli cy
legisla-
tion, and advocacy as leaders in evidence-informed respiratory
therapy
practice [72, 73]. However, as Abbott indicated, professional
practice is
not the only source of knowledge [12]. All aspects of
knowledge (e.g.,
practical knowledge, theoretical knowledge) should be
developed con-
currently to support the abstraction of knowledge. The Doctor
of
Philosophy degree (Ph.D.) can be used to help professionals
contribute
to their profession on a theoretical and conceptual level rather
than on
an immediately practical one. For example, Ph.D. graduates in
respira-
tory therapy may focus on the profession on a philosophical
level by
considering “why” and “how” types of research questions and
by chal-
lenging existing knowledge and professional assumptions. Each
degree
contributes distinct yet complementary knowledge to a
profession; this
knowledge serves as the foundation of abstract knowledge and,
as such,
25. supports the professionalization of the profession [12].
Professionalization, jurisdiction, and professional autonomy in
respiratory therapy
Professional autonomy is defined as having control over one’s
profes-
sion, the professional’s work, and jurisdiction of a field of
expertise [74].
Although professional autonomy is foundational for
professional power
and professionalization within modern society, it is constantly
evolving
[12, 75, 76]. Professional autonomy is gained, negotiated, and
potentially
lost depending on the profession’s relationship with society [22,
77].
According to Abbott, possessing a degree of professional
autonomy
means successfully achieving a jurisdiction [78, 79]. In the
subsequent
paragraphs, we use the terms jurisdiction and professional
autonomy
interchangeably to discuss the professional autonomy of RTs
with regards
to their professionalization.
The first step towards securing a jurisdiction involves finding a
vacant area of work to control, which may happen for numerous
reasons
(e.g., social or technological evolution) [12]. RTs benefited
from a new
jurisdiction formed by technological advancements (i.e.,
positive pres-
sure mechanical ventilators) during Canada’s polio epidemic’s
manage-
ment. Physicians successfully argued that a new profession was
26. needed to
manage this new technology; specifically, they recommended
that new
experienced technicians had to be trained to assist physicians
“since, by
and large, interns, nurses and other paramedical personnel are
not trained to
carry out these specialized duties” [14]. We will discuss RTs’
jurisdictional
claim in the three areas outlined by Abbott [12]: the workplace,
the legal
system, and public opinion.
Workplace
Spurred by concrete needs, resources, and other workplace
contextual
circumstances, newly developing jurisdictions begin in the
professional
world (i.e., the workplace) [12]. During the 1950s, physicians
had consid-
erable interest in administering oxygen therapy to patients.
However,
because of the absence of medical gas pipeline systems, there
was a need
for the delivery of oxygen cylinders and related oxygen
equipment to the
patient’s bedside [13, 45]. As the physician’s demands for
oxygen services
grew, RTs’ jurisdiction also grew. This jurisdictional growth
was in large
part caused by physicians’ actions as the dominating health care
profes-
sional. Rather than physicians performing the labor-intensive
work
themselves, they decided to delegate (but remain in control of)
the rou-
27. tine application of oxygen work to a separate occupation. The
original
tasks of RTs (e.g., delivering oxygen tanks) were deemed too
simple given
the nature and level of physicians’ expertise. The RTs’ work
was labour
intensive, using technical skills to provide safe oxygen service;
the need
for any medical knowledge or expertise was minimal [13].
Delegating jurisdictional control of the routine application of
oxygen
work was advantageous for physicians as it enabled them to
retain a
major influence over RTs’ growth and independence [12, 77].
This type
of jurisdictional control is called subordination [11, 80]. The
negative
connotation of subordination notwithstanding, physicians’
involvement
in developing the RTs’ workplace jurisdiction was key in the
profession-
alization of respiratory therapy in Canada. Physicians held a
vision for
cardio-respiratory care that included a new type of personnel,
resulting
in the creation of trained employees to help them attain this
goal
[13–15]. Physicians’ support helped create an initial foothold in
the pro-
fession’s jurisdiction and constituted the first step towards
professional-
ization. Despite the support that RTs received from their local
physicians,
http://B.RT
28. Professionalization of respiratory therapy in Canada
Can J Respir Ther Vol 57 133
they recognised that to evolve as a profession they need to
develop their
jurisdiction in other, larger areas such as the legal system and
public
opinion.
Legal
Without legal protection (i.e., statutory rights, administrative
structure),
a health care practitioner’s right to claim a specific jurisdic tion
is more
vulnerable to challenges from other professions. RTs
successfully
obtained a jurisdiction in the workplace when they began
providing oxy-
gen therapy and managing mechanical ventilators. Despite their
success
in the workplace, RTs’ jurisdiction was at risk when their work
became
more routine, most notably in the delivery of aerosol medication
[11].
Nurses lobbied to gain control of the routine delivery of aerosol
medica-
tion to strengthen their own position as professionals. They
contended
to claim the work of determining doses, monitoring patients,
and choos-
ing the nebulizers used to deliver the drugs. These
developments in the
nursing profession resulted in a loss of workplace jurisdiction
29. for RTs
[11, 13]. Despite these setbacks, more physicians made requests
for the
work of RTs in areas such as post-operative and intensive care
[11]. It was
clear that because of the increased reliance on RTs’ skills, RTs
had to
move beyond the local workplace jurisdiction and legally (and
more per-
manently) secure their jurisdiction.
To claim a legal jurisdiction, a group of health care
practitioners
needs to organize itself into a single, identifiable association
[12]. Two
distinctions are made here; the first is “being organized” and
the second
is “possessing a membership to their association”. When a
profession is
strongly organized, they become better at mobilizing and
controlling its
members in an effort to assure the public’s concerns of
trustworthy
work, leading to more effective claims of jurisdictions. The
second is
“the association”. Professional associations (formed at the local
or
national level) advocate for the interest of their members,
support capac-
ity building within the profession, and lobby policymakers. In
contrast,
the regulatory body protects the public’s interest [81]. In
respiratory ther-
apy, Manitoba became the first province in 1981 to form a
provincial
organized regulatory body to advocate for obtaining legislative
30. protec-
tion, the privilege of self-regulation, the control of work, and
jurisdic-
tion. Since then, eight more provincial regulatory bodies
followed
(Table 1) [82]. Legislation relates to a law or laws that describe
the extent
of legal authority delegated to the profession; it draws a
boundary or
border around the profession [83]. It essentially acknowledges
the profes-
sion, the expertise, and the body of knowledge and gives it the
privilege
of self-regulation. Across the provinces and territories of
Canada, the
respiratory therapy profession is legislated in eight out of 11
provinces
(Table 1). The provincial regulatory bodies operate under a
model of
statutory self-regulation. Self-regulation refers to a professional
organiza-
tion’s powers to set a framework of rules that holds its members
account-
able [84, 85]. Self-regulation is a social contract between the
profession
and society where legislation allows the profession to set,
within broad
limits, its own standards. In return, patients receive an
augmented level
of standardized care [84].
It is important to note that some professions might not yet have
achieved legislation in their respective location of practice for
reasons
such as an insufficient number of members, adequate oversight
31. from
employers, and lack of perceived benefit for quality of patient
care.
Without one or more of these reasons, a profession will not earn
the
right to self-regulate [86].
As part of the delegated authority, self-regulated professions are
(first
and foremost) entrusted with ensuring the safety and interest of
the pub-
lic. It is not to support the profession or individual members.
Regulatory
bodies ensure patient safety by establishing entrance
requirements, man-
dating continuing education and professional development
programs,
developing a code of ethics, and developing and updating
practice stan-
dards. Regulatory bodies also implement procedures to address
com-
plaints and allegations of professional misconduct. These
administrative
standards and accountability instituted for the publi c’s interest
and
safety support the profession’s jurisdiction [83].
Regulations play an important role in facilitating—and
sometimes lim-
iting—the jurisdiction of a profession. Regulations place
boundaries on
work that professions can and cannot do, which is more
commonly
referred to as a scope of practice [87]. According to this,
autonomy refers
to the ability to act according to one’s knowledge and
32. judgement, provid-
ing care within the full scope of practice as defined by existing
profes-
sional, regulatory, and organization rules [88]. Autonomy does
not and
cannot mean full independence [89]. Autonomy is enacted
within the
context and boundaries of an interdependent health care team.
RTs work
in a complex system, with physicians often exerting some
degree of domi-
nance in the decision-making in the workplace [87, 89–92].
Essentially, a
status of self-regulation removes a profession’s constant
oversight and
direction by a third party (e.g., physicians in the case of RTs)
and confers
the oversight to members of that profession a degree of
autonomy to pro-
vide care in a manner that is consistent with the public’s best
interest.
Self-regulation is a privilege granted by the government based
on the
public’s trust. Trust and jurisdiction are tenuous concepts often
influ-
enced by social environments. Some argue that self-regulation
is a
TABLE 1
Respiratory therapy legislation
Province or Territory Regulatory body Governing legislation
Ontario College of Respiratory Therapy of Ontario (CRTO)
Regulated Health Professions Act;Respiratory Therapy
Act, 1991 and regulations under the Act
33. Alberta College and Association of Respiratory Therapists of
Alberta (CARTA) Health Professions Act, Revised Statutes of
Alberta
(R.S.A) 2000 serves as umbrella legislation for multiple
health professions.
Manitoba Manitoba Association of Registered Respiratory
Therapists (MARRT) Registered Respiratory Therapists Act
C.C.S.M. c. R115
Québec Ordre professionnel des Inhalothérapeutes du Québec
(OPIQ) Respiratory therapy is one of the professions regulated
under the Professional Code, R.S.Q., chapter C-26.
Nova Scotia Nova Scotia College of Respiratory Therapists
(NSCRT) Respiratory Therapists Act, S.N.S. 2007, c. 13
Respiratory Therapists’ Regulations
New Brunswick New Brunswick Association of Respiratory
Therapists (NBART) An Act Respecting Respiratory Therapists
2009
Saskatchewan Saskatchewan College of Respiratory Therapists
(SCRT) The Statutes of Saskatchewan, (2006)
The Respiratory Therapists Act
Newfoundland and Labrador The Newfoundland and Labrador
College of Respiratory Therapists
(NLCRT)
Health Professions Act
Respiratory Therapists Regulations
Prince Edward Island None Professional credential overseen by
the Canadian
Society of Respiratory Therapists (CSRT)
34. British Columbia None Professional credential overseen by
CSRT
Prince Edward Island None Professional credential overseen by
CSRT
Yukon None Professional credential overseen by CSRT
Nunavut None Professional credential overseen by CSRT
Northwest Territories None Professional credential overseen by
CSRT
Zaccagnini et al.
134 Can J Respir Ther Vol 57
monopolistic endeavour by professions; they do not serve the
public’s
best interest and that the focus should be on a new model of
care (e.g., a
model that includes lay people in leadership positions) [93, 94].
The
removal or significant modification of a self-regulation model
and subse-
quent regulation redesign may cause a significant paradigm
shift across
the health professions, potentially impacting the limits of
jurisdiction
and, therefore, the professionalization of those professions.
However, it
is unknown whether this paradigm shift would be a positive or
negative
change.
Public
The public’s opinion about the profession is the third element in
profes-
35. sionalization. Professionals aim to build their image in the
public’s eye
by attracting the public’s sympathy and support for the work
that they do
and their approach to problem solving [12]. The more public
support a
profession possesses, the stronger jurisdiction it will hold. No
docu-
mented literature exists regarding the public’s perception and
knowledge
of RT compared with, for example, the nursing literature, which
con-
tains numerous empirical reports of patient satisfacti on, patient
percep-
tion, and self-concept, which contribute to enhancing the
public’s
opinion of the nursing profession and reinforcing their
jurisdictional
claims [95–97].
Due to the critical nature of the RTs’ role, they are often at the
forefront of public health emergencies, notably the severe acute
respi-
ratory syndrome (SARS) outbreak in 2003, the H1N1 influenza
pan-
demic of 2009, and now the COVID-19 global pandemic in
2020. In
all of these scenarios, RTs deliver acute and critical care
services such
as diagnostic testing, respiratory therapeutics, and emergency
airway
management and mechanical ventilatory support [98]. The
recent
COVID-19 pandemic has bolstered the respiratory therapy
profes-
sion’s public perception and placed a critical eye on the
36. profession, the
work they perform, and their contribution to worldwide health.
Media
reports and marketing campaigns are emphasizing the
importance of
RTs’ work, methods of problem-solving, and jurisdiction [6–
10].
Although currently uncertain, the enhanced focus on RTs might
potentially translate into new areas of jurisdiction. As the
respiratory
therapy profession emerges from the COVID-19 pandemic with
a
heightened level of recognition and a clear demonstration that
its
work has greatly benefitted the public’s interest, RTs may be
well-posi-
tioned to advocate for a greater jurisdiction. Already,
conversations are
beginning regarding how RTs may contribute more efficient
care with
additional expertise in future jurisdictions. Some examples
might
include advanced practice roles (e.g., cardiovascular specialists,
case
management), primary care, health systems leadership, and
practice in
new settings (e.g., public health) [99–101]. These new
jurisdictional
areas of practice might represent the continuation of
professionaliza-
tion of respiratory therapy.
Moving forward
Based on Abbott’s theoretical perspective [12], RTs can rightly
justify
their position as members of a profession. However, as we
37. explored in
this paper, professionalization is an ongoing negotiative process
and is
worthy of ongoing attention and nurturing. Many key events in
the pro-
fessionalization of RTs in Canada, including the advent of new
technol-
ogy, consistent medical support, and the organization of the
profession,
highlight how oxygen orderlies became the profession of
respiratory ther-
apy. Notwithstanding the foundational events, RTs need to
acknowledge
that professionalization is a dynamic and continuous process
that
requires creative changes to innovate within the profession and
to sup-
port future efforts to reinforce their position as members of a
profession.
Throughout this paper, we offer suggestions for how RTs can
contribute
to respiratory therapy professionalization.
There is a need to increase and strengthen the abstract
knowledge
of the respiratory therapy profession. Abstract knowledge is of
value to
a profession and can be strengthened in three ways: promoting
higher
education, conducting research, and increasing the professions’
legiti-
macy. We contend that the respiratory therapy profession would
benefit from raising the current entry-level diploma degree to an
under-
graduate degree. Existing respiratory therapy educational
38. curricula gen-
erally focus on the minimum competencies required to function
as
professionals. The aim of an undergraduate degree is to
introduce
learners to a broader range of competencies directly related to
the pro-
fession and its functioning within the health care system (e.g.,
public
health, health policy, leadership, research skills, etc.) to expand
the clin-
ical reasoning and broaden the impact and influence of RTs. By
virtue
of the competencies and corresponding content included in
many exist-
ing RT educational programs, RTs may be far from maximizing
their
possible contributions to advancing respiratory therapy
knowledge,
and as such, may be limited in their potential to optimize
patient care
and meet the needs of a highly complex health care environment
[56].
Enhancing the entry-level educational standards of respiratory
therapy
training may enable certain RTs to dedicate their careers to
building
abstract knowledge in the profession through conducting
research for
example.
There is a related need to create research-related positions
(whether
in clinical practice settings or in educational institutions)
specific for
RTs whose primary mandate is respiratory care research.
39. Respiratory
care research led by RTs can play a significant role in
contributing to
abstract knowledge in the profession. Finally, RTs who do (or
will even-
tually) conduct respiratory care research need to widely explore
respira-
tory therapy knowledge in many distinct ways to enhance the
legitimacy
of the knowledge. Examples of this distinction include applying
and
exploring respiratory therapy knowledge through the lens of a
range of
knowledge paradigms (e.g., post-positivism, constructivism),
using dif-
ferent methodologies (qualitative, quantitative, and mixed
method) and
drawing from different academic disciplines (e.g., epidemiology
and
social sciences).
In Canada, for the most part, RTs possess jurisdictional
professional
autonomy evidenced by strong provincial administrative
structures and
the statutory right to self-regulate; however, the permanence of
a strong
administrative structure and self-regulation cannot be [93]. The
calls for
an overhaul of the professional self-regulation system are in
response to
perceptions that regulatory bodies may not be optimally
protecting the
public [93, 94]. The ongoing need for abstract knowledge will
be required
to safeguard and advance the legal aspect of jurisdiction by
40. linking evi-
dence and concepts about care and expectations with frontline
practice.
The role of regulatory bodies could be expanded to suppor t
research,
activities, innovations, and quality improvement initiatives that
build an
understanding of the safe and competent care RTs are equipped
to
provide.
Finally, we contend that the weakest aspect of jurisdiction in
the
respiratory therapy profession derives from the public’s
opinion. Before
the COVID-19 pandemic, personal exchanges with laypeople
often
began with, “A respiratory therapist? I’ve never heard of that;
so, you’re like a
nurse?” A major unintended consequence of the pandemic was
the
immediate propulsion of the respiratory therapy profession into
the
limelight. Media reports, medical reports, and marketing
campaigns
began emphasizing the importance of RTs’ work, their method
of prob-
lem-solving, and jurisdiction. This renewed emphasis on the
respiratory
therapy profession and the focus on the work they do and how
that may
contribute to more efficient care might translate into further
profession-
alization opportunities. RTs need to begin producing evidence
that
demonstrates improved health outcomes when RTs are involved,
41. further
informing and convincing the public and policymakers of the
impor-
tance of this profession [102–104].
DISCLOSURES
Acknowledgement
This work was completed in partial fulfillment of MZ’s doctoral
degree
at the School of Physical and Occupational Therapy, McGill
University.
MZ would like to acknowledge the feedback provided on early
drafts of
this manuscript by Shawna Strickland, PhD, CAE, RRT, RRT-
NPS,
RRT-ACCS, AE-C, FAARC and Kevin Taylor, MBA, RRT.
Professionalization of respiratory therapy in Canada
Can J Respir Ther Vol 57 135
Contributors
MZ conceptualized the idea, drafted the manuscript, provided
feedback
on manuscript drafts, and read and approved the final
manuscript. AB,
PN, AW, and AT provided content expertise, provided feedback
on man-
uscript drafts, and read and approved the final manuscript.
Funding
McGill University Faculty of Medicine and Health Sciences
Max E. Binz
42. Fellowship.
Competing interests
MZ and AW are members of CJRT’s editorial board and were
not
involved with any decisions about the manuscript. All other
authors
declare no conflict of interest.
Ethical approval
Ethical approval was deemed not to be necessary as the data is
publicly
available literature.
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