The BRPT announces new recertification rules for the RPSGT credential.

The need for credentialing organizations to maintain standards that ensure those with the credential have all the skills necessary for the job the title refers to is self-evident. However, there are many approaches on how to do this, and a careful balance must always be struck between making the credentialing process rigorous enough to ensure the value of the credential while also keeping it reasonable enough that achieving the credential is not needlessly difficult.

The McLean, Va-based Board of Registered Polysomnographic Technologists (BRPT) has spent a great deal of time and effort carefully considering the best approach to assuring the highest standards of care by registered polysomnographic technologists. It recently announced an updated system for the maintenance of the Registered Polysomnographic Technologist (RPSGT) credential.

Recertification will now be required every 5 years for all RPSGTs in order for credentialed sleep technologists to continue to be included in the BRPT registry and use the RPSGT title after their names. Recertification may be achieved either by accumulating 50 continuing-education hours every 5 years (with a minimum of 5 hours per year), or by retaking and passing the RPSGT examination every 5 years.

“We feel it is vitally important that high standards be maintained and that the individuals working in this field are qualified and competent,” says BRPT President Bonnie Robertson, CRT, RPSGT. “In order for the RPSGT credential to have the greatest possible meaning, it is imperative that certified individuals be able to demonstrate competency that has kept pace with advances in our field. Discoveries in sleep medicine and changes in polysomnography are occurring at such a rapid rate that there is an ever greater need for our certificants to be educated on a recurring basis, to continually be in the position of having to seek new knowledge and new information, and to learn new technologies in order to ensure that they can provide patients with the best care possible both diagnostically and therapeutically.”

It’s About Quality
According to Bobby Stanley, executive director of the BRPT, to ensure fairness to those who already have the RPSGT credential and may not have expected this change, there will be a transition period to accommodate “grandfathered” RPSGTs for whom recertification was previously not required and those RPSGTs who were under the 10-year recertification program.

A sleep-school perspective
Glenn Roldan, RPSGT, of Global Sleep Institute, a school in Antioch, Calif, has been following the efforts of the Board of Registered Polysomnographic Technologists to set up a continuing-education system as a means of recertifying holders of the RPSGT title. It is his opinion that RPSGTs will encounter little or no trouble acquiring the credits needed for recertification because educational resources and opportunities for instruction abound. “RPSGTs can turn to the various sleep medicine societies at the national, regional, and even state levels,” he says. “Also, many of our CPAP vendors offer continuing-education credits [CECs] for in-services on their CPAPs, bilevels, and masks.” At present, Roldan’s school lacks courses of the sort he believes the Board of Registered Polysomnographic Technologists will probably want recertifying RPSGTs to take. “The curricula at my school are mainly geared toward the entry-level or novice technologist who seeks basic skills in preparation for first-time taking of the RPSGT exam,” he says. “I’m sure eventually, though, once we know specifically what the Board of Registered Polysomnographic Technologists will accept as CECs, we’ll be offering courses that do satisfy the requirements for recertification. “In the larger context, though, I think that the BRPT should recognize and accept continuing-education courses focused on ‘real life’ events, such as how to deal with extensive electrode popping or respiratory artifact in the EEG channels, how to properly titrate CPAP and bilevel pressures, what to document on a polysomnogram, and how to score a study. I also believe there should be an emphasis on online training—the board should take that into consideration, because not too many techs can afford to fly from one state to another and, on top of that, have to pay for hotels, meals, and ground-transportation expenses.” —Rich Smith

The continuing-education hours can be earned through participation in a variety of educational opportunities. In general, the BRPT will accept a maximum of 10 hours (out of the required 50) for participation in case conferences or in-service programs it has approved and 15 hours (out of the required 50) for reading BRPT/Education Advisory Committee-approved journals, such as Sleep Review, A2Zzz, and the Journal of Clinical Sleep Medicine. Also acceptable will be material from Association of Poly­somnographic Technologists (APT) review courses and various sleep-related online modules from any credit-granting organizations—for example, Web-based seminars—with program assessments following the course.

Weighing the Options
The decision to expand from retesting to a system of continuing-education hours was not easily reached by the BRPT.

“While we often receive unsolicited requests for a recertification program for all certificants from RPSGTs, as well as other stakeholders, we also realized that any changes would have to be planned and carried out with the utmost due diligence and deliberation,” Stanley explains.

Robertson was also aware that concerns might surface. A number of individuals made it plain to her that obtaining continuing education would be difficult for them—difficult in terms of access to educational programming and difficult with regard to costs.

According to Robertson, the greatest concern came from technologists in rural areas who would feel the expense of traveling to conferences to earn continuing-education hours the most. To allay those concerns, the board included a number of options for obtaining continuing education that do not require travel, and those options are expected to expand as time goes on.

“We’ve tried to be sensitive to the needs of our registrants,” Robertson says. “However, the BRPT has a responsibility to the profession and the public to ensure that RPSGTs continue their education and keep their skills updated. The BRPT is currently accredited by the National Commission for Certifying Agencies [NCCA]. The NCCA and other accrediting bodies require a formal recertification process that includes a ‘same policy for all’ approach. The BRPT is adhering to best practices for credentialing programs and working to ensure that the RPSGT certification continues to be recognized as the leading credential for polysomnographic technologists by the medical community, allied health professions, legislative bodies, regulatory decision-makers, and the public.”

“A Complex Process”
In June 2005, the BRPT reached a final, formal agreement that recertification would need to be accomplished by means of continuing education.

“We first began looking at this issue in 2001 and knew back then that our certificants would need to have some type of recertification or continued competency assessments to demonstrate the quality of their skills,” Robertson says. “The allied health field as a whole was already moving in that very same direction, which is what helped convince us this was something we really needed to do. But we also knew that development of a system by which we could measure the continued competence of our certificants would be a complex process.”

Initially, the board decided to go with a 10-year recertification program, one that involved taking the test a second time along with 18 hours of continuing-education credits. “This was only a first step, so we then started the very arduous task of looking at how other organizations handle this same issue,” Robertson says. “Our goal was to find, adapt, or develop the most sensible approach possible—which ultimately led us to the current continuing-education-hours concept.”

How to make continuing-education hours workable for RPSGTs posed some difficult questions. “We had to figure out how certificants would receive this continued education—specifically, who would be the education providers,” Robertson says. “The Board of Registered Polysomnographic Technologists as a certifying body cannot itself engage in education—that would be in direct conflict with the fact that we administer an exam. So, we turned to organizations such as the APT and the American Academy of Sleep Medicine (AASM) that can provide education—and we have been working closely with them on this.”

What the board decided was, first, to require RPSGTs who certified after January 1, 2006, to recertify every 5 years, with the 5-year period beginning on the date of the score report for the testing window in which the examination was taken. RPSGTs in this category will thus need to obtain 50 credit hours of continuing education over their 5-year recertification period (with a minimum of 5 credits each year) and submit documentation to that effect at the time they send in their recertification application. “Alternatively, these RPSGTs will have the option to retake and pass the RPSGT exam within 90 days of the end of their 5-year recertification period,” Robertson adds.

The board also came up with requirements for RPSGTs certified before January 1, 2006, who already have volunteered to switch or will be voluntarily switching from grandfathered status or 10-year status to 5-year recertification. These RPSGTs will recertify every 5 years, with the 5-year period beginning on the date a written request to switch was made to the BRPT. In addition, they must also earn a minimum of 5 credits annually with a required 50 credits in 5 years.

Last, the board required RPSGTs certified before January 1, 2006, who have not already voluntarily switched for 5-year recertification, to recertify every 5 years with the 5-year period beginning on January 1, 2007. As with the RPSGTs in the other, heretofore-mentioned categories, these RPSGTs would need to earn a minimum of 5 continuing-education hours per year during the 5-year period with a total of 50, documented at the time of their recertification applications—or opt to retake and pass the RPSGT examination within 90 days of the end of their 5-year recertification period. Certificants in this category may opt to switch to 5-year recertification early, in many cases because they want to begin obtaining credits before January 1, 2007, that count toward their recertifications.

“We’ve tried to anticipate all the questions that RPSGTs and prospects are likely to have,” Stanley explains. “We’ve developed a four-page guide to the new recertification policy that is readable and downloadable from our new Web site at www.brpt.org. Stanley also anticipates extra phone calls and e-mails to the BRPT’s headquarters on the subject of recertification, and he and his staff are geared up to address those inquiries. In addition, current “grandfathered” and 10-year recertification program RPSGTs will get an individualized mailing that informs them of the new policies.

Continuing-Education Options Abound
As to how continuing-education hours will be earned, a range of choices are available, according to the BRPT. These include: attendance at seminars, conferences, and workshops; participation in distance education programs documented by post-test (an examination following the education program); in-service training; and reading of relevant professional journals. Even sleep centers that conduct monthly “case conferences” are included in the list of acceptable sources of credit hours, as long as they meet the BRPT’s guidelines.

A list of approved courses and opportunities will be available at the APT Web site, www.aptweb.org, and at the BRPT Web site, www.brpt.org.If a program you are considering attending is not listed, you can also contact the sponsoring organization directly to find out if it will be applying for credit, according to the BRPT.

For a program to be approved, the sponsor of the conference, course, seminar, workshop, or in-service that would like to offer continuing-education hours must submit its educational program or presentation to a credit-granting organization such as the American Medical Association, APT, AASM, American Association for Respiratory Care (AARC), American Society of Electroneurodiagnostic Technologists (ASET), British Sleep Society, or European Sleep Research Society. If there is any question about the sleep-related portion of the activity once the program or presentation is approved for credits, it should be reviewed by the BRPT Education Advisory Committee, which will assign a specific number of continuing-education hours for the purposes of RPSGT recertification. According to the BRPT, in general, 1 hour of continuing education will be awarded for each appropriate educational hour attended. Educational activity time will be rounded to the nearest 15-minute segment—so, if a presentation is 35 minutes, it will count as 30 minutes, but if it is 40 minutes, it will count as 45 minutes.

According to the BRPT, each registrant is responsible for maintaining a record of the number of hours of continuing education that have been accrued during his or her 5-year cycle, including dates and documentation. The board also anticipates that some organizations, such as the APT, may maintain databases of continuing-education hours for a fee or as a membership benefit. To recertify, the RPSGT must submit documentation of 50 hours of approved, sleep-related continuing education with a documented minimum of 5 each year along with the recertification application and a $100 recertification fee within 90 days after the end of the 5-year period. A minimum of 5 hours of continuing education must be obtained annually, but the BRPT recommends 10 credit hours annually.

This may sound more difficult than it actually is. The BRPT anticipates that many sleep technologists may receive 10 credit hours per year simply by attending a single 2-day educational conference, as most 2-day meetings will offer between 10 and 15 credit hours. In addition, the AASM standards for accreditation of sleep disorders centers require that “The center’s professional and technical staff must each participate in an average of 10 credit hours per year of sleep-related educational activities.” The BRPT anticipates that this requirement will be in direct alignment with the new recertification guidelines.

The new maintenance of certification requirements may take some getting used to, but the BRPT hopes its certificants will find it manageable and ultimately better for both the RPSGT and the profession. As Robertson says, “We’re anticipating that recertification will be a hot topic for some time to come, but we know this was the right course of action to ensure that sleep technologists keep pace with other allied health professionals involved in delivering the highest standards of patient care.”

Rich Smith is a contributing writer for Sleep Review.