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Permalink Reply by Mike on January 19, 2011 at 11:10am

what does everyone think of this and what it will do to Sleep Techs specifically and the Sleep Medical field generally?

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Permalink Reply by RockRpsgt on January 19, 2011 at 11:35am

Wow! I will have to think on this for a moment Mike.

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Permalink Reply by Mike on January 19, 2011 at 1:12pm

AASM Letter to BRPT

December 17, 2010
Janice East, RPSGT, R. EEG T.
8400 Westpark Drive
2nd Floor
McLean, VA 22102

Sent via e-mail

Dear Ms. East:
The role of sleep technologists is important to the diagnostic and therapeutic services provided to sleep disorders patients. The American Academy of Sleep Medicine (AASM) has always supported sleep technology as an independent allied health profession, and is committed to ensuring its vitality as the practice of sleep medicine evolves with new policy and technology. To this end, the AASM has offered standardized educational programs for technologists and aided in efforts to enact legislation that safeguards the profession. These efforts have helped raise the profile of sleep technology within allied health care and with governing boards at the state level.
A provision in these laws is the professional credentialing of sleep technologists. However, according to data provided by the Board of Registered Polysomnographic Technologists (BRPT), the pass rate for the Registered Polysomnographic Technologists™ examination indicates that a majority of otherwise qualified sleep technologists currently employed at sleep centers are unable to obtain the necessary credentials required to stay in the profession.

Further, for a number of years, sleep physicians who are medical directors of sleep centers have expressed concern that certification by the BRPT does not ensure professional readiness, which results in increased costs and time to train technologists whose credentials should indicate otherwise. These sleep physicians have also expressed concern that the BRPT examination does not test the basic knowledge necessary to perform sleep studies. The AASM has raised the concern of its members to the BRPT; past response to these concerns has focused on methodology – that surveys of current registered technologists are used to develop and modify exam content.

The AASM’s Board of Directors regularly discusses the state of the sleep technology profession, including the educational and certification aspects, as it relates directly to the quality of care received by our patients at sleep centers. After extensive discussion and serious consideration over several meetings, the Board of Directors has voted to develop a Sleep Technologist Certification Examination that will be administered by the American Board of Sleep Medicine (ABSM).

We are undertaking this effort after many years of discussion with the BRPT leadership about content areas, pass rate performance and, most important, the relevance of the examination to the day-to-day work of sleep technologists. While progress has been made with the introduction of the Certified Polysomnographic Technician credential, it is the belief of the AASM’s Board of Directors that a certification examination based on a methodology that reflects the on-the-job experience of sleep technologists is critical. If efforts to improve certification rates are not expedited, many sleep technologists will be forced out of their job by legislation that is necessary to protect the profession.

The ABSM was established as an independent entity in 1989 and has extensive experience in the development and administration of examinations of sleep medicine professionals. The ABSM administered an examination in sleep medicine from 1989 until 2007. We plan to use established procedures in the development of the examination, subject the results to rigorous statistical analysis and pursue appropriate accreditation.
Comprehensive, quality and standardized education, training and certification for the sleep technology profession remain important goals for the AASM, and we look forward to working cooperatively with the BRPT on issues of mutual interest. Please do not hesitate to contact me directly at (206) 731-4999 to discuss this new examination further.

Sincerely,

Nathaniel F. Watson, MD
President, American Board of Sleep Medicine

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Permalink Reply by Mike on January 19, 2011 at 1:20pm

BRPT Response to AASM

 

January 10, 2011

Nathaniel F. Watson, MD

President, American Board of Sleep Medicine

2150 N. Frontage Road

Darien, IL 60561

 

Dear Dr. Watson:

 

Thank you for talking with me about your December 17 letter informing the Board of Registered Polysomnographic Technologists (BRPT) that the American Academy of Sleep Medicine (AASM) is undertaking the development of a Sleep Technologist Certification Examination to be administered by the American Board of Sleep Medicine (ABSM). Unfortunately, this conversation made the news no less disturbing.  

 

Frankly, my colleagues on the BRPT Board of Directors and I are stunned that AASM is developing a new certification exam less than 10 months after we collaborated with AASM to launch the Certified Polysomnographic Technician (CPSGT) examination.  The CPSGT exam came about in direct response to a request from AASM.  We invested in excess of $100,000 in the development of a strong certificate-level exam, treating the process with such a sense of urgency that we developed and launched the CPSGT exam within nine months.  The CPSGT exam development process included both AASM and AAST input, item review, and exam approval.  In response to the AASM concern that too few technologists were passing the Registered Polysomnographic Technologist (RPSGT) credentialing exam, we now have in place a certification exam that yielded a consistent 83% passing rate for 2010 and positions technicians with limited experience in a tiered progression toward the RPSGT exam.  

 

It is hard to imagine how the development of an ABSM examination for sleep technologists will serve our shared goal of strengthening levels of competence and professionalism in the field.  Sleep technology is a relatively new discipline in the allied health universe, and the greatest challenge we face is the absence of a widely available common curriculum – didactic and clinical – against which competence in our field can be reliably tested.  That point was strongly reiterated by AASM Executive Director Jerry Barrett at a joint American Association of Sleep Technologists (AAST) / BRPT Board meeting in September 2010.  We believe the development of a new exam intended to address a short-term demand for “certified” technologists will be of no long-term benefit, and will, in fact, deflect attention, time and resources from a focus on the development of the strong educational resources badly needed by our field.    

 

As you know, the BRPT has earned national accreditation for a credentialing examination in sleep technology that is now 32 years old.  The RPSGT examination has been a vital component in raising the profile of sleep technology within the allied health care disciplines.  It was developed and is maintained in full accordance with best practices in professional credentialing, and is accredited by the National Commission for Certifying Agencies (NCCA).    

 

With that in mind, our Board is mystified by the assertion in your letter that “sleep physicians who are medical directors of sleep centers have expressed concern that certification by the BRPT does not ensure professional readiness” and that “the BRPT examination does not test the basic knowledge necessary to perform sleep studies.” This is a serious indictment that leaves me puzzled. If in fact AASM believes the RPSGT exam is not producing competent technologists, why has AASM repeatedly – and aggressively – pressed BRPT to lower the passing score in order to achieve a higher pass rate? In addition, bear in mind that more than 70% of candidates coming to the RPSGT exam are testing after 18 months of work experience, presumably under the direction of “sleep physicians who are medical directors of sleep centers.” Yet, you assert that those candidates come to the RPSGT exam lacking “professional readiness.” Is that assertion supported by quantitative data? I’m sure you can understand my confusion: on the one hand, AASM has been urging us for at least three years to lower the passing score for the RPSGT exam. On the other hand, AASM is now saying the technologists who worked hard enough to pass the test may not be ready for the job. 

 

Further, your letter of December 17 contains an inaccurate reference to the pass rate for the RPSGT exam: “… a majority of otherwise qualified sleep technologists currently employed at sleep centers are unable to obtain the necessary credentials required to stay in the profession.” The pass rate for the RPSGT exam in 2010 was 62%.

 

If the goal is, in fact, simply to offer a test that is easier to pass than the RPSGT exam, then we need to consider where this takes the profession and what is says to the 17,000 sleep technologists for whom their RPSGT credential is a source of enormous professional pride. The strength of the RPSGT examination is a great asset to the sleep field, both for what it delivers for patients and for the respect it engenders in legislative and regulatory quarters. 

 

Dr. Watson, the AASM decision to move forward with the development of an ABSM certification exam for sleep technologists has been an unpleasant surprise for us. We are sensitive to the need to provide alternatives for technologists who soon will be facing legislative and regulatory deadlines to prove their competence in the field. That was the stated objective of the CPSGT exam, an exam for which both AASM and AAST indicated full support.

 

 I was disappointed when we spoke by phone on December 21 that you indicated that there was no opportunity for further discussion around AASM’s decision. I am alarmed by the impact the AASM decision to move forward with the development of a certification exam for sleep technologists will likely have on the profession of sleep technology. 

 

Sincerely,

Janice East, RPSGT, R. EEG T.

President 

 

cc: Jerome A. Barrett Patrick Strollo, Jr., MD Nancy Collop, MD Clete Kushida, MD, PhD, RPSGT

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Permalink Reply by Mike on January 19, 2011 at 1:22pm

BRPT webpage dedicated to the AASM credential issue: http://www.brpt.org/default.asp?contentID=153

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Permalink Reply by Mike on January 19, 2011 at 1:40pm

shrewd analysis, my friend.  i don't disagree.  i have been puzzled by the real motivations behind this AASM move, and your explanation certainly rings true.  At a time when home testing threatens the prospects of every sleep tech and sleep lab in the country, rather than building these techs up so that they remain relevant and important to the field, the AASM appears to be knocking them down so that they don't stand a chance against the onslaught of technology and consumer access to sleep medical solutions.

j n k said:

My translation:

 

What the letter said:

 

"A majority of otherwise qualified sleep technologists currently employed at sleep centers are unable to obtain the necessary credentials required to stay in the profession."

 

What the message is:

 

Too many docs are complaining because they like the techs they presently use, whether the techs are good at taking tests or not, so the docs want to keep their present techs that do a good job instead of firing them for other people they will have to retrain to do things that particular doc's way.

 

What the letter said:

 

"Sleep physicians who are medical directors of sleep centers have expressed concern that certification by the BRPT does not ensure professional readiness, which results in increased costs and time to train technologists whose credentials should indicate otherwise."

 

What the message is:

 

Each doc wants techs who do things that particular doc's preferred way and want every tech on the planet to be taught the way that doc wants it done without questioning the doc's methods or instructions. Ever. Period.

 

What the letter said:

 

"These sleep physicians have also expressed concern that the BRPT examination does not test the basic knowledge necessary to perform sleep studies."

 

What the message is:

 

Docs don't want educated techs. They want techs who do things without questioning the doc. They want techs with on-the-job experience, meaning, having already worked for the doc long enough to know what that doc's preferences are.

 

After all, there are plenty of good docs who couldn't make it through today's medical school, so there are likely plenty of good techs who do a great job of administering sleep tests but who are  just not good at taking written tests about information that may not be directly related to the administering of good sleep tests.

Mike said:

AASM Letter to BRPT

December 17, 2010
Janice East, RPSGT, R. EEG T.
8400 Westpark Drive
2nd Floor
McLean, VA 22102
Sent via e-mail
Dear Ms. East:
The role of sleep technologists is important to the diagnostic and therapeutic services provided to sleep disorders patients. The American Academy of Sleep Medicine (AASM) has always supported sleep technology as an independent allied health profession, and is committed to ensuring its vitality as the practice of sleep medicine evolves with new policy and technology. To this end, the AASM has offered standardized educational programs for technologists and aided in efforts to enact legislation that safeguards the profession. These efforts have helped raise the profile of sleep technology within allied health care and with governing boards at the state level.
A provision in these laws is the professional credentialing of sleep technologists. However, according to data provided by the Board of Registered Polysomnographic Technologists (BRPT), the pass rate for the Registered Polysomnographic Technologists™ examination indicates that a majority of otherwise qualified sleep technologists currently employed at sleep centers are unable to obtain the necessary credentials required to stay in the profession.
Further, for a number of years, sleep physicians who are medical directors of sleep centers have expressed concern that certification by the BRPT does not ensure professional readiness, which results in increased costs and time to train technologists whose credentials should indicate otherwise. These sleep physicians have also expressed concern that the BRPT examination does not test the basic knowledge necessary to perform sleep studies. The AASM has raised the concern of its members to the BRPT; past response to these concerns has focused on methodology – that surveys of current registered technologists are used to develop and modify exam content.
The AASM’s Board of Directors regularly discusses the state of the sleep technology profession, including the educational and certification aspects, as it relates directly to the quality of care received by our patients at sleep centers. After extensive discussion and serious consideration over several meetings, the Board of Directors has voted to develop a Sleep Technologist Certification Examination that will be administered by the American Board of Sleep Medicine (ABSM).
We are undertaking this effort after many years of discussion with the BRPT leadership about content areas, pass rate performance and, most important, the relevance of the examination to the day-to-day work of sleep technologists. While progress has been made with the introduction of the Certified Polysomnographic Technician credential, it is the belief of the AASM’s Board of Directors that a certification examination based on a methodology that reflects the on-the-job experience of sleep technologists is critical. If efforts to improve certification rates are not expedited, many sleep technologists will be forced out of their job by legislation that is necessary to protect the profession.
The ABSM was established as an independent entity in 1989 and has extensive experience in the development and administration of examinations of sleep medicine professionals. The ABSM administered an examination in sleep medicine from 1989 until 2007. We plan to use established procedures in the development of the examination, subject the results to rigorous statistical analysis and pursue appropriate accreditation.
Comprehensive, quality and standardized education, training and certification for the sleep technology profession remain important goals for the AASM, and we look forward to working cooperatively with the BRPT on issues of mutual interest. Please do not hesitate to contact me directly at (206) 731-4999 to discuss this new examination further.
Sincerely,
Nathaniel F. Watson, MD
President, American Board of Sleep Medicine

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Permalink Reply by birdshell on January 19, 2011 at 1:52pm

j n k, I think you left out something...

 

Docs do not want techs working for them who actually know more than the doc...and it is my assertion, from having talked to a lot of techs and patients,  that many, many techs know more about such things as scoring and equipment usage than their bosses, the docs. 

 

That said, the field of sleep has seemed to me to be something in which many with an M.D. in ANYTHING have seen as a cash cow.  Sorry that sounds cynical but..that should not take away anything from a truly knowledgeable and competent doctor.  I'm just saying that such practices as giving a patient an APAP set for 4-20 cm Hg pressure for two weeks does not at all take the place of a good PSG done with observation.

 

I have had a number of problems myself with the BRPT's protocols for RPSGT testing.  I have helped a friend study for the thing; they hired Pearson to administer the test, the testing practices used are statistically justified, but there is something missing there.  I hate to say it, but charging a candidate well over $300 some dollars per administration seems like some form of robbery. (Another cash cow?)   I have to wonder about the true preparation for the exam meaning enough in practice that the letters "RPSGT" after a tech's name make a difference. 

 

.j n k said:

My translation:

 

What the letter said:

 

"A majority of otherwise qualified sleep technologists currently employed at sleep centers are unable to obtain the necessary credentials required to stay in the profession."

 

What the message is:

 

Too many docs are complaining because they like the techs they presently use, whether the techs are good at taking written exams or not, so the docs want to keep their present techs that do a good job instead of firing them for other people they will have to retrain to do things that particular doc's way.

 

What the letter said:

 

"Sleep physicians who are medical directors of sleep centers have expressed concern that certification by the BRPT does not ensure professional readiness, which results in increased costs and time to train technologists whose credentials should indicate otherwise."

 

What the message is:

 

Each doc wants techs who do things that particular doc's preferred way and want every tech on the planet to be taught the way that doc wants it done without questioning the doc's methods or instructions. Ever. Period.

 

What the letter said:

 

"These sleep physicians have also expressed concern that the BRPT examination does not test the basic knowledge necessary to perform sleep studies."

 

What the message is:

 

Docs don't want techs educated on the finer points of sleep medicine. They want techs who do things without questioning the doc. They want techs with on-the-job experience, meaning, having already worked for the doc long enough to know what that doc's preferences are.

 

After all, there are plenty of good docs who couldn't make it through today's medical school, so there are likely plenty of good techs who do a great job of administering sleep tests but who are  just not good at taking written tests about information that may not be directly related to the administering of good sleep tests.

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Permalink Reply by Chris H on January 19, 2011 at 5:23pm

Knowledge is power ,Power is choice .The more choice the wider the interpritation of data .The people with hands on feel the pulse their accurate input should not be over shadowed .So the more informed they are the better. Thank You ! To the people whom have worked their butts off to pass the tests.and get certified.Good Sleep Chris

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Permalink Reply by Amy on January 19, 2011 at 5:25pm

Okay I know i am joining this late but my lab is busy and patients always come first.  Why do I think the AASM is doing this.  To prove they are in control and  because they need a test that more closely follows the A-Step program they designed.  My techs have taken the A-Step and to be honest they will tell you that it does not respresent the test well.  However if the test more closely resembles the program then they wioll be able to keep control of a field that is being attacked on all sides. 

 

Remember this is coming out after the competitive bid came out and Medicare basically said that Sleep is not a specialty.  What better way to prove that they are still relevent and a specialty then to say look we control the eduction and testing of everyone in the field. 

 

I personally thing that it is a strange move on their part to do this.  Why in the world would you negate all the people who are already credentialed and why would you make an opening for Respiratory Therapy to come back again and say see we know what we are doing and there is all this infighting in the field let us handle it.

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Permalink Reply by Rock Conner on January 19, 2011 at 6:20pm

I think the AASM is after power, control & revenue, not necessarily in that order.

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Permalink Reply by Gary R. Munn on January 19, 2011 at 10:18pm

I think that many of the stores selling various technologies for sleeping, including Sleep Apnea, are owned by the Doctors themselves. They don't need anyone with any particular training, as long as they can set up a machine, adjust a mask, and most important of all, SELL, SELL, SELL!! Therefore, people working in these stores do not have to have any kind of qualification, they just have to have basic knowledge of the machines, and the ability to follow the Doctor's orders. A high school grad could easily do this with very little training.

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Permalink Reply by RockRpsgt on January 19, 2011 at 10:54pm

"A provision in these laws is the professional credentialing of sleep technologists. However, according to data provided by the Board of Registered Polysomnographic Technologists (BRPT), the pass rate for the Registered Polysomnographic Technologists™ examination indicates that a majority of otherwise qualified sleep technologists currently employed at sleep centers are unable to obtain the necessary credentials required to stay in the profession"

 

"Further, for a number of years, sleep physicians who are medical directors of sleep centers have expressed concern that certification by the BRPT does not ensure professional readiness, which results in increased costs and time to train technologists whose credentials should indicate otherwise. These sleep physicians have also expressed concern that the BRPT examination does not test the basic knowledge necessary to perform sleep studies."

 

These 2 paragraphs contradict one another.

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