Classic Pages of the Journal of Extracorporeal Technology

Abstract

This paper represents a significant puzzle piece in the advancement of our profession and was published at a critical time in the development of our profession’s educational process. On reading it, I was immediately struck by both the contemporary timeliness of this subject material and the spirit of collaboration and professional community which must have existed circa 1980 to produce an article which so pointedly addressed a question for our entire profession. At the time of this publication, the young American Board of Cardiovascular Perfusion (ABCP) (founded in 1975) was diligently reporting from their database of test taker demographics and test outcomes to establish that there was statistically significant evidence to support an increase in the standards for perfusion education programs; that test scores were higher from schools with longer curriculum. At the time, the movement afoot in our community focused on the discontinuation of on-the-job-training programs. This movement can be compared to a discussion occurring in our profession right now which is calling for the entry level degree for all perfusion programs to be set at the master’s degree level (2). Considering that 56% of the perfusion education programs in the United States award a bachelor’s or a post-baccalaureate degree, this would be a significant change and would undoubtedly result in the termination of several programs if they failed to secure the prerequisite university affiliation to offer a graduate degree. Needless to say the suggestion is not without its opponents (3). Although the overall goal of improved minimum educational standards is the same, the primary difference between the educational movement in the 1980s and the present day discussion is our access to outcome data. This classic paper by Richmond, Arnold, and Kurusz represents the full participation of the ABCP in the growth of our professional community through the open distribution of outcome data for educational programs. This stands in sharp contrast to the current state of the discussion regarding an entry level Master’s degree for perfusion, which is, so far, based on thoughtful yet biased rhetoric. The demographic and outcome data for every perfusionist entering and re-entering the field is collected as a matter of procedure for all national certification test takers. The potential implications of rigorous statistical analysis of these data are obvious. While each program is currently provided outcome data for their students, the results are de-identified making it impossible for a program to validate the performance of programassessment tools through comparison of their graduate’s performance on program assessments to the same student’s performance on the certification examinations. Furthermore, there is currently no greater analysis beyond each individual program. Generation and distribution of national benchmark performance profiles would help identify programs of excellence and facilitate goal setting for all perfusion education programs. There is rarely any opposition to improving education. The debate generally focuses on how that should be done. Great improvements in clinical outcomes have been realized with the use of information obtained from clinical registries and mandated state reporting. In the 1980s, in my home state of New York, there was a great deal of skepticism over reporting of provider outcomes. Some believed that providing these data would limit access to care for the elderly and cause a shift of high-risk cases out of New York (nobody would operate on really sick people as it would ruin their stats and reputation). In 1998, Petersen and colleagues sought to determine if the prediction of the skeptics came true and found that not only was there no out migration of patients, nor access issues, States like New York and the Northern New England States that Richmond M, Arnold B, Kurusz M. The relationship of duration of training to American Board of Cardiovascular Perfusion written certification examination scores. J Extra Corpor Technol. 1980;12:127–30.