Resp Care
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Comparative Study
A comparison of problem-based learning and traditional curricula in baccalaureate respiratory therapy education.
Problem-based learning (PBL) is a constructivist model of education that uses ill-structured, authentic problems to stimulate and organize all learning. The major goal of PBL is to help learners construct knowledge in contexts similar to the real-world environments in which the knowledge will be used. Although PBL is a widely accepted educational method, controversy persists about its effectiveness, how appropriately to measure its outcomes, and, more generally, whether grand education experiments can explain a curriculum intervention's effects. The present study was undertaken to compare PBL and traditional curricula in baccalaureate-level respiratory-therapy education, in terms of (1) graduate and employer ratings of cognitive, psychomotor, and affective competencies on standardized follow-up surveys mandated by the Committee on Accreditation for Respiratory Care, and (2) scores on the National Board for Respiratory Care (NBRC) examinations. ⋯ Respiratory-therapy graduates from the 2 PBL programs were more satisfied with their program's overall quality than were the graduates of the 2 traditional-curricula programs. Moreover, the PBL teaching and learning method did not place graduates at a disadvantage on standardized, objective tests of knowledge (the licensing and credentialing examinations). These findings are consistent with similar published studies on PBL approaches in medical and health care professional education.
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Multicenter Study Comparative Study
Noninvasive positive-pressure ventilation with different interfaces in patients with respiratory failure after abdominal surgery: a matched-control study.
Acute respiratory failure (ARF) is a relatively common complication after abdominal surgery. ⋯ NPPV can be an alternative to conventional ventilation in patients with ARF after major abdominal surgery, and helmet use is associated with a better tolerance and a lower rate of complications.
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Respiratory compromise is the leading cause of morbidity and mortality in patients with neuromuscular and neurologic disease, and in elderly patients, who have a reduced pulmonary reserve from deterioration of the respiratory system associated with the normal aging process. Although the otherwise healthy older patient is normally asymptomatic, their pulmonary reserve is further compromised during stressful situations such as surgery, pneumonia, or exacerbation of a comorbid condition. The inability to effectively remove retained secretions and prevent aspiration contribute to this compromise. ⋯ Patients with neuromuscular disease often can not generate an effective cough to mobilize and evacuate secretions. Respiratory muscle training, manual cough assistance, mechanical cough assistance, high-frequency chest wall compression, and intrapulmonary percussive ventilation have each been suggested as having potential benefit in this population. Although strong evidence supporting the benefit of these therapies is lacking, clinicians must be guided as to whether there is a pathophysiologic rationale for applying the therapy, whether adverse effects are associated with the therapy, the cost of therapy, and whether the patient prefers a given therapy.