Certification of specialists in respiratory sleep medicine for the purposes of continuing professional development http://ow.ly/4uX9309g3Hs
What is the greatest challenge in the delivery of quality care to respiratory disease patients? Is it lack of resources, avoidable harm to patients, or more complex disease presentation? Healthcare delivery has been in the media spotlight in recent months across many countries and the question of how to deliver safe, effective and efficient care to patients remains at the forefront of political agendas at a national level. Education is the passport to the future and the European Respiratory Society (ERS) is in the unique position of being able to work with the most respected respiratory experts internationally in order to design and deliver educational activities to raise standards of training for our respiratory health practitioners.
The challenge of delivering high quality care for patients is also true of respiratory sleep medicine. Inconsistencies in the diagnosis, treatment and management of sleep-related conditions emphasise the need for standards in practice and harmonised training and certification for medical practitioners managing respiratory sleep patients .
In 2014 key medical education and respiratory medicine experts came together to plan the future of education within the ERS. The result of this seminar underpins the new direction of ERS education and the decision to move towards more comprehensive educational programmes using a blend of online learning materials, self-assessment multiple-choice questions, a mini-portfolio with personal mentoring and skills-based workshops and assessments. Such a programme has the intended purpose of bringing us one step closer to the overall aim of our healthcare systems: the enabling of medical professionals to deliver high quality healthcare to their patients.
The ERS International Certificate in Respiratory Sleep Medicine
This training programme is designed to allow the ERS to consolidate and organise the delivery of education in respiratory sleep medicine. It will provide a framework for training, at a national and a local level, especially to address those countries where no structured training or certification exist . Additionally, it has been discussed that this programme will, in the future, link key training centres together across Europe and allow specific sleep centres to become part of a network to share best practice in training and delivery of care to patients.
Organised in a modular format, this continuing professional development programme in respiratory sleep will provide learners with the opportunity to follow core modules in key topic areas (figure 1). For knowledge-based modules it is intended to develop online materials with self-assessment. For skills-based modules (e.g. polysomography) future participants will have the option to access interactive online teaching materials, to attend a skills-based workshop and to complete a portfolio of tests with mentoring support from an expert. On successful completion of a module, participants will receive their certificate of competence in each specific topic area.
All healthcare professionals working within respiratory sleep are eligible to partake in this training and the curriculum may be described as an inter-profession educational programme. It defines three specific target groups: 1) medics: those healthcare professionals who provide patient care by diagnosing, treating and managing respiratory sleep disorders; 2) advanced practitioners: those healthcare professionals who initiate and lead clinical practice, education and the development of services for respiratory sleep patients; 3) practitioners (allied health professionals): those healthcare professionals who provide patient care for the treatment and management of respiratory sleep disorders.
How do I register for a specific module in respiratory sleep medicine?
Participants can register to attend the European Respiratory Society/European Sleep and Research Society (ERS/ESRS) conference Sleep and Breathing 2017 in Marseille (April 6–8, 2017). A limited number of modules will be available for completion, allowing certification in polysomography, assessment of daytime sleepiness, continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV), respiratory conditions, and medicolegal aspects of sleep disorders. To obtain these certificates, participants will be required to attend specific sessions during Sleep and Breathing 2017 and to complete some follow-up learning objectives post-conference (those who register will receive continued learning support during the training period). Each module will require participants to continue through a learning programme consisting of several parts, each of which provide the opportunity to gain or update knowledge and basic skills in a specific topic or technique (key guidelines, reading materials and learning resources have been identified). To complete part one and move on to the next part of training participants will be asked to successfully complete an online multiple-choice test (a link will be sent to participants after attending Sleep and Breathing 2017). Part two of the training programme is important as it offers participants the opportunity to put theory into practice. The online portfolio will help participants build competence in respiratory sleep as they will be requested to complete a case portfolio as well as a few short assignments. During this process participants will be asked to propose a mentor to guide them and, if both parts of the training programme are successfully completed, the participant will receive the ERS module or technique certification in respiratory sleep medicine.
Enrolment is open to all those attending Sleep and Breathing 2017. You do not have to be a member of the ERS to take part in this initiative but simply need to register for the sessions outlined above. Those who register for the skills-based workshops will be guided by a mentoring programme. As a prerequisite it is expected that all participants are working in the field of respiratory sleep medicine and have the necessary qualifications for their target group: 1) medics: must have medical specialist certification recognised in their country of practice; 2) advanced practitioners: must have a university Bachelor’s or Master’s diploma in an allied health field; 3) practitioners: must have a university Bachelor’s or Master’s diploma in an allied health field. An example of an educational programme can be found in figure 2.
Defining the target audience to ensure the best design and organisation of an educational programme fit for purpose has been the single most important development to come from the ERS Respiratory Sleep Task Force. For the first time within ERS education the curriculum modules are designed for all medical practitioners and allied health professionals working with respiratory sleep patients . While this may pose a challenge across different countries depending on the legal requirements and allocation of tasks, the intention of this international framework for training is to improve practice and raise standards of care . The second crucial development is the consideration and organisation of topics within ERS education (figure 3). This organisational structure guarantees the organisation and delivery of training at this tertiary level in a flexible way and considers two specific target groups: 1) respiratory medicine practitioners approaching a specific topic area (such as sleep) for the first time to develop a specialty; 2) respiratory medicine practitioners who would like to remain up to date and test their competence in specific topic areas. For the purpose of continuing professional development, trained specialists may choose which module or modules they wish to follow within a given timeframe according to their individual needs.
Recognition of this qualification
We hope that in the future any national- and local-level training programmes that wish to deliver standardised modules in respiratory sleep medicine will fully support this international educational initiative. For those who employ candidates from other countries, this training programme should be recognised as a high-quality qualification. Furthermore, as a high-quality programme, it should be recognised for raising standards of practice performance in those working in respiratory sleep medicine.
The future of respiratory sleep training
To support the overall growth and true potential of this initiative, it is foreseen that ERS partners together with local training institutions will offer the tools for standardised training and assessment for those wishing to partake in the programme. The importance of the collaboration with the ESRS cannot go unnoticed as both societies work together to try and achieve a common framework for mutual recognition of modules. This will be particularly important for the ERS module in non-respiratory sleep disorders as the ERS will depend on guidance from the ESRS. While the ERS will certainly take a lead in the delivery of some of the modules, the primary goal will be to assist local training institutions to improve training and certification of their respiratory sleep training programmes by offering educational tools and strategies for implementation.
Medical education has evolved from a didactic lecture-based training system to a more interactive learning process involving simulation and real-life experience. With the focus on high-quality patient care and safeguarding practice, lifelong learning and continuing professional development are crucial. For the first time a training framework has been assembled and published which emphasises both the essential elements required for the delivery of high-quality care to respiratory sleep patients (accounting for knowledge, skills and attitudes)  and how these may be attained in the setting of the ERS respiratory sleep medicine continuing professional development programme. To register for the programme, visit the Sleep and Breathing 2017 website (www.sleepandbreathing.org).
We would like to sincerely thank W. De Backer who has led this project, guided us through many questions and challenges in the development of the sleep curriculum, and helped make plans for its implementation. He is an integral part of the success in standardising training for respiratory sleep specialists in Europe. The collaborating members of the ERS Education Sleep Working Group are Maria R. Bonsignore (University of Palermo, Palermo, Italy); Brendan Cooper (Queen Elizabeth Hospital, Birmingham, UK); Thomas Penzel (Charité-Universitätsmedizin Berlin, Berlin, Germany); Winfried J. Randerath (Krankenhaus Bethanien, Solingen, Germany); Wilfried De Backer (University Hospital of Antwerp, Antwerp, Belgium).
Conflict of interest Sharon Mitchell is an employee of the European Respiratory Society. Further disclosures can be found alongside this article at breathe.ersjournals.com
- Received February 8, 2017.
- Accepted February 22, 2017.
- ©ERS 2017
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