microsoft powerpoint - developing an astep and physician

Marietta B. Bibbs, BA, RPSGT

Morton Plant Mease Medical Center

Clearwater, FL

�A-STEP Program description

�A-STEP for Students & Providers

�The A-STEP Process

�Becoming an A-STEP Provider

�Benefits of being an A-STEP Provider

�A-STEP Application

�A-STEP Standards

�A-STEP Syllabus

�Physician Training Program

The Accredited Sleep Technology Education Program was

developed by the American Academy of Sleep Medicine to

standardize sleep technologists education and training.

The program is designed to equip students with the knowledge

and skills to be successful in the field of polysomnography.

It also provides a level of formal education for RPSGT candidates

which is one area that has been lacking in polysomnography

� The Introductory Course:

� A minimum of 80-hours of educational training provided by an accredited A-STEP provider.

� The A-STEP curriculum consists of basic instruction about sleep, sleep disorders, sleep studies and patient care, and it concludes with an online examination.

� Programs are now permitted to present 30% of their instruction through on-line education

� Students who complete the Introductory course proceed to begin the AASM A-STEP Self-Study Modules.

� A-STEP Self Study Modules

� A web-based program of 14 online educational modules.

� It is suggested that the modules be taken while working during 18 months of supervised, on-the-job training in a sleep disorders center.

� New entrants to the profession who need a basic

understanding of sleep, sleep disorders and sleep

technology.

� Previously, included all on-the-job trainees who are

candidates for the Registered Polysomnographic

Technologist (RPSGT™) Examination in 2010; however

this pathway is delayed.

� Candidates taking the new Pathway #4 for the registry

examination. This pathway was developed specifically to

accommodate individuals who have completed both an A-STEP

Introductory Course and the A-STEP Self-Study Online Modules,

(or a BRPT-designated alternative educational program).

� Pathway #4 is available to candidates submitting proof of

completion of both an A-STEP Introductory Course and the A-STEP

Self-Study Online Modules (or a BRPT-designated alternate

educational program). Duties must be within a 3-year period

prior to the exam. The new Pathway #4 will be available to

candidates beginning with the December 2009 testing window.

�Students must have completed high

school prior to beginning the program

�Students must be able to perform the

duties specified in the AASM/AAST/BRPT

Job descriptions for a trainee

� Currently, Registry certificants are NOT required to take

the A-STEP Introductory course unless they are using

Pathway #4 to qualify or the RPSGT examination. Effective

July 1, 2009, technicians who are not certified by the BRPT

and are working in accredited sleep disorders centers, will

need to be enrolled in A-STEP, or enrolled in a CAAHEP

Program (CoA PSG, Co ARC or CoA END).

� Previously, the rule was that in 2012, A-STEP would no

longer be required and all BRPT certificants would need

to be graduates of a CAAHEP program. This option has

been delayed.

� Note: BRPT has changed these requirements for 6-month

Candidates.

� A-STEP students are high school graduates at the “trainee” level.

� Trainees advance to “sleep technician” once they have an overall understanding of polysomnography. The A-STEP program prepares students with the comprehensive education and practical trainingneeded to pass the BRPT Registry examination.

� When technicians work in the field for 18 months and pass ALL theA-STEP modules, they qualify to take the registry examination.

� When the technician passes the registry examination, he or she becomes a Registered Polysomnographic Technologist (RPSGT™)

� The student enrolls in an AASM A-STEP Introductory Course and complete the 80 hours of educational instruction.

� The A-STEP program director signs a completed notification form and sends it to the AASM by fax or mail to verify that the student has completed the course.

� The students must take an online examination after completing the Introductory course at a cost of $50.

� Students have 30 calendar days to earn a score of 70% or higher on the 106 question, multiple choice, three-hour examination. The A-STEP provider determines whether or not the exam is open-book. Students have three chances to pass the examination.

� If the student fails the examination three times, then he or shemust repeat the 80-hour course and pay the $50 exam fee again.

� Accredited sleep disorders centers and academic institutions that are affiliated with an AASM-accredited sleep disorders center.

� Once the application is approved, the facility becomes an accredited provider of the AASM A-STEP Introductory Course.

� A-STEP providers now have the option to place a portion of the 80 hours on-line (24 hours)

�Need for standardized educational programs in

Polysomnography—problems with respiratory

licensure laws

� Provides a solid background for trainees to

enter the field.

� Enables trainees to better understand

information presented in the AASM online

educational modules

� Benefits your practice, your staff, sleep

trainees and technicians, and the field.

� Becoming an A-STEP Provider demonstrates to both colleagues and patients the commitment of your sleep disorders program to the assurance of quality care.

� As an A-STEP provider, the tools become available to provide standardized training and education to current and future employees.

� Becoming an AASM A-STEP Provider allows you to take advantage of the opportunity to educate and train technicians for the hundreds of candidates that take the RPSGT examination.

�Application

�Syllabus

�Outcomes Assessment

�Fair Practices

�Policies & Procedures

�The Program Director must be a RPSGT

�The Clinical Director must be a Boarded

Sleep Specialist

�The Technical Director must be a RPSGT

� Instructors can be RPSGT, RRT, R.EEG T,

Physicians and other certified allied

health professionals

�PSG equipment must be available for

training in recording and treatment.

�A classroom for didactic instruction

available if more than four students enroll.

�The program’s library must include: � The International Classification of Sleep Disorders, Second Edition

� The AASM Clinical Practice Parameters

� The AASM Manual for the Scoring of Sleep & Associated Events

� CPR/AED for the Professional Rescuer

�Programs must submit the syllabus for

the AASM A-STEP Introductory Course

with the application.

�The course must provide a MINIMUM of

eighty hours of instruction.

� PURPOSE: To provide a program that follows the guidelines and standards established by the American Academy of Sleep Medicine and to ensure content also includes areas covered in the RPSGT Examination Content Outline.

� POLICY: The program’s curriculum follows AASM standards 9-19 with additional courses offered to students.

� PROCEDURES: (my program)• The program includes 102.5 hours of continuous training over a 14-day period.

• The Program includes 55 hours of didactic instruction, 41.5 hours of practical/interactive instruction; and 3 examinations (2 mid-point examinations and 1 final examination).

• The curriculum includes an introduction to the history of sleep and overview of the

sleep disorders (Reference: Course 101)

� A basic understanding of the nervous, respiratory, skeletal and cardiovascular systems (Reference: Course 101)

� Training in patient safety, infection control, fall precautions and recognition of emergencies (Reference: Course 101)

� Training in obtaining patient histories, interpersonal communication and management of the difficult patient (Reference: Courses 101 and 103)

� Training in patient confidentiality, informed consent and HIPAA regulations (Reference: Course 101)

� Instruction in patient preparation and equipment preparation for polysommography (Reference: Course 103)

� Procedures for polysomnographic recording equipment and electrical safety (Reference: Courses 102 and 103)

� Introduction to sleep stage scoring and polysomnographic event detection (Reference: Courses 104, 105, 106 and 107)

� Standard polysomnographic procedures and covers the Multiple Sleep Latency Test and Maintenance of Wakefulness Test (Reference: Courses 102, 103, 108 and 109)

� Application of positive airway pressure, supplemental oxygen and nocturnal ventilation (Reference: Course 106)

Course Description Hours of Instruction

The history of sleep medicine 0.50 - Didactic

Normal sleep architecture 0.50 - Didactic

Overview of the sleep disorders 0.50 - Didactic

Review of Systems (Nervous, Respiratory, Cardiovascular, Muscoskeletal) 0.75 - Didactic

Effects of sleep deprivation 0.50 - Didactic

Somnopharmacology 0.50 - Didactic

EEG pattern recognition 0.50 - Didactic

The technologists role in the sleep disorders laboratory 0.50 - Didactic

Patient care in the sleep laboratory 0.50 - Didactic

Medical ethics and Professional behavior 0.25 - Didactic

HIPPA and patient confidentiality and informed consent 0.50 - Didactic

Chart review 0.50 - Didactic

Patient safety 0.50 - Didactic

Infection control 0.50 - Didactic

Emergency protocols & Cardiopulmonary Resuscitation 0.50 - Didactic

Documentation during recording 0.25 - Didactic

Summarizing the PSG report 0.25 - Didactic

Total Hours of Instruction 8.00- Didactic

Course Objectives:

♦ Understand the evolution of sleep medicine ♦ Describe the most common sleep disorders ♦ Recognize EEG patterns

♦ Identify the role of the sleep technologist in the sleep laboratory ♦ Explain HIPPA, privacy rules, medical ethics and standards of conduct

♦ Discuss patient safety and infection control ♦ Devise emergency protocols

Course Requirements, Student Evaluation and Grading:

♦ Classroom Instruction – 100%

♦ Attendance Policy: ♦ Attendance at all classes and passing the final examination.

Text, Tools and Supplies: ♦ Kryger, Roth, Dement, Principles and Practice of Sleep Medicine-4th Edition, 2005 ♦ American Academy of Sleep Medicine, The International Classification of Sleep Disorders,

2nd. Edition, 2005 ♦ Egan, Scanlan, Wilkins, Stoller, Eagen’s Fundamentals of Respiratory Care, 2003

♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 1, 1983.

♦ CPR/AED for the Professional Rescuer by the American Red Cross


Operation of DC and AC amplifiers 0.50- Didactic

0.50 - Practical

Ancillary equipment 0.50 - Didactic

Electrical safety 0.25 -Didactic

Digital vs analog recording equipment 0.25- Didactic

Theory of operation of PSG recording equipment 0.50 - Didactic

Sensitivity, voltage and amplitude of waveforms 0.50 - Didactic 0.50 - Practical

Low and high frequency filters in PSG recording amplifiers 0.50 – Didactic 0.50 - Practical

Aliasing, screen resolution and sampling rate 0.50 - Didactic 0.50 - Practical

Total Hours of Instruction 3.50 Didactic 2.00 Practical

Course Objectives:

♦ Practice electrical safety ♦ Demonstrate an understanding of instrumentation and ancillary equipment

used in polysomnography

♦ Calculate sensitivity, voltage and amplitude of waveforms

♦ Understand filters, aliasing, screen resolution and sampling rate ♦ Understand the theory of operation of AC and DC amplifiers


♦ Classroom Instruction (60%); Practical Instruction (40%) Course Activities: Didactic & Practical Attendance Policy:

♦ Attendance at all classes and passing the final examination. Text, Tools and Supplies:

♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 1, 1983. ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 2, 1983.


Hardware and software calibration 0.50 – Didactic

1.00 - Practical

Data acquisition and patient monitoring procedures 0.50 - Didactic 1.00 - Practical

Patient assessment, taking a history, managing difficult patients 0.50 - Didactic

Equipment interface 0.50 – Didactic 0.50 - Practical

Recording montages 0.50 - Didactic 1.00 - Practical

Documentation during recording 1.00 - Didactic

Recognition and response to critical events during sleep 0.75 – Didactic

1.00 – Practical

The 10-20 system of electrode placement 1.00 - Didactic 2.00 – Practical

Ancillary devices placement 0.75 – Didactic 1.00 - Practical

Baseline polysomnography 1.00 - Didactic

CPAP titration polysomnography 1.00 – Didactic

Split-night polysomnography 1.00 – Didactic

Recording and monitoring procedures for MSLT and MWT 0.50 – Didactic

Recognition and response to parasomnias 0.50 – Didactic 0.50 – Practical

Recognition and resolution of artifacts 0.50 – Didactic 1.00 – Practical

Pediatric polysomnography 1.00 - Didactic 1.00 - Practical

Total Hours of Instruction 11.5 – Didactic

10.0- Practical

Course Objectives: ♦ Perform both pediatric and adult polysomnogram procedures

♦ Monitor and record various types of sleep studies that may be ordered ♦ Create and revise recording montages as needed to record appropriate data

♦ Apply electrodes following the10-20 system of electrode placement ♦ Recognize and respond to critical events that may occur during sleep

♦ Troubleshoot and resolve artifacts

Outline of Instruction: ♦ Pediatric and adult polysomnography

♦ The 10-20 System of Electrode Placement ♦ Recording montages

♦ Monitoring and documentation during recording ♦ Recording Protocols

Course Activities: Didactic/Practical/Examination

Mid-Point Assessment: 2.0 hour examination Course Requirements, Student Evaluation and Grading:

♦ Classroom Instruction (55%); Practical Instruction (45%)

Attendance Policy:


♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 1, 1983. ♦ Tyner, Knott, Mayer, Fundamentals of EEG Technology, Volume 2, 1983. ♦ Chokroverty, Sleep Disorders Medicine Basic Science, Technical Considerations and Clinical

Aspects, 2nd. Editiion, 1999.

♦ The 10-20 System of Electrode Placement ♦ Ferber, Kryger, Principles and Practice of Sleep Medicine in the Child, 4th Edition, 2005 ♦ Kryger, Roth, Dement, Principles and Practice of Sleep Medicine-4th Edition, 2005

♦ CPR/AED for the Professional Rescuer by the American Red Cross ♦ AASM Clinical Practice parameters from the Standards of Practice Committee


Sleep Stage Scoring in Adults 1.00 – Didactic

2.00 – Practical

Sleep Stage Scoring in Pediatrics 1.00 – Didactic 2.00 – Practical

Arousal scoring 0.50 – Didactic

0.50 - Practical

Abnormal EEG and sleep-related seizures 1.00 – Didactic

0.50 - Practical

Anatomy, physiology and mechanics of breathing 1.00 - Didactic

Use of oximetry in polysomnography 0.50 - Didactic

Respiratory disorders 1.00 - Didactic

Scoring apnea 1.00 – Didactic

1.00 - Practical

Scoring Hypopnea 0.50 – Didactic 0.50 - Practical

Scoring Respiratory effort related arousals 0.50 – Didactic

0.50 - Practical

Scoring Cheyne Stokes breathing 0.50 – Didactic

0.50 - Practical

Cardiac anatomy and physiology 1.00 - Didactic

Scoring ECG arrhythmias and cardiac abnormalities 1.00 - Didactic

1.00 - Practical

Scoring periodic limb movement disorder 0.75 – Didactic 0.75 - Practical

Identifying bruxism 0.25 – Didactic

0.25 - Practical

Identifying restless legs syndrome

0.25 – Didactic

0.25 - Practical

Identifying disorders of arousal 0.50 – Didactic

0.25 - Practical

Identifying REM and non-REM parasomnias 0.50 – Didactic 0.50 – Practical

Identifying Circadian rhythm disorders 0.25 - Didactic

Identifying Seizure disorders and appropriate intervention 0.50 – Didactic 0.50 - Practical


11.00 - Practical

Course Objectives:

♦ Score the stages of sleep in adult and pediatric populations using the American Academy of Sleep Medicine Scoring rules

♦ Score apnea, hypopnea, and upper airway resistance

♦ Identify Cheyne Stokes respiration, periodic breathing and hypoventilation ♦ Understand the principle of operation of oximeters ♦ Evaluate the oximetry recordings

♦ Recognize and score cardiac events according to established guidelines ♦ Respond to cardiac events according to clinical practice guidelines ♦ Score limb movements according to established clinical practice

♦ Score other movement disorders, e.g. bruxism ♦ Identify other movement disorders, e.g. hypnagogic foot tremor, alternating

leg muscle activation, rhythmic movement disorder, and excessive fragmentary myoclonus

♦ Identify disorders of arousal ♦ Identify REM Sleep Behavior Disorder ♦ Summarize scored data and generate a technician’s report

Outline of Instruction:

♦ Historical development of sleep scoring rules ♦ The new AASM scoring rules ♦ Adult and pediatric sleep ♦ Scoring Respiratory Events ♦ Scoring Cardiac Events

♦ Scoring movement disorders Course Activities: Didactic/Practical Course Requirements, Student Evaluation and Grading:

♦ Classroom Instruction (60%); Practical Instruction (40%) ♦ Attendance Policy:


♦ American Academy of Sleep Medicine, The AASM Manual for the Scoring of Sleep and Associated Events, 2007.

♦ Rechtschaffen and Kales, A manual of standardized terminology, techniques and scoring system for the sleep stages of human subjects, 1968

♦ Thaler, The only EKG book you’ll ever need, 1999

♦ Egan, Scanlan, Wilkins, Stoller, Egan’s Fundamentals of Respiratory Care, 8th edition, 2003

♦ Berry, Sleep Medicine Pearls, 1999

♦ Chokroverty, Sleep Disorders Medicine, Basic Science, Technical Considerations and Clinical

Aspects, 2nd. Edition, 1999


Continuous positive airway pressure titration 1.00 – Didactic 2.00 – Practical

Bilevel positive airway pressure 1.00 – Didactic 2.00 – Practical

CPAP and BPAP split-night titration procedures 0.50 – Didactic 0.50 – Practical

Non-invasive ventilation 1.00 – Didactic 1.00 – Practical

Oxygen titration 0.50 – Didactic

0.50 – Practical

Total Hours of Instruction 4.00 – Didactic 6.00 – Practical

Course Objectives:

♦ Understand and apply PAP devices according to protocol

♦ Educate and acclimate the patient to PAP therapy

♦ Interface PAP recording devices to PSG recording equipment

♦ Titrate PAP pressure according to written protocols

♦ Perform split-night polysomnography

♦ Perform oxygen titration according to protocol

♦ Use oxygen simultaneously during PAP titration

♦ Understand and titrate using non-invasive ventilation Outline of Instruction:

♦ PAP titration ♦ Non-invasive ventilation

♦ Oxygen titration

Course Activities: Didactic/Practical


♦ Classroom Instruction (60%); Practical Instruction (40%)

Attendance Policy:


♦ American Academy of Sleep Medicine, The AASM Manual for the Scoring of Sleep and Associated Events, 2007.

♦ Chokroverty, Sleep Disorders Medicine Basic Science, Technical Considerations and Clinical Aspects, 2nd. Editiion, 1999.

♦ AASM Clinical Practice parameters from the Standards of Practice Committee ♦ Egan, Scanlan, Wilkins, Stoller, Egan’s Fundamentals of Respiratory Care, 8th edition, 2003

♦ Berry, Sleep Medicine Pearls, 1999 ♦ Chokroverty, Thomas, Bhatt, Pulmonary Pathophysiology: The Essentials, 6th. edition, 2005


Evaluation of hypersomnia 0.50 - Didactic

MSLT & MWT Tests and questionnaires 0.25 – Didactic 0.25 – Practical/Interactive

Data acquisition procedure 0.50 – Didactic

0.50 - Practical

Scoring procedures 0.25 – Didactic 0.25 - Practical

Quality assurance during PSG testing 0.75 – Didactic

Hands-on clinical instruction: (patient wiring, monitoring

and troubleshooting)

8.00 – Practical/Interactive


9.00 - Practical

Course Objectives: ♦ Calibrate PSG equipment for recording MSLT or MWT

♦ Perform the MSLT and the MWT ♦ Record, score and summarize the MSLT and the MWT ♦ Understand quality assurance activities for the sleep center ♦ Understand interscorer reliability

♦ Recognize appropriate data storage procedures ♦ Perform troubleshooting during polysomnography ♦ Skill in clinical activity in the sleep laboratory ♦

Outline of Instruction:

♦ Recording the MSLT and MWT ♦ Recording montages for the MSLT and MWT

♦ Clinical procedures during the MSLT and MWT ♦ Quality Assurance in the sleep center ♦ Interscorer reliability ♦ Clinical laboratory exposure

Course Activities: Didactic/Practical Course Requirements, Student Evaluation and Grading:

♦ Classroom Instruction (50%); Practical Instruction and Exam (50%) Attendance Policy:


♦ AASM Clinical Practice parameters from the Standards of Practice Committee

� Summary of Instruction:

� Total Hours: 102.5

� Didactic Instruction: 55.0 hrs. = 53.7%

� Practical/Interactive Instruction: 41.5 hrs. = 40.5%

� Midpoint and Final Examination: 6 hours = 5.9%

�Completion of the AASM A-STEP

Introductory Course requires completion

of the online 106-item, three-hour

examination with a score of 70% or

better.

�Maintain records of student’s performance

�Maintain objective measures of success� Students take a standardized sleep technology trainee test

� Assess students preparation for work after a period of work

experience

� Assess employer’s satisfaction with the trainee’s education

STUDENT ASSESSMENT POLICY (A-STEP Standards 20, 21, 22)

� PURPOSE: Students’ assessment of the program allows objective measures to serve as markers of success of the program. Program assessment serves as a quality assurance measure that refines and improves training within the program.

POLICY: • Assessment of general education is accomplished through course projects, performance evaluations and examinations administered at midpoint and the end of the course.

• Student outcomes are measured through sampling and analysis of courses.

• Samples of student work are selected from program courses following each course and are evaluated to determine the level of student achievement.

• Results of these direct measures are compared with indirect measures such as employer surveys, graduate surveys, and student satisfaction surveys.

�Student Assessment Policy (cont.)

PROCEDURES:� Assessments and Tools:

� The methods of evaluation for this course are assignments, on-

site “hands-on” performance, two mid-point examinations and

the final examination.

� “Hands-on” performance includes skills testing.

�Student Assessment Policy (Cont.)

1. Grading:

Didactic Instruction (59.5%) a. Assignments – 10%

b. Mid-point examination #1 – 10%

c. Mid-point examination #2 – 10%

d. Final Examination – 70%

Practical Instruction (40.5%) a. Assignments – 10%

b. Skills Testing – 90%

2. Student Performance and Attendance Records are maintained at the Florida Sleep School for a

period of 7 years.

GRADE PERCENT

A 90-100%

B 80-90%

C 70-80%

D 60-70%

F <60%

� Student Enrollment and Attendance Assessment

Date of

Course

# of Students

Enrolled

# Students Attending All

Classes

#Students taking

Mid-Point Exam

# Students Taking

Final Exam

# Students

Passing the Course

�Performance Improvement PlanSummary of Indicators

Indicator

Standard Definition Source Frequency

1. Students’ Evaluation

and Satisfaction

Survey

90% a) Students complete an assessment of the

course

b) Students assess their preparation for

work

Student Assessment Form Following

each course

2. Students’ Performance

Evaluation

90%

a.) Student performance on mid-term and final

examinations is assessed

b.) Student ability to gain employment

following the course is assessed

Student Performance

Evaluation Form

During and

following

each course

3. Performance measure on

Standardized Sleep

Technology Trainee

Examinations and the

National Registry Exam

90%

a.) Students are contacted while employed to

determine if they are enrolled in A-STEP

module training while training at work

b.) Student performance on exams in A-STEP

modules are assessed

c.) Students contacted when eligible to take the

RPSGT examination to determine intent

d.) Students performance on RPSGT

examination is assessed

Student Performance on

Trainee Examinations

Form

Bi-Annually

6. Employer Satisfaction 90% a.) Employers contacted to determine level of

satisfaction of Program Graduates

Employer Satisfaction

Form

Bi-Annually

7. Program Self-Assessment 90% a.) The Florida Sleep School self-assesses the

program to determine adherence to A-STEP

Standards

Program Self-Assessment

Form Yearly

STUDENT PERFORMANCE EVALUATION

Date of

Course

# of Students

Enrolled

# Passing Mid

Point Exam

# Passing Final

Examination

# Employed (6

months post-course)

% Student

Attendance

# of

Students

Y ear S tu dent’s N a m e G rad uation D ate

P assed T rainees E x am

P assed R P S G T Ex am

D ate R egistry A chieved

Student Performance on Standardized Trainee Exams and the RPSGT Exam

STUDENT PERFORMANCE ON STANDARDIZED TRAINEE EXAMS AND THE RPSGT EXAM

Year Student’s Name Graduation

Date

Passed Trainees

Exam

Passed RPSGT

Exam

Date Registry

Achieved

YEAR PASS/FAIL PERCENTAGE ON

STANDARDIZED EXAMS

PASS/FAIL PERCENTAGE ON

RPSGT EXAM

EMPLOYMENT RATE OF STUDENTS (POST-COURSE) Student’s Name FSS Course Completion Date Contact Date Employed (Yes/No) Employer’s Name Employer’s Address Employer’s Phone Number Hire Date

Student Assessment of the Program

The F lorida Sleep School’s L ibrary inc luded: YES NO COM M ENTS

♦ International Classification of S leep Disorders

♦ C lin ical P ractice P aram eters

♦ A ASM Scoring M anual, Adult and P edia tric S coring M anuals

♦ CP R/AED for the Professional Rescuer by the Am erican Red C ross

A M inim um 80 hours of instruction was provided

The course provided an introduction to the history of s leep and an ove rview of s leep disorders and s leep m edicine

The course provided a basic understand ing of the nervous, respiratory, skeletal and cardiovascu lar system

The course provided training in patient safety incorpora ting infection control techniques, fall precautions and recognizing em ergencies

The course provided training in obtaining patien t histo ries, interpersonal com m unication and m anagem en t o f the difficult patient

The course provided training in patient confiden tiality , inform ed consent and discussion of H IPAA regulations

The course provided instruction in preparation o f the patient and equipm ent for polysom nography

The course provided an introduction to polysom nographic recording, treatm ent equipm ent and electrical safe ty

The course provided an introduction to s leep stage scoring and polysom nographic event detection

The course provided instruction in standard polysom nographic procedures, inc luding the M SLT and MW T

The course provided included instruction in the application of PA P and supplem ental oxygen the rapy as well as discussion of nocturnal ventilation

The course provided an evaluation at the m idpoin t of the program that allows fo r correction of defic iencies in knowledge

The program m ust m aintain records of student pe rfo rm ance and attendance

I feel that I obtained suffic ient knowledge to seek em ploym ent in a s leep disorders center

M ay we contact your future em plo yer for a fo llow -up survey concerning your on-the-job perform ance*

EMPLOYER ASSESSMENT OF STUDENT ON-THE-JOB PROFICIENCY

Dear Employer:

You have recently hired a former student of the Florida Sleep School, who completed the accredited sleep

technology training program (A-STEP) in ________________, 200 . We always seek to improve the

quality of training received by our students, and we value input from employers who have hired our former

trainees. As part of our performance improvement, we send out surveys to employers who have hired the

graduates of our A-STEP program. ____________________________ has notified us that he/she is

currently employed at your sleep disorders center and has agreed to participate in the employer survey at

the time of graduation. Please complete the information below and return the form in the included

postage-paid envelope to Florida Sleep School, 6350 Techster Boulevard, Suite #2, Fort Myers, FL 33966.

Thank you for your participation.

Sincerely yours,

Marietta B. Bibbs, RPSGT

Program Director

============================================================================

Employee’s Name:__________________________________________ Hire Date: _________________

EMPLOYER ASSESSMENT OF STUDENT ON-THE-JOB PROFICIENCY

Description Yes No N/A Is proficient in sleep medicine terminology Dresses appropriately Interacts well with patients and exhibits professional behavior Understands HIPAA and patient privacy Is able to assess the patient Understands the theory of Polysomnography Is able to perform Polysomnography- preparation and setup Is able to calibrate PSG equipment Performs physiological calibration and recognizes Is proficient in the 10-20 System of Electrode Placement Recognizes the stages of sleep Recognizes and can distinguish the types of sleep apnea and other breathing

disorders

Understands and performs PAP titration Understands and performs oxygen titration Recognizes and responds appropriately to cardiac arrhythmias Recognizes movement disorders Recognizes and responds to artifact Has basic understanding of seizures and Understands Pediatric polysomnography Recognizes and responds to emergencies in the sleep lab Is able to perform the duties of a PSG Trainee specified in the AASM/AAST/BRPT

Job description of a PSG Trainee

School’s Yearly Self-Assessment

Program Director is RPSGT or ABSM Diplomat Clinical Director is an ABSM Diplomat Technical Director is an RPSGT Faculty is adequate Associated with a comprehensive accredited Sleep Disorders Center Access to PSG recording and treatment equipment Classroom for classes larger than 4 students Library includes (minimal):

♦ International Classification of Sleep Disorders -2005 Edition ♦ Clinical Practice Parameters

♦ AASM Scoring Manual, Adult and Pediatric Scoring Manuals ♦ CPR/AED for the Professional Rescuer by the American Red Cross

Minimum 80 hours of instruction

10 Curriculum includes an introduction to the history of sleep and an overview of sleep disorders and sleep medicine

11 Curriculum includes a basic understanding of the nervous, respiratory, skeletal and cardiovascular system

12 Curriculum includes training in patient safety incorporating infection control techniques, fall precautions and recognizing emergencies

13 Curriculum includes training in obtaining patient histories, interpersonal communication and management of the difficult patient

14 Curriculum includes training in patient confidentiality, informed consent and discussion of HIPAA regulations

15 Curriculum includes instruction in preparation of the patient and equipment for polysomnography

16 Curriculum introduces the student to polysomnographic recording, treatment equipment and electrical safety

17 Curriculum introduces the students to sleep stage scoring and polysomnographic event detection

School’s Yearly Self-Assessment

Table of Contents

Statement of Understanding …………………………………………….… 3

Student Acceptance, Anti-discrimination, Local, Federal, Sate laws…..…. 4

Grievance Policy……………………………………………………….….. 4

Dress Policy…………………………………………………………….….. 5 Smoking and Cell Phone Policy…………………………………………… 5

Class Attendance Policy…………………………………………………… 5

Organizational Chart ……………………………………………………… 6

Personnel…………………………………………………………….…….. 7

Program Resources………………………………………………….…….. 8

Curriculum policy…………………………………………………..……… 9

Student Assessment Policy…………………………………………..…….. 10

Student Enrollment & Attendance Assessment……………………….…… 10

Outcomes Assessment…………………………………………………….. 11 Performance Improvement Plan…………………………………………… 11

Student Performance Evaluation……………………………………………11

Student Performance on standardized tests and RPSGT Examination……..12

Employment rate of students………..………………………………………12

Student assessment of the Program……………………………………….. 13

Employer’s assessment of Student on-the-job performance………………. 14

Yearly Self-Assessment…………………………………………………… 15-16

Syllabus……………………………………………………………………. 17-34

Curriculum…………………………………………………………………

� Grievance Policy

• Students who feel that they have been discriminated against

can report the activity to the Equal Employment

Commission, the _____ Department of Education and the

Regional Director of the U.S. Department of Education.

• Students should also report any deficiencies in education,

educational methods, teacher deficiencies, etc. to the

American Academy of Sleep Medicine, the Accrediting

agency for Accredited Sleep Technology Training Program.

Student Acceptance and Equal Opportunity Policy1.) All students accepted into the program must have a minimum high school

education.

2.) Students must be proficient in the English language. The Florida Sleep School

requires that instructors act with integrity and strive to engage in equitable verbal

and nonverbal behavior with respect to differences in age, gender, race, handicap

and religion.

3.) All Students meeting criteria are accepted into the program based on availability

of classroom space.

4.) All Students accepted into the program must be able to perform the duties

specified in the AASM /APT/BRPT job description for Polysomnographic

Trainee.

5.) The Florida Sleep School follows all local, state and federal laws regarding

student and faculty recruitment and employment practices.

6.) It is the policy of The Florida Sleep School not to discriminate in admission to or

participation in its programs and activities on the basis of race, color, national

origin, ancestry, creed, religion, family or medical leave, disability, age, sex,

sexual orientation, arrest record or conviction record.

7.) All students

8.) All students have access to the policies and procedures of the Florida Sleep

School.

DRESS POLICY� Students are allowed to dress in casual attire during the didactic instruction of

the course; however, students must keep in mind that as a future employee in a

healthcare environment, they must promote an image of professionalism.

� During didactic instruction, students must:

• maintain an appearance of a well-groomed individual

• No hats/caps in the classroom

• No distracting or clothing considered vulgar in nature (halter tops, shorts)

� 3.) During Practical and “hands-on” instruction, students must dress

professionally, have an appropriate appearance and demeanor so as to

maintain the image of the affiliated Sleep Disorders Laboratory: Student

should:

� a. wear scubs during practical instruction in the affiliated Sleep Disorders

� Laboratory

� b. be mindful of personal hygiene

� c. place long hair into a pony tail or a clip

� d. avoid wearing open-toed shoes

� 3.) Students who violate the dress policy will be asked to correct the discretion

� prior to returning to class or the laboratory.

Smoking and Cell Phone Policy� Smoking is not allowed at The Florida Sleep School.

� If students smoke, they must smoke outside of the

building and clean up all cigarette butts after

smoking

� Cellular phones must be turned off or on silent mode

during class and while engaged in practical and

“hands-on” instruction.

� Students may use personal computers to take notes

during class, but internet access is not allowed

during class.

Class Attendance� Successful completion of the course requires

attendance at all didactic classes as well as

practical/interactive sessions and in-laboratory

“hands-on” sessions

� There is no “make-up” class or “make-up”

examination.

� Assignments must be turned in on time or they will

be docked 5% for each day late.

� All announcements, catalogs and

publications that advertise the

program must be accurate

� The policies and procedures

must be available to students

� The program must have a

student grievance procedure

� The program must follow

federal, state and local

regulations regarding student

and faculty

�Purpose:• Develop a training program that physician’s can

attend to learn the basics of sleep and sleep

disorders.

Enrollees:• Family Practice, Pulmonologists, Internal

Medicine, Psychiatrists, etc. who are preparing

for the Board Exam of those planning to set up a

sleep center in their practice

�Most physicians who plan to take the exam

this year must also review 200 PSGs and

45 MSLTs. Review must be documented

by a DABSM.

�Psychiatry Boards must be completed next

year.

�After this year, physicians that become

boarded in sleep medicine must complete

a Fellowship Training Program.

� There will always be a group of physicians who

will set up sleep disorders services within their

practice

� There will always be a focus on accreditation

� There will always be a need for continuing

education—not necessarily having a focus on

becoming a DABSM

Topic

The Spectrum and Classification of Sleep Disorders

Sleep Assessment- Clinical Approach

Sleep Assessment- Laboratory Approach

Adult Polysomnography (PSG, MSLT, MWT, HST)

PSG Scoring Workshop 1

- Normal Adult

- Obstructive Sleep Apnea

- Multiple Sleep Latency Test

Sleep Related Breathing Disorders

Narcolepsy & Other Causes of Sleepiness

Insomnia (1’, PPI, ISH, PLMD, RLS, Psy, Circadian)

Insomnia Treatment (Pharmacologic & Nonpharmacologic)

PSG Scoring Workshop 2

- Complex Sleep Apnea

- Positive Airway Pressure Titration

- Mask Fitting and Adjustment

Topic

Pediatric Sleep Polysomnography & Scoring

Parasomnia & Seizures

Preparing a Clinical Report

PSG Reading Workshop

- Split Night PSG

- Composite Night Study

Topic

Safety in the sleep Laboratory

Sleep Laboratory protocols, policies & procedures

Instrumentation, Filters, Sensitivity

PAP Titrations and Interpretations & PSG Scoring

Sleep Report Calculations

Intrascorer Reliability

Quality Assurance B

Protocols and Policies development

Post Course Examination

microsoft powerpoint - developing an astep and physician

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